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IMPRESSION MATERIALS
          &
 PROCEDURES FOR R.P.D

                     Presented by
                     Jean Michael
                  Final Year Part 2
INTRODUCTION
• An impression is defined as a negative likeness
  of the teeth and/or edentulous areas where
  the teeth have been removed, made in a
  plastic material which becomes relatively hard
  while in contact with these tissues
CLASSIFICATION OF IMPRESSION
              MATERIALS
RIGID MATERIALS
Plaster of Paris
Metallic Oxide Paste
THERMOPLASTIC MATERIALS
Modeling plastic
Impression Waxes & Natural Resins
ELASTIC MATERIALS

Reversible Hydrocolloids
Irreversible hydrocolloids
Mercaptan Rubber-base materials
Polyether Impression Material
Silicone Impression Materials
  Condensation SIM
  Addition SIM
IRREVERSIBLE HYDROCOLLOIDS
                  (ALGINATE)

Indicated for diagnostic casts,
orthodontic treatment casts &
master casts for R.P.D.
Can be used in presence of saliva
Hydrophilic
Pleasant taste and smell
Nontoxic, nonstaining & inexpensive
Can be disinfected with 2% Gluteraldehyde
Should be stored in 100% moisture & poured within
1 Hour
Low tear strength
Surface details - less than elastomeric impression
materials
Dimensional stability – less than elastomeric
impression materials
POLYSULFIDE IMPRESSION MATERIALS
   High tear strength
   Long working and setting time (8 to 10 minutes)
   Can be disinfected
   Cast poured will have smoother texture & will be
   harder as they do not retard or etch the surface of
   the setting stone
   Should have a uniform thickness that does not
   exceed 3mm
Medium and heavy body should not be used in case
of large/multiple undercuts
Long term dimensional stability is poor due to
water loss after setting
Should be held still during the impression making
procedure
Allow to rebound for 7 to 15 minutes after removal
from mouth and pour immediately
Unpleasant odor & Stains clothes
POLYETHER IMPRESSION MATERIALS

  Good surface details
  Hydrophilic – good wettability for easy cast forming
  Shorter working and setting time
  Flow characteristics and flow - lowest among others
  Stiffness – cast breakage of while removal from tray
Unpleasant taste
Absorbs water
Cannot be immersed in disinfecting solutions
Pour within 2 hours for better results
CONDENSATION SILICONES
Moderate working time (5 to 7 minutes)
Pleasant odor
Good tear strength
Excellent recovery from deformation
Can be disinfected with disinfecting solutions without
any alternation in accuracy
Hydrophobic
Ideally pored within 1 hour
ADDITION SILICONES
Most accurate among elastic
impression materials
Low polymerization shrinkage &
distortion
Fast recovery from distortion
Good tear strength
Working time – 3 to 5 minutes
Both hydrophilic & hydrophobic forms are available
Available in automixing devices
Pouring can be delayed up to 1 week
Stable in sterilizing solutions
Sulfur in latex gloves – retards the setting reaction
IMPRESSION OF PARTIALLY
      EDENTULOUS ARCH
Elastic impression materials are used for making
impression of partially edentulous arch
This is due to the presence of undercuts in the
partially edentulous mouth
MATERIALS AVAILABLE FOR MAKING
          IMPRESSION
Reversible hydrocolloids (agar-agar)
Irreversible hydrocolloids (Alginate)
Elastomeric impression materials
STEPS IN IMPRESSION MAKING
Position of patient & dentist
Tray selection
Mixing the material & loading into the tray
Impression making & removal
Inspecting, cleaning & disinfecting the impression
POSITION OF PATIENT & DENTIST
Dentist should stand & patient should sit upright
Occlusal plane should be parallel to the floor

MAXILLARY IMPRESSION- dentist should stand at
the right rear of the patient
MANDIBULAR IMPRESSION- dentist should stand at
the right front of the patient
IMPRESSION TRAY SELECTION
Stock trays for dentulous & partially edentulous
arches are of 3 types:
      Rimlock trays
      Perforated metal trays
      Plastic disposable trays
CHECKING MAXILLARY TRAY SIZE
There should be a clearance of 5-7mm between the
inner flanges of the tray & facial surface of teeth &
edentulous ridge
Tray should cover the desired anatomic areas
Too large a tray may be difficult to insert & may
interfere with the coronoid process of mandible
CHECKING MANDIBULAR TRAY SIZE
 There should be a clearance of 5-7mm between the
 tray and tooth surface and ridge
 If the tray extends too far in the lingually, there is a
 tendency to trap the tongue or floor of the mouth.
