Mamata Dugaraju

IMPRESSIONS IN FPD Mds 1st year

Department of Prosthodontics
CONTENTS
1. INTRODUCTION
2. PRINCIPLES OF IMPRESSION MAKING
3. CLASSIFICATION OF IMPRESSION TECHNIQUES
4. PROBLEMS ENCOUNTERED IN IMPRESSION MAKING
5. DIGITAL IMPRESSIONS
6. INTRA ORAL SCAN BODIES
7. CONCLUSION
8. REFERENCES
DEFINITIONS
Impression - a negative likeness or copy in reverse
of the surface of an object; an imprint of the teeth
and adjacent structures for use in dentistry.
Impression material - any substance or combination
of substances used for making an impression or
negative reproduction
 IDEAL
IMPRESSION
NT
MATERIAL
SUFFICIE DIMENSI
ONAL
FLUIDITY STABILIT
TO Y&
RECORD ACCURA
01 02
FINE 03 04
CY 05
DETAIL
COMPLET ABILITY COMPLET
ELY TO WET ELY
PLASTIC ORAL ELASTIC
BEFORE TISSUES AFTER
CURE CURE
 Guidelines for a impression material

Uniform,
homogenous mix
of material
No tray should Tray sufficiently
show through filled with
impression impression
material. material

Detailed margins Thoroughly

with no tears or applied tray
rough surface. adhesive

No voids or pulls Rigid, sturdy

on margin detail. impression tray
Accuracy

• Light body – 25 microns

• Putty consistency – 75 microns. So, cervical margins should be recorded in light

body consistency.

Elastic recovery

• Elastic impression materials need to rebound back from undercuts.

• PVS – best elastic recovery (99%)

• Best way to maximize elastic recovery is to block out the undercuts in tooth
preparation by using restorative materials.
Dimensional stability

• Ideal impression material should not have by product and cast could be poured immediately or delayed.

• PVS – immediately/delayed

• Condensation silicone & Polysulfides – 30 min

• Polyether – stored in dry field and can be delayed

Flow & flexibility

• Readily flow to capture grooves, pinholes, and cervical margin detail.

• Should be thixotropic.

• Polyether – not for long, thin preperations of periodontally weak teeth. The impression tears in gingival
sulcus. Fracture of casts is also a common problem.

• Reversible hydrocolloid – Least rigid of all materials. Indicated in multiple periodontally compromised
Uniform bulk

• Elastomeric impression materials set by means of polymerization which leads to shrinkage.

• Uniform bulk leads to a uniform shrinkage. This is counteracted by slight expansion of the gypsum
material.

• Reversible and irreversible hydrocolloids – minimum cross sectional thickness of 4-6mm.

• Elastomeic impression materials – 2mm

• Stock tray – 1.5 – 2mm thicker material than custom tray.

• Custom tray – 3 occlusal stops on non functional cusps. Atleast 1 stop posterior to the prepared tooth.

• Spacer to be covered by a foil before making the tray – facilitates easy removal and prevents wax
residues on tray which might interfere with the adhesives.
Conventional techniques

1.Putty- wash Technique

a) Relieved putty impression technique.
b) Simultaneous/ Squash technique.
c) Injection Moulded putty wash technique.
2.Copper tube/Resin coping system
3.Monophase/Single viscosity technique
4.Dual viscosity technique
5.Dual arch impression technique
a) Dual-arch multiple mix technique
b) Dual-arch monophase technique
c) Laminar impression technique
d) Hydraulic pressure technique
6.Segmental impression technique
7.Hydrocolloid laminate technique
8.Impression using polycarbonate crown
9.Functional check-bite technique
10.Sectional impressions and ‘ every other tooth’ technique in FPD
1. PUTTY WASH TECHNIQUE/RELINE
TECHNIQUE

üLow viscosity elastomers against high viscosity elastomers

üPerforated stock tray
üPolymerization shrinkage
 A.) RELIEVED PUTTY IMPRESSION TECHNIQUE

Diagnostic impression –
Tooth preparation
unprepared tooth - Putty “Relief” by round bur

