Special Impression Procedures

DR MAHMOOD ABU RUJAI BDS, M.Sc Prosthodontics Full- Time Lecturer Dep. Prosthodontics

Requirement
record the tissues under uniform loading distribute load over as large an area delineate the peripheral extent of the denture

Factors Influencing Support of the Distal Extension Base

1. Quality of soft tissue covering edentulous ridge
A firm , tightly attached mucosa displaying moderate thickness (2 to 3 mm) will offer the greatest support

2. Type of bone in the denture-bearing area

Cancellous bone, as compared with cortical bone, is less able to resist vertical forces

3. Design of the prosthesis

4. Amount of tissue coverage of denture base

5. Anatomy of the denture-bearing area

Each denture base must be made to fit the areas that can serve as primary stress-bearing regions

Indications
1. mandibular distal extension application 2. a long-span anterior edentulous base (normally including at least the six anterior teeth)

Impression Methods
1. McLean physiologic impression 2. Functional reline method 3. Corrected cast procedure (selected pressure techniques)

McLean physiologic impression

a dual impression technique constructed a custom tray on a diagnostic cast A functional impression was made using this tray and a suitable impression material hydrocolloid "over-impression could not produce same functional displacement generated by occlusal forces

McLean physiologic impression

McLean Dis Advantage

clasps is sufficient :may result i n compromised blood flow with adverse soft tissue reaction and resorption of the underlying bone clasps is not sufficient: the denture base will be occlusally positioned (premature contact)

Functional reline method

Done after the partial denture has been completed (done at a later date) adding a new surface to the intaglio of the denture base The partial denture is constructed on a cast made from a single impression with a soft metal spacer under neath to ensure a uniform space for the impression material

 The patient must keep the mouth partially open to permit appropriate tissue control and visual assessment modeling plastic is applied to the intaglio of the denture base

Functional reline method

1mm of modeling plastic is removed from the intaglio surface and an impression is made

Disadvantage
failure to maintain the correct relationship between the framework and the abutment teeth during the impression failure to achieve accurate occlusal contact following the reline procedure occlusal discrepancies must be corrected: slight: accomplished in the mouth majority of cases: remount on an articulator

Corrected cast procedure (selected pressure techniques)

Adding an impression tray after the framework has been fitted using a chemically activated or light-activated resin

Corrected cast procedure (selected pressure techniques)

Undercuts that would interfere with removal of the tray are blocked out separating medium is then placed

 Tray is adapted to the cast Boarders trimmed using a laboratory knife and gently rounded the edge of the tray should be 2 to 3 mm from the depth of the buccal vestibule

 Border molding for a corrected cast is basically the same as that for a complete denture covers the buccal flange to the most posterior extent the lingual and distolingual flanges

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