 Tray is held in the right hand
 Left thumb & index fingers are used to manipulate
 the right corner of the mouth
As the right flange of tray is rotated toward
mouth, depress the lower lip & stretch the right
corner of mouth with the left thumb & index finger
EXTENDING AN IMPRESSION TRAY
Some times impression
tray of adequate width
may not cover the
desired impression area
In such cases, the tray is
lengthened using
modeling wax
MIXING IMPRESSION MATERIAL
LOADING IMPRESSION TRAY
Place impression material in small amounts.
Tray should be filled in level with the flanges
Overfilling should be avoided
Mandibular Impression Technique
 Inject some material over occlusal surface of
 teeth, into vestibular areas & alveolo-lingual sulcus
 Then tray is rotated into mouth & is carefully seated
 The patient is asked to keep the tip of tongue in
 contact with the upper surface of tray during
 gelation
 Maintain the position of tray by placing the
 forefinger of each hand on top of tray on premolar
 area & thumb under patient’s chin
Maxillary Impression Technique
Inject alginate into occlusal surface & vestibular areas
& wipe some amount on the palate
Tray must be centered & properly aligned & verify the
position by looking at the patient’s face from above
It should protrude straight from the center of the
mouth.
After this, the tray is seated by using fingers of both
hands over the premolar areas & stabilize the tray
Removal of Impression From Mouth
 Clinically the initial set of alginate is determined by
 loss of surface tackiness
 Release seal by retracting lips & cheek
 Then impression is removed by a sudden jerk
INSPECT THE IMPRESSION FOR DEFECTS
CLEAN & DISINFECT THE IMPRESSION
Preparation Of Custom Tray
Marking the outline on the cast
Wax spacer adaptation
Self Cure Acrylic
Apply self cure acrylic over wax spacer
Attaching the Handle and polishing
Wax spacer scraped and tray perforated
Secondary Impression
• Same as that for diagnostic impression.
• In this procedure paint or inject impression
  material in critical areas:
           Rest preparation
           Hard palate
           Peripheral extensions
SPECIAL IMPRESSION PROCEDURES
Anatomic and Functional
     Form of Ridge
Anatomical form of Ridge
           The anatomic form is the
           surface contour of the ridge
           when it is not supporting an
           occlusal load
Functional form of Ridge
             The functional form of the
             residual ridge is the surface
             contour of the ridge when it
             is supporting a functional
             load
SPECIAL IMPRESSION PROCEDURES
1. Physiologic or functional impression technique
    Functional Relining method
    Mc Lean’s and Hindel’s methods
    Fluid Wax method
2. Selected Pressure technique
Mc LEAN’S PHYSIOLOGIC IMPRESSION
Procedure
     A custom impression tray is constructed over a
     preliminary cast
     Functional impression of distal extension ridge is
     made. Patient applies some biting force with
     occlusion rims
     Then an Alginate impression is made with the 1st
     impression held in it’s functional position with
     finger pressure
HINDEL’S MODIFICATION
Main difference of this with Mc Lean’s is that
impression of edentulous ridge is not made under
pressure but is an anatomic impression made at rest
with ZOE paste.
As the hydrocolloid impression was being made
finger pressure was applied through holes in the tray
to the anatomic impression.
Disadvantages of these methods
  Constantly compressed residual ridge is prone to
  excessive bone resorption.
  If the clasp do not hold the partial denture, the
  denture will be pushed slightly occlusally by the
  tissue causing premature contacts (TISSUE
  REBOUND)
FUNCTIONAL RELINING METHOD
Here a new surface is added into the inner, or tissue
side of the denture base
The partial denture is made from a cast made from
impression made with alginate
A space is provided by adapting a metal spacer over
the ridge on the cast before processing the denture
base.
A functional impression of the edentulous area is
made using the cast partial denture framework.
The patient must maintain the mouth in a partially
opened position
Border moulding is carried out.
Then a low fusing modeling plastic/green stick
compound is allowed to flow over the tissue side of
the denture base.
It is tempered in water bath & seated in patient’s
mouth.
To provide space for the impression
material, modeling plastic is scraped to a depth of
1mm
The modeling plastic serves a s a tray material for the
secondary impression material
The final impression is made with a Zinc Oxide
Eugenol impression paste
If undercuts are present, light bodied rubber based
impression materials can be used
Advantages
  The amount of soft tissue displacement is controlled
  by the amount of relief given to the modeling plastic
  before final impression is made
  Greater the relief, the less will be the tissue
  displacement.