Final impression Loading of light body

II. STAGE PUTTY WASH
B.) SIMULTANEOUS
/ SQUASH
TECHNIQUE

Stock tray
loaded with
putty material

Syringe
material
injected around
prepared tooth
 C.) INJECTION MOULDED PUTTY WASH TECHNIQUE

Diagnostic impression – Buccal escape channel from outer

unprepared tooth - Putty surface of tray

Final impression After preparation – light body

injected through channel
 2. COPPER TUBE / RESIN COPING SYSTEM

Copper band – heat annealed and Occlusal 1/3rd by compound

Orientation
quenching in alcohol

Impression by heavy viscosity Hole drill 0.2mm clearance

material
 3. MONOPHASE / SINGLE VISCOSITY
TECHNIQUE
Custom tray with 2-4 mm space

Medium viscosity material STRAINED through syringe – ‘Shear

thinning effect’

Viscosity in tray unaffected

Advantage – Simple, easy to use, excellent handling

property
Drawback – More polymerization shrinkage than
heavy body
4. DUAL
VISCOSITY
TECHNIQUE

High viscosity Low viscosity

loaded on tray syringed
around
prepared tooth

Impression
made
 5. DUAL ARCH IMPRESSION
TECHNIQUE
• Synonyms– Dual quad tray, triple arch, accu-bite, closed mouth
impression, close bite double arch method
• The simultaneous recording of tooth preparation(s), the opposing
antagonistic teeth, and the inter-occlusal relation of the relative opposing
dentition within a single impression for the fabrication of one or two
indirect restorations was first introduced by Wilson & Werrin in 1983.

Maximum for two teeth

Existing anterior guidance
Able to close in MIP
Sufficient teeth to maintain vertical dimension
 Advantages
• Less impression material
• Comfortable for patient

Disadvantage
• Tray used is not rigid
• Only used for one casting per quadrant
A.) DUAL ARCH
MULTIPLE MIX
TECHNIQUE

High viscosity loaded on

tray – putty

Low viscosity syringed

around prepared tooth –
light body

Impression made
 Medium viscosity material
STRAINED through syringe –
‘Shear thinning effect’

Viscosity in tray unaffected

Close the mouth and MIP

B.) DUAL ARCH MONOPHASE

TECHNIQUE
 Preliminary impression by
plastic ‘triple arch’ tray &
bite registration material

No. 6 round bur 2 holes

on mesiobuccal and
distobuccal line angles

Inject light body

impression material
C.) LAMINAR
IMPRESSION
TECHNIQUE
 D.) HYDRAULIC PRESSURE TECHNIQUE

Preoperative impression – medium

bodied impression material
‘Wash impression’ by – light /
medium bodied material
Close in MIP
 6. SEGMENTAL IMPRESSION TECHNIQUE

Teeth preparation Tin foil adaptation Custom tray fabrication

Final impression Impression making Polymerized sectional tray

7. HYDROCOLLOID LAMINATE TECHNIQUE

Agar injected around

prepared tooth – gels by
contact with cool
alginate

Alginate loaded on tray –

Gels by chemical
reaction
 8. IMPRESSION USING POLYCARBONATE CROWNS

Crown shell placed with regular body Pick up impression using regular
body
Advantage: Less potential for soft tissue trauma, less polymerization shrinkage
9. FUNCTIONAL CHECK BITE
TECHNIQUE

Syringe
material
injected around
prepared tooth Advantage: Restorations require less
Tray loaded adjustment
with putty
positioned Indication: Inlays, crown, FPD
intraorally

Close in MIP
10. SECTIONAL IMPRESSION
AND ‘EVERY OTHER TOOTH’
TECHNIQUE

“Every other
tooth” technique Sectional
of gingival impression
displacement
 11. Matrix impression system

• A series of three impression procedures are required in this newer

system.
• It uses three types and/or viscosities of impression materials.
• It strives to overcome the imperfections of the older systems and at
the same time incorporate their best features.
• The matrix system effectively controls the four forces (relapsing,
retraction, displacement, and collapsing) that impact on the gingiva
during the phase of making the impression when attempting to
register the sub gingival margins.
• Tearing is virtually eliminated because of the improved
configuration
 Over the tooth preparations a matrix of occlusal
registration elastomeric material is made.

