JOURNAL CLUB PRESENTATION

PRELIMINARY IMPRESSION TECHNIQUES

FOR MICROSTOMIA PATIENTS
Journal of Indian Prosthodontic Society Jul-Sept 2016, Vol16, Issue 3

Presented by:
Dr.Gurjeev Kaur
PG Student
Dept of Prosthodontics & Crown
and Bridge
 CONTENTS

• Introduction
• Techniques of impression for microstomia
• Flexible tray techniques
• Sectional tray techniques
• Discussion
• Conclusion
• References
 INTRODUCTION
• Microstomia is defined as as abnormally small
orifice ie reduction in size of oral aperture
which can be either accquired or congenital.

• Prosthetic rehabilitation of microstomia patient

presents difficulties at all stages.

• The difficulty begins with primary impression

making due to tongue rigidity and decreased
oral opening.
 TECHNIQUES

• FLEXIBLE TRAY TECHNIQUES

• SECTIONAL TRAY TECHNIQUES

 FLEXIBLE TRAY TECHNIQUES
1. FLEXIBLE IMPRESSION TRAYS:
• Material used - Silicone putty.
• Tray used - Non Rigid Impression tray
 2. FLEXIBLE PLASTIC TRAY
• Horse shoe shaped flexible plastic tray is
selected & No. 8 round bur is used to make
preforations in tray.
• Material is loaded onto tray.
• Wash impression is made with light body
silicone Impression material.
• Once the material sets, the impression is
examined for details & casts are prepared.
 3. REINFORCED FLEXIBLE IMPRESSION
TRAYS
• A 19 gauze orthodontic wire is formed into U shaped corresponding to arch form &
cross arch is soldered to connect two arms of horse shoe shaped wire which is then
encapsulated in acrylic resin for additional strength.

• This whole impression is then incorporated within the putty impression.

• This helps in preventing excess flexibility of impression & prevented it from distortion.
 SECTIONAL TRAY TECHNIQUES
1. ANTERO POSTERIORLY SECTIONED STOCK TRAYS
 2. MEDIO LATERALLY SECTIONED
STOCK TRAY

• In this technique, the selected stock tray are

sectioned medio laterally & the impression is
made in the posterior segment first & then the
anterior segment is used to make the impression
with posterior impression in the mouth.

• Both the impressions are taken out separately

assembled & were poured.
 3. PLASTIC TRAYS WITH BUILDING
BLOCKS

• Plastic impression trays corresponding to width of arches

measured using caliper.

• Trays are sectioned into 2 sections with a disk

• 3 Plastic building blocks are selected to approximate sectioned

tray as a single unit.

• Smaller blocks are joined with tray using acrylic & larger
block is joined with small blocks attached to small segment of
tray
• Impression is made with irreversible hydrocolloid using
larger sectional tray.

• With this impression in mouth, impression is then made

on smaller tray segment.

• When impressions are in mouth, pressure was applied

onto building blocks till all the material sets.

• once the material sets, smaller segment is first removed

from the mouth and then both the smaller & larger
segments are reassembled outside the mouth before
pouring the cast.
 4. TECHNIQUE USING IMPRESSION
COMPOUND

• First sectional impression is made & trimmed to

midline.

• Petroleum jelly is applied to entire impression & is

repositioned on arch.

• Then the impression of other section wis made with

impression compound.

• Both impressions are removed & reassembled outside

mouth & poured to obtain primary cast.
 5. TECHNIQUE USING CROSS PINS
& SLOTS

• Cross pins are placed on one section & slot placed

on other section of handle of tray using Pindex
Machine.

• Impression compound is used to make primary

impression.

• Primary casts are poured after tray sections are

reassembled extra orally.
 6. TECHNIQUE USING MAGNETS
• Magnet is embedded in acrylic formed around the handle of one half of
cut stock tray & a metal plate is attached on other half.

• After that sectional impressions are aligned outside the mouth aided by
magnetic attraction.
 DISCUSSION
Sectional tray techniques:
• Convenient to use due to
ease of insertion & removal.
• in sectional tray technique,
modified stock trays are
used which are sectioned to
facilitate ease reassembling
of impressions outside the
mouth
Flexible tray techniques:
Due to its flexibility, it is
easier to insert & remove
tray easily through limited
oral opening
But due to same reason,
the chances of distortion
are also more .
 CONCLUSION

• Prosthodontic management of microstomic

patient is very challenging. so selection of
appropriate technique should be done on the
basis of case requirement .
 REFERENCES
Prasad R, Bhide S, Gandhi P, Divekar N, Madhav V. Prosthodontic management of a patient
with limited mouth opening: A practical approach. J Indian Prosthodont Soc 2008;8:83.


Kumar KA, Bhat V, Nandini VV, Nair KC. Preliminary impressions in microstomia patients: An innovative
technique. J Indian Prosthodont Soc 2013;13:52-5.


Chiramana Sandeep, O. Swetha Hima Bindu, B. Sreedevi, K. Sai Prasad .Prosthodontic

management of complete edentulous microstomia patient.Journal of orofacial sciences vol6,
issue1 jan 2014

Ashish satpathy, Anil K Gujjarr.Complete denture in microstomia patients.Journal of

clinical & diagnostic research 2015, May vol.9(5)

Jayaprakash Mugur etal. Sectional denture for microstomia patient - A clinical

report.
International journal of prosthodontontics & restorative dentistry April - june
2013;3(2):62-67.
 Shantanu Mulay, Sarandha DL, Smitha Annie Jacob, Zina
Raja .Impressiontechniques for microstomia patient - review Int J Dent Oral
health 1 (2)

Dr.Poonam malik, Dr.Manu rathee.Restricted mouth opening - impression making. -

Review Sci J Dent Sci, Vol2 issue 1,Dec - Feb 2015