  Tissue surface of metal frame work can be relined
  after insertion
Disadvantage
  Since open mouth technique is used it is difficult to
  maintain the previous occlusal contact
FLUID WAX FUNCTIONAL IMPRESSION
• Make an anatomic impression of the arch using
  alginate
• Fabricate a refractory cast using this impression
• Fabricate the partial denture framework over the
  refractory cast
Draw the outline of the denture base
Cast is coated with separating medium
Wax Spacer is adapted over the crest of the
edentulous ridge
Framework is placed over the spacer
Auto-polymerizing resin is mixed to dough
stage and is adapted and contoured over the
framework along the length of the ridge
Borders of the tray are trimmed
Impression Procedure
Wax is softened at 51 ̊ to 54 ̊
Softened wax is painted on the tissue surface with a
brush
Wax is painted in excess near the border to record
the sulcus
Tray is seated and held in position
It takes at least 5 minutes for the wax to set
The tray is removed and the impression is examined
The wax surface that has contacted soft tissue
appears glossy and the other areas that has not
contacted the tissues will appear dull
The impression should be placed in the mouth finally
for 12 minutes
SELECTIVED PRESSURE IMPRESSION
 More force are applied to areas that can absorb
 stress without adverse response & protect that areas
 that is least able to absorb force
 Stress bearing areas are the buccal shelf area & the
 lingual slopes of residual ridge stress bearing areas
 The denture base made from this impression will be
 closely adapted to & in firm contact with the tissues
 in buccal shelf area
Custom Trays
The tissue surface if the tray is trimmed with burs to
provide adequate relief
Impression material is loaded on the prepared
special tray and inserted into the patient’s mouth
Impression is made with the patient with his mouth
open under finger pressure
Only the stress bearing areas will be compressed
during impression making
Materials used for Secondary Impression
    Zinc Oxide Eugenol impression paste
    Rubber base material
Altering The Master Cast
This procedure is done to obtain a ‘Hybrid Cast’
which records the edentulous areas in the functional
form and the dentulous areas in the anatomic form
Conclusion
• An accurate impression is vital for the success
  of a cast partial denture. So proper selection
  of material, impression technique and the skill
  of the dentist plays a key role in the success of
  the overall treatment.
REFERENCE
Mc Cracken’s Removable Partial Prosthodontics
Clinical Removable Partial Prosthodontics
Impression - RPD

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Impression - RPD

  • 1.
  • 2. IMPRESSION MATERIALS & PROCEDURES FOR R.P.D Presented by Jean Michael Final Year Part 2
  • 3. INTRODUCTION • An impression is defined as a negative likeness of the teeth and/or edentulous areas where the teeth have been removed, made in a plastic material which becomes relatively hard while in contact with these tissues
  • 4. CLASSIFICATION OF IMPRESSION MATERIALS RIGID MATERIALS Plaster of Paris Metallic Oxide Paste THERMOPLASTIC MATERIALS Modeling plastic Impression Waxes & Natural Resins
  • 5. ELASTIC MATERIALS Reversible Hydrocolloids Irreversible hydrocolloids Mercaptan Rubber-base materials Polyether Impression Material Silicone Impression Materials Condensation SIM Addition SIM
  • 6. IRREVERSIBLE HYDROCOLLOIDS (ALGINATE) Indicated for diagnostic casts, orthodontic treatment casts & master casts for R.P.D. Can be used in presence of saliva Hydrophilic Pleasant taste and smell Nontoxic, nonstaining & inexpensive
  • 7. Can be disinfected with 2% Gluteraldehyde Should be stored in 100% moisture & poured within 1 Hour Low tear strength Surface details - less than elastomeric impression materials Dimensional stability – less than elastomeric impression materials
  • 8. POLYSULFIDE IMPRESSION MATERIALS High tear strength Long working and setting time (8 to 10 minutes) Can be disinfected Cast poured will have smoother texture & will be harder as they do not retard or etch the surface of the setting stone Should have a uniform thickness that does not exceed 3mm
  • 9. Medium and heavy body should not be used in case of large/multiple undercuts Long term dimensional stability is poor due to water loss after setting Should be held still during the impression making procedure Allow to rebound for 7 to 15 minutes after removal from mouth and pour immediately Unpleasant odor & Stains clothes
  • 10. POLYETHER IMPRESSION MATERIALS Good surface details Hydrophilic – good wettability for easy cast forming Shorter working and setting time Flow characteristics and flow - lowest among others Stiffness – cast breakage of while removal from tray
  • 11. Unpleasant taste Absorbs water Cannot be immersed in disinfecting solutions Pour within 2 hours for better results
  • 12. CONDENSATION SILICONES Moderate working time (5 to 7 minutes) Pleasant odor Good tear strength Excellent recovery from deformation Can be disinfected with disinfecting solutions without any alternation in accuracy Hydrophobic Ideally pored within 1 hour
