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DENTAL TECHNOLOGY WiNEI. H CXHL.

One-step border molding of complete denture

impressions using a polyether impression material
Dale E. Smith, D.D.S., M.S.D.,* L. Brian Toolson, D.D.S., M.S.D.,**
Charles L. Bolender, D.D.S., M.S.,*** and James L. Lord, D.D.S., M.S.D.****
The University of Washington, School of Dentistry, Seattle, Wash.

B order molding an impression tray to more closely

adapt it to the tissues of the vestibule before securing
the final impression is a time-honored procedure in
prosthetic dentistry. The original material used for
this purpose was modeling compound, which was
introduced in 1907 by the Green brothers.* Modeling
compound is still effectively used today for this
purpose by many dentists, and this procedure is
commonly taught in introductory courses in
complete denture prosthodontics in American dental
schools.
The technique of using impression compound for
border molding is usually divided into steps where
sections of the borders are molded in separate
applications. The technique taught at the University Fig. 1. Relief wax is placed over the ridge and the median
raphe of the maxillary cast. Stops are placed on the ridge
of Washington before 1976 required a minimum of in the canine regions.
24 insertions of the trays, eight for the maxillary and
16 for the mandibular, for border molding maxillary
and mandibular impressions, provided the proper
extensions were secured on the first insertion for each
section.? Woelfel and associates” have determined
that seven dentists required an average of 17 inser-
tions to secure a final maxillary impression on the
same patient when utilizing modeling compound for
border molding and impression plaster for the final
impression. Because of the number of insertions
required, such a technique can be quite tedious and
difficult, particularly for the beginning student.
Efforts to facilitate this procedure have included
border molding larger sections and initiating four-
handed procedures, both of which can be effective
with adequate training for the dentist and the Fig. 2. Relief wax is placed over the crest of the ridge on
assistant. the mandibular cast.

Read before the Pacific Coast Society of Prosthodontists in San The technique of using modeling compound is
Prancisco. Calif. difficult because the softened compound must be
*Associate Professor, Department of Prosthodontics.
placed into the mouth without touching the lips,
**Instructor, Department of Prosthodontics.
***Professor and Chairman, Department of Prosthodontics. cheeks, or ridge. It retains its flow for so short a
****Clinical Associate, Department of Prosthodontics. period that once it is displaced, the surface cools and

0022.1(91.~/7’~,‘(1:10347 + 05$00.50/0~~ 1979 The C. V. Mosby Co. THE IOURNAL OF PROSTHETIC‘ I)ENTISTRl 347
 SMITH ET Ai

Fig. 3. The tissue surface of the maxillary tray retains the relief wax during border molding
There is no relief on the flanges.
Fig. 4. The mandibular tray contains the relief wax over the crest of the ridge.

the material into deficient parts after seating the

tray, (6) not cause excessive displacement of the
tissues of the vestibule, and (7) be readily trimmed
and’shaped so that excess material can be carved and
the borders shaped before the final impression is
made.
Hard acrylic resin and silicone materials have
been used for this purpose, and both have serious
deficiencies. Hard resins have a long setting time, do
not attain proper consistency immediately after
mixing, which requires a waiting time before inser-
tion, and are difficult to trim. Also, if insertion is
delayed too long, overextension will result. Heavy-
Fig. 5. The extension of the tray is verified by draping bodied silicone materials do not allow preshaping,
the border tissues at right angles to the ridge. placement into deficient spaces with a finger after
insertion, and are difficult to trim after setting.
flow ceases. This causes an inaccurate impression if Polyether impression materials* meet ail of the
tissues are contacted before the tray is properly requirements previously listed. They can be shaped
seated for border molding. with a moist finger in or outside the mouth, and can
A material which will allow simultaneous mold- be trimmed with a scalpel or a bur.
ings of all borders has two general advantages: (1) The following procedure is a technique which
the number of insertions of the trays for maxillary utilizes polyether impression materials for border
and mandibular border molding could be reduced to molding. It has been used effectively at the Gniver-
two, a great time and motion advantage; and (2) sity of Washington, significantly reduces the time
development of all borders simultaneously avoids required for making impressions, and also reduces
propagation of errors caused by a mistake in one the amount of motion used by the dentist, thus
section affecting the border contours in another reducing the psychological stresses of a busy prac-
section. tice.
The requirements of a material to be used for TECHNIQUE
simultaneous molding of all borders are that it
should (1) have sufficient body to allow it to remain I. Constructing autopolymerizing acrylic resin
in position on the borders during loading of the tray, impression trays
(2) allow some preshaping of the form of the borders 1. Make diagnostic casts in the usual manner.
without adhering to the fingers, (3) have a setting
2. Block out undercuts on the cast with baseplate
time of 3 to 5 minutes, (4) retain adequate flow while
seating in the mouth, (5) allow finger placement of *Impregum, Premier Dental Products Co., Philadelphia, Pa.

