RPD Manual 11 - Removable Prosthodontics - Dalhousie University

Clinical Protocol, Final Impressions - 81
Custom trays should have two thicknesses of baseplate wax spacer over the remaining teeth and
one thickness over edentulous ridges. Two thicknesses of baseplate wax over the dentulous
portion of the tray provide additional space for increased flexibility to help prevent breakage of
the teeth during separation of the impression from the model. The tray should be short of the
vestibular depth in dentate areas remote from abutments or framework. Custom trays should be
neat, rigid and properly extended.
When border molding is completed, the custom tray should be stable at rest and during slight
manipulation of tissues and the flanges should extend to height of vestibule. No border molding
is necessary on the buccal of uninvolved dentate areas.
Particular attention should be focused on the peripheral extension of the anterior lingual portion
of mandibular trays. Overextension in this area will result in a cast with an inaccurate
registration of the level of the floor of the mouth, which can affect the selection of the major
connector. Similarly, attention should be focused on the extension of the tray in areas of frenal
attachments or areas of minimal vestibular depth. Overextension in these areas can result in a
master cast that appears to allow for the selection of infrabulge direct retainers even thought soft
tissue contours dictate otherwise.
The posterior extension for maxillary bilateral extension cases should be marked at or anterior to
the vibrating line prior to the impression so that the line can be transferred to the impression and
thus the master cast. Do not err in marking the posterior limit past the vibrating line, since the
metal will have to be shortened. This is difficult due to hardness of the metal. If the metal is
shortened the beading on the posterior border of the denture will be lost, possibly allowing for
food to get under the denture.
All framework impressions will be made with polyvinyl siloxane material in custom trays. These
materials have the following properties, which make them a the impression material of choice
for removable prosthodontics:
a) low viscosities available (less tissue distortion)
b) excellent dimensional stability
c) good tear strength
d) no taste
Polyvinyl siloxanes are sensitive to latex glove powder contamination, so try to minimize or
avoid contact of the tray in areas where the impression material will contact. Contaminated
impression material will tend not to set. Some glove/material combinations are worse than
others. Early silicone impression materials were severely hydrophobic causing bubble formation
during pouring, but most materials have improved significantly in this regard.
Prior to making a final impression of the mouth preparations, make an alginate impression and
pour it in quick setting plaster, and survey the resulting cast to ensure optimum preparations have
been achieved. A small amount of alginate should be wiped into the rest seats and over guiding
plane surfaces prior to seating the filled impression tray. The student may repeat this process
several times if required, but should discuss additional preparations with their instructor before
proceeding further. Final impressions cannot be made if there is any plaque or calculus on
the teeth, since this will affect the fit of the framework. Therefore it is essential to ensure
proper oral hygiene and prophylaxis prior to the tooth preparation appointment. Failure to do so