  • 13. ADDITION SILICONES Most accurate among elastic impression materials Low polymerization shrinkage & distortion Fast recovery from distortion Good tear strength Working time – 3 to 5 minutes
  • 14. Both hydrophilic & hydrophobic forms are available Available in automixing devices Pouring can be delayed up to 1 week Stable in sterilizing solutions Sulfur in latex gloves – retards the setting reaction
  • 15. IMPRESSION OF PARTIALLY EDENTULOUS ARCH Elastic impression materials are used for making impression of partially edentulous arch This is due to the presence of undercuts in the partially edentulous mouth
  • 16. MATERIALS AVAILABLE FOR MAKING IMPRESSION Reversible hydrocolloids (agar-agar) Irreversible hydrocolloids (Alginate) Elastomeric impression materials
  • 17. STEPS IN IMPRESSION MAKING Position of patient & dentist Tray selection Mixing the material & loading into the tray Impression making & removal Inspecting, cleaning & disinfecting the impression
  • 18. POSITION OF PATIENT & DENTIST Dentist should stand & patient should sit upright Occlusal plane should be parallel to the floor MAXILLARY IMPRESSION- dentist should stand at the right rear of the patient MANDIBULAR IMPRESSION- dentist should stand at the right front of the patient
  • 19.
  • 20. IMPRESSION TRAY SELECTION Stock trays for dentulous & partially edentulous arches are of 3 types: Rimlock trays Perforated metal trays Plastic disposable trays
  • 21. CHECKING MAXILLARY TRAY SIZE There should be a clearance of 5-7mm between the inner flanges of the tray & facial surface of teeth & edentulous ridge Tray should cover the desired anatomic areas Too large a tray may be difficult to insert & may interfere with the coronoid process of mandible
  • 22. CHECKING MANDIBULAR TRAY SIZE There should be a clearance of 5-7mm between the tray and tooth surface and ridge If the tray extends too far in the lingually, there is a tendency to trap the tongue or floor of the mouth. Tray is held in the right hand Left thumb & index fingers are used to manipulate the right corner of the mouth
  • 23. As the right flange of tray is rotated toward mouth, depress the lower lip & stretch the right corner of mouth with the left thumb & index finger
  • 24. EXTENDING AN IMPRESSION TRAY Some times impression tray of adequate width may not cover the desired impression area In such cases, the tray is lengthened using modeling wax
  • 26. LOADING IMPRESSION TRAY Place impression material in small amounts. Tray should be filled in level with the flanges Overfilling should be avoided
  • 27. Mandibular Impression Technique Inject some material over occlusal surface of teeth, into vestibular areas & alveolo-lingual sulcus Then tray is rotated into mouth & is carefully seated The patient is asked to keep the tip of tongue in contact with the upper surface of tray during gelation Maintain the position of tray by placing the forefinger of each hand on top of tray on premolar area & thumb under patient’s chin
  • 28.
  • 29. Maxillary Impression Technique Inject alginate into occlusal surface & vestibular areas & wipe some amount on the palate Tray must be centered & properly aligned & verify the position by looking at the patient’s face from above It should protrude straight from the center of the mouth. After this, the tray is seated by using fingers of both hands over the premolar areas & stabilize the tray
  • 30.
  • 31. Removal of Impression From Mouth Clinically the initial set of alginate is determined by loss of surface tackiness Release seal by retracting lips & cheek Then impression is removed by a sudden jerk
  • 32. INSPECT THE IMPRESSION FOR DEFECTS
  • 33. CLEAN & DISINFECT THE IMPRESSION
  • 35. Marking the outline on the cast
  • 38. Apply self cure acrylic over wax spacer
  • 39. Attaching the Handle and polishing
  • 40. Wax spacer scraped and tray perforated
  • 41. Secondary Impression • Same as that for diagnostic impression. • In this procedure paint or inject impression material in critical areas: Rest preparation Hard palate Peripheral extensions
  • 43. Anatomic and Functional Form of Ridge
  • 44. Anatomical form of Ridge The anatomic form is the surface contour of the ridge when it is not supporting an occlusal load
  • 45. Functional form of Ridge The functional form of the residual ridge is the surface contour of the ridge when it is supporting a functional load
  • 46. SPECIAL IMPRESSION PROCEDURES 1. Physiologic or functional impression technique Functional Relining method Mc Lean’s and Hindel’s methods Fluid Wax method 2. Selected Pressure technique
  • 47. Mc LEAN’S PHYSIOLOGIC IMPRESSION Procedure A custom impression tray is constructed over a preliminary cast Functional impression of distal extension ridge is made. Patient applies some biting force with occlusion rims Then an Alginate impression is made with the 1st impression held in it’s functional position with finger pressure
  • 48.
