special Impression procedures for removable partial dentures

Goals of Impression Techniques for RPD

Record hard unyielding tissues (teeth)

as well as the soft yielding tissues (mucosa) and Surfaces that will contact the RPD framework Delineate accurately Critical landmarks: preipheral extention retromolar pads, hamular notch, vestibular depths and edentulous regions.

Impression Techniques
1- Anatomic ridge form:

for tooth suppoted R.P.D. (Kenedys

class III, short span class IV) so the edentulous ridges dont contribute to the support of the R.P.D. Single, pressure-free imp. records the teeth and soft tissues in their anatomic form .

Impression Techniques
2-Physiologic or functional ridge form: for tooth- tissue supported R.P.D. (Kenedys class I,II,long span class IV)

When the occlusal forces fall on toothtissue supported R.P.D., the ridge contribute to support as well as teeth This imp. recordteeth in their anatomic form and the ridge in its functional form under pressure.

The objective of any functional

impression technique is : to provide maximum support for the removable partial denture bases. This allows for: 1. maintenance of occlusal contact between both natural and artificial dentition 2. minimum movement of the base, which would create leverage on the abutment teeth.

Impression Techniques
2-Physiologic or functional ridge form: for tooth tissue supported R.P.D. (Kenedys class I,II,long span class IV)

The imp. must: 1. Record and relate the tissues under uniform loading. 2. Distribute the load over as large an area as possible 3. Accurately delineate the peripheral extent of the denture base.

Factors influencing support from distal extension bases (factors influencing the amount of tissue displacement
1- Quality of soft tissues covering edentulous ridge 2- Type of bone making up denture bearing area 3- Design of partial denture 4- Amount of tissue coverage of denture base: 5- Amount of occlusal forces 6- Anatomy of denture bearing area: 7- Fit of denture base: 8. Type and accuracy of the impression registration:

Factors influencing support from distal extension bases (factors influencing

the amount of tissue displacement

1- Quality of soft tissues covering edentulous ridge

It should be firm, dense fibrous C.T. of even

thickness slightly compressible and firmly attached to the bone

Factors influencing support from distal extension bases (factors influencing the amount of tissue displacement

2- Type of bone making up denture bearing area:

The ideal ridge would consist of: Cortical bone that covers dense Cancellous bone with broad rounded crest and high vertical slops. Cortical bone can resist vertical forces better than cancellous bone.

Factors influencing support from distal extension bases

3- Design of partial denture:
Knowledge of basic principles of designs

guides the management of functional forces.

The use of indirect retainer will control

rotational movement of distal extension RPD.

Factors influencing support from distal extension bases

4- Amount of tissue coverage of denture base: The broader the coverage of the edentulous ridge, the greater the distribution of the load & the smaller the force per unit area

Factors influencing support from distal extension bases

5- Amount of occlusal forces:
1- Number of

artificial teeth. 2-Width of the occlusal table. 3- Efficiency of occlusal table. 4- type of the opposing dentition 5-powerfull musculature of the patient

It influences the amount of support required to stabilize the denture base..

Factors influencing support from distal extension bases

6- Anatomy of denture bearing area:

To distribute the forces of mastication

to the ridge most efficiently, the majority of force must be directed to the primary stress bearing areas, that are capable of withstanding that force.

Factors influencing support from distal extension bases

7- Fit of denture base: Support is enhanced by intimate contact between the mucosa and the fitting surface of the partial denture; 8. Type and accuracy of the impression registration: the majority of the force must be directed to portions of the ridge that are capable of withstanding the force

Impression for distal extension R.P.D.

At the imp. stage: Mcleans and Hindels methods = dual imp. Technique = pseudo-functional imp. or Impressions with custom trays. At the framework stage: Altered cast method either by functional imp.method (fluid wax) or by selected pressure imp.method At the finished denture stage: Functional relining method using fluid wax or zinc oxide euginol or rubber base relining method.

Imp. for Dis. Ex. R.P.D.

1. At the imp. stage:

Imp. for Dis. Ex. R.P.D.

1- At the imp. stage:

McLeans technique (closed mouth)

The technique consists of making an impression of the edentulous ridge in border-moulded denture base tray which is provided with occlusion rims. Impression paste is used to record ridge areas under biting stresses After setting of ZnO eugenol it is removed, tested, reinserted; overall alginate impression is made with the ZnO imp.seated in the mouth.

Imp. for Dis. Ex. R.P.D.

1- At the imp. stage:

McLeans technique (closed

mouth)

Since the tray used for the overall imp. is in contact with the occlusal rims, finger pressure is necessary to hold the original imp. in its functional position while the hydrocolloid material geles.

Imp. for Dis. Ex. R.P.D.

1- At the imp. stage:

Disadvantages
If the clasp action is sufficient to maintain the

denture base in its intended position, This may result in compromised blood flow with adverse soft tissue reaction and bone resorption. If clasp action is not sufficient to maintain that functional relationship of the denture base to the soft tissue, this will result in floating denture with premature contact and patient dissatisfaction.

Imp. for Dis. Ex. R.P.D.

2. At the framework stage:

Altered cast method :

Steps:
1- after the RPD frame work is constucted on anatomic imp.cast.it should be evaluated for any metal projections and sharp edges.
2-check the RPD metal frame work in the patients mouth

Altered cast method

3-the impression tray is made using chemically activated resin, a the frame work with the attached impression tray is placed in the patients mouth and correct peripheral extension 4-border molding the impression tray using low fusing modeling plastic < green or grey sticks >

Altered cast method

5-the final impression is made by using zinc-oxide euginol paste

with the mouth opened and tripod pressure is applied on occlusal rests and indirect retainer
6-after the impression material is set, the tray is removed and checked for any discrepancies

Altered cast method

7. The metal framework with the attached imp. is positioned on the master cast with all occlusal rests properly seated in their prepared recesses.

8. The entire assembly is boxed and poured in a different colored stone.

Imp. for Dis. Ex. R.P.D.

3- At the finished denture stage: Functional relining method:

Imp. for Dis. Ex. R.P.D.

3- At the finished denture stage: Functional relining method:

The finished denture is relined by applying for example ZnO eugenol imp. paste to the acrylic fitting surface of the distal extension saddle the impression is made with the denture being seated by pressure on the occlusal rests and indirect retainers only. No pressure is applied to the occlusal surface of the artificial teeth