348 MARCH 1979 VOLUME 41 NUMBER 3

ONE-STEPBORDERMOLDlhC

Fig. 6. The polyether material is placed on the borders in generous amounts.

Fig. 7. The polyether material does not stick to a wet finger. so it can be preshapecl 1
desired.
Fig. 8. The completed border molding. The acrylic resin tray will show through the polvethef
material in pressure or overextended areas.
Fig. 9. Polyether material can be cut readily with a bur.

wax. One thickness of baseplate wax relief is 2. Thoroughly mix the material tar 30 to 43
provided over the crest of the ridge or both upper seconds using a metal spatula.
and lower casts and over the median raphae area of 3. Position the polyether material on the borders,
the palate (Figs. 1 and 2). No relief is placed on the making certain a minimum width of 6 mm rxists on
border areas except where undercuts are present. the inner portion (Fig. 6).
3. Construct autopolymerizing acrylic resin cus- 4. Quickly preshape the materi;% to proper
tom impression trays over the relieved diagnostic contours with fingers moisfened ill cold water
casts (Figs. 3 and 1). (Fig. 71. This is done quickl?. and is :>ot a critical
4. Check the extensions of the impression trays step.
carefully intraorally (Fig. 5). This step is very impor- 5. Place the impression tray in the mouth, making
tant because adding to overextended borders will not certain to retract the lips sufficiently tcj avoid scrap-
rest!: in proper extensions. Areas of overextension ing the material from the borders.
are reduced until they are 2 mm underextended. 6. Inspect all borders to make certain that impres-
Areas that are over 6 mm underextended should be sion material is present in the vestibule. If there is a
corrected with acrylic resin. deficient space. transfer some mat&~1 from an
5. Confirm the extension of the posterior palatal adjacent site with a finger moistened in rhe patient’s
border with an indelible mark placed on the posteri- saliva.
or border and transfer it to the mouth. 7. Immediately instruct the patient to perform the
following border molding movements’
II. Border molding the maxillary tray a. Move the mandible from side to side. Make
1. Express a 3-inch strip of polyether material certain the mandible is elevated sufficiently to
from the large tube onto a large mixing pad. Next, allow lateral movement and caution the
express 2% inches of catalyst from the small tube. patient to avoid extreme lateral movements.
The reason for using less catalyst than recommended b. Elevate the mandible so that tire mandibular
is to provided sufficient working time to complete ridge closes on the operator’s fingers placed
the border molding. between the tray and the ridge. ‘This molds the

THE JOURNAL OF PROSTHETIC DENTISTRY 349

 SMITH ET A:

Fig. 10. The tray relief is completed, ready for the final impression.
Fig. 11. The completed impression has a posterior palatal seal made with mouth-temperature
wax.