  • 49.
  • 50. HINDEL’S MODIFICATION Main difference of this with Mc Lean’s is that impression of edentulous ridge is not made under pressure but is an anatomic impression made at rest with ZOE paste. As the hydrocolloid impression was being made finger pressure was applied through holes in the tray to the anatomic impression.
  • 51. Disadvantages of these methods Constantly compressed residual ridge is prone to excessive bone resorption. If the clasp do not hold the partial denture, the denture will be pushed slightly occlusally by the tissue causing premature contacts (TISSUE REBOUND)
  • 52. FUNCTIONAL RELINING METHOD Here a new surface is added into the inner, or tissue side of the denture base The partial denture is made from a cast made from impression made with alginate A space is provided by adapting a metal spacer over the ridge on the cast before processing the denture base. A functional impression of the edentulous area is made using the cast partial denture framework.
  • 53. The patient must maintain the mouth in a partially opened position Border moulding is carried out. Then a low fusing modeling plastic/green stick compound is allowed to flow over the tissue side of the denture base. It is tempered in water bath & seated in patient’s mouth.
  • 54. To provide space for the impression material, modeling plastic is scraped to a depth of 1mm The modeling plastic serves a s a tray material for the secondary impression material The final impression is made with a Zinc Oxide Eugenol impression paste If undercuts are present, light bodied rubber based impression materials can be used
  • 55.
  • 56. Advantages The amount of soft tissue displacement is controlled by the amount of relief given to the modeling plastic before final impression is made Greater the relief, the less will be the tissue displacement. Tissue surface of metal frame work can be relined after insertion Disadvantage Since open mouth technique is used it is difficult to maintain the previous occlusal contact
  • 57. FLUID WAX FUNCTIONAL IMPRESSION • Make an anatomic impression of the arch using alginate • Fabricate a refractory cast using this impression • Fabricate the partial denture framework over the refractory cast
  • 58.
  • 59. Draw the outline of the denture base Cast is coated with separating medium Wax Spacer is adapted over the crest of the edentulous ridge
  • 60.
  • 61.
  • 62.
  • 63. Framework is placed over the spacer Auto-polymerizing resin is mixed to dough stage and is adapted and contoured over the framework along the length of the ridge Borders of the tray are trimmed
  • 64.
  • 65. Impression Procedure Wax is softened at 51 ̊ to 54 ̊ Softened wax is painted on the tissue surface with a brush Wax is painted in excess near the border to record the sulcus Tray is seated and held in position It takes at least 5 minutes for the wax to set
  • 66. The tray is removed and the impression is examined The wax surface that has contacted soft tissue appears glossy and the other areas that has not contacted the tissues will appear dull The impression should be placed in the mouth finally for 12 minutes
  • 67.
  • 68. SELECTIVED PRESSURE IMPRESSION More force are applied to areas that can absorb stress without adverse response & protect that areas that is least able to absorb force Stress bearing areas are the buccal shelf area & the lingual slopes of residual ridge stress bearing areas The denture base made from this impression will be closely adapted to & in firm contact with the tissues in buccal shelf area
  • 70. The tissue surface if the tray is trimmed with burs to provide adequate relief
  • 71.
  • 72. Impression material is loaded on the prepared special tray and inserted into the patient’s mouth Impression is made with the patient with his mouth open under finger pressure Only the stress bearing areas will be compressed during impression making
  • 73. Materials used for Secondary Impression Zinc Oxide Eugenol impression paste Rubber base material
  • 74. Altering The Master Cast This procedure is done to obtain a ‘Hybrid Cast’ which records the edentulous areas in the functional form and the dentulous areas in the anatomic form
  • 75.
  • 76.
  • 77.
  • 78.
  • 79.
  • 80.
  • 81.
  • 82.
  • 83. Conclusion • An accurate impression is vital for the success of a cast partial denture. So proper selection of material, impression technique and the skill of the dentist plays a key role in the success of the overall treatment.
  • 84. REFERENCE Mc Cracken’s Removable Partial Prosthodontics Clinical Removable Partial Prosthodontics