Depending on the distribution and complexity of the preparations

the matrix may be made in one piece or in two or more sections.

The matrix is trimmed to prescribed dimensions and, after retraction

cord is removed, a definitive impression is made in the matrix of the
preparation with a high viscosity elastomeric impression material.

While the matrix impression is in patients mouth, a stock tray filled with a
medium viscosity elastomeric impression material is seated over the matrix
and remaining teeth for creating an impression of the entire arch .
 Problem Cause Remedy
Marginal Tears - Syringeable material with insufficient tear - Additional tissue retraction.
strength. - More viscous syringeable material.
- Removal of the impression prior to complete - Occlude into a cotton device for several
setting minutes
 Problem Cause Remedy
Drags and Pulls - Teeth rebounding off the tray •Less viscous material either syringed
and sliding into position. around the teeth or placed over the more
- Impression material beyond its viscous material in the tray prior to
working time insertion.
- Insufficient material used
- Movement of tray after
positioning
Tray Selection Either positioned improperly or the Proper tray selection
tray was too small
 Problem Cause Remedy
Separation from the Tray •Tray adhesive not applied Tray adhesive
(Delamination) •Trays with slots and holes to lock
the impression material

Tray Distortion Triple trays Rigid setting PVS material

NEW TECHNIQUES
WHY DIGITAL IMPRESSIONS?
Digital implant impressions offer advantages over conventional impressions
including reduced risks of

1. distortion during the laboratory phases

2. improved patient comfort and acceptance

3. improved efficiency
 1.
CHAIRSID
E
PRODUCTI
ON
DIFFERENT TYPES OF DIGITAL
IMPRESSION SYSTEMS
1. CEREC SYSTEM

2. E4D TECHNOLOGIES

3. I TERO

4. LAVA C.O.S SYSTEM

LABORATORY PRODUCTION

• This variant of production is the equivalent to the traditional working

sequence between the dentist and the laboratory.

• The dentist sends the impression to the laboratory where a master cast is
fabricated first.

• The remaining CAD/CAM production steps are carried out completely in

the laboratory
 3. CENTRALIZED PRODUCTION

• In this variation, it is possible for ‘satellite

scanners’ in the dental laboratory to be
connected with a production centre via the
Internet.
 INTRA ORAL SCAN BODIES
Scan Bodies are placed directly on implants or abutments in the patients' mouth and
are intended as a means to perform a digital impression using an intra oral
scanner
Digital work flow :

1. direct

2. indirect
CONCLUSION
 An accurately fitting restoration requires a good quality impression that depends
upon skill of the operator and accurate impression techniques used.

 Numerous factors should be considered while making of a definitive impression,

all of which must be considered and studied properly to obtain an acceptable result
accurately.
REFERENCES
• Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed prosthodontics. 5 th ed. St. Louis:
Elsevier; 2016. Chapter 25: Fluid control and impression making; p. 546-575.

• Donovan TE, Chee WW. A review of contemporary impression materials and techniques.
Dental Clinics. 2004 Apr 1;48(2):445-70.

• Kumar V, Seth J, Sagar M, Aeran V. Anatomization of various impression techniques in fixed

partial prosthodontics. Int J Oral Health Dent 2018;4(4):208-13.

• Ryan M. Mizumoto and Burak Yilmaz, Intraoral scan bodies in implant dentistry: A systematic
review, the journal of prosthetic dentistry,2018.
• Sudhapalli S. Sectional Impressions and ‘Every Other Tooth’Technique in
FPD. Journal of Clinical and Diagnostic Research: JCDR. 2017
Jan;11(1):ZD18.

• Livaditis GJ. The matrix impression system for fixed prosthodontics. The
Journal of prosthetic dentistry. 1998 Feb 1;79(2):208-16.

• Getz EH. Functional “checkbite-impressions” for fixed prosthodontics. The

Journal of Prosthetic Dentistry. 1971 Aug 1;26(2):146-53.