2. Remove any of the material that extends inter-

nally within the tray more than 6 mm. A scalpel
works best for this step.
3. Remove the wax spacer. Heating the wax in
warm water makes removal easier.
4. Reduce the polyether material where it extends
into an undercut with a denture bur to allow the tray
to go to place easily.
5. Remove any excess material that has flowed
onto the external portion of the tray away from the
borders.
6. Reduce the thickness of the labial flange to
approximately 2% to 3 mm from the buccal frenum
Fig. 12. The borders of the lower impression are divided
to the buccal frenum.
into sections which are affected by various functional
border movements used in molding them. 7. Remove a small amount (approximately %
mm) of material from borders that have not been
tray adjacent to the anterior border of the previously adjusted. This includes the inner portion,
medial pterygoid muscle. the border, and the outer surface to allow space for a
c. Pucker the lips. thin film of final impression material (Fig. 10).
8. Remove the tray when the impression material 8. Make the final impression in silicone* or
is set. The material is set when no permanent metallic oxide paste.? The posterior palatal seal is
indentation results when the fingernail is intruded placed with mouth-temperature wax$ (Fig. 11).
into it.
9. Examine the border molding and determine if IV. Border molding the mandibular tray
it is adequate (Fig. 8). The contour of the borders 1. Prepare the mandibular tray for border mold-
should be rounded. Any deficient sites can be ing in a similar manner as described for the maxil-
corrected with a small mix of polyether material or lary tray.
with a small addition of impression compound 2. Carefully evaluate the extensions of the tray
which will adhere to set polyether materials. Overex- intraorally.
tensions are readily detected as the tray will protrude 3. Express a 4-inch strip of polyether material
through the polyether border molding. from the large tube and 3% inches of catalyst from
the small tube onto the mixing pad.
III. Preparation of the maxillary tray to secure 4. Thoroughly mix the material.
the final impression 5. Follow the same loading and shaping proce-
1. Reduce borders on the tray which protrude
through the polyether material, as they indicate
*Syringe Elasticon, The Kerr Mfg. Co., Romulus, Mich.
overextension or pressure spots (Fig. 8). Use a +Coe-Flo, Coe Laboratories Inc., Chicago, Iii.
denture bur for these reductions (Fig. 9). $Iowa Wax, The Kerr Mfg. Co., Romulus, Mich.

350 MARCH 1979 VOLUME 41 NUMBER 3

ONE-STEP BORDER MOLDING

Fig. 13. The right side border-molded lower tray. The polyether material often flow!; ~>verthi
ridge and can later be removed.
Fig. 14. The S-shaped lower lingual border is apparent on the left side. Pressure spots JI’~
readily visible.

dure as described for the maxillary tray. Since

approximately twice the length of borders are
involved on the lower than on the upper tray,
loading must be done with a minimal delay.
6. Place the impression tray in the mouth, making
certain to retract the lips sufficiently to avoid scrap-
ing the polyether material from the borders.
7. Instruct the patient to elevate the tongue as the
tray is seated.
8. Hold the lower lip out so the excess material
can flow labially.
9. Have the patient drop the tongue so the tip
contacts just behind the handle of the tray.
10. Quickly pull both cheeks buccally to make
Fig. 15. The completed mandibular impression. Impreg-
certain the cheek mucosa has not been trapped
urn which shows through the final impression material is
under the buccal flanges. not important if it does not interrupt the continuity of the
11. Complete the border molding movement as surface.
follows:
a. Pucker the lips, which molds sections 3 and 4 (Fig. either the maxillary or mandibular impression.
12). 2. Border molding can be accomplished with one
b. Wet the lower lip with the tongue, which molds insertion of the tray.
section 6 (Fig. 12). 3. Functional movements performed by the
c. Swallow, which molds section 5 (Fig. 12). patient are used in border molding.
d. Open and close the mandible slightly, which 4. The technique is easily mastered.
molds sections 1 and 2 (Fig. 12).
REFERENCES
e. Examine the borders after the material has set to
determine if they are adequate (Figs. 13 and 14). 1. Green. J. W.: Green Brothers’ Clinical (:ourse in Dental
Prosthesis, ed 5. Detroit. 1910. Detroit I)ental Mfg. Co.
Section 5a is not molded by this procedure (Fig.
P 1.
12). ‘Ihis section must be trimmed so that cover- 2. Bolender, C. I,.. Lord, J. L., Smirh, D. E . f;rank, K. P., and
age distal to the retromylohyoid fossa is elimi- Swoope. C. C.: Complete Denture Syilabm. cd 8. Seattle,
nated. 1975. University of Washington, p 49.
f. Prepare the tray and secure the final impression as 3. Woelfel. J. B.. Hickey, J. C., and Berg. 7 (Contour varia-
tions in one patient’s impressions made ir) wven dentists. .J
described for the maxillary impression (Fig. 15).
Am Dent Assoc 67:1, 1963.
SUMMARY AND CONCLUSIONS Reprznt requests to:
DR. DALE E. SI*IITH
A technique has been described which uses a
DEPARTMENTOF PROSTHODONTICS SM-S:!
polyether impression material for border molding of SCHOOL OF DENTISTRY
complete denture impressions. It has the following UNIVERSITY OF WASHINGTON
advantages: SEATTLE. \%.ASH. 981%

1. There is simultaneous molding of all borders of

THE IOURNAI. OF PROSTHETIC DENTISTRY 351