Chairside - Glidewell Dental Labs

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stone is made in consideration of selecting one with controlled expansive/contractive properties 9 (Figure 12). An evaluation of the adequacy of the bond between the various viscosities of impression material was performed. Four different viscosities of impression material were used to build and complete the final impression (Figure 13). High viscosity (green), medium viscosity (purple), low viscosity (teal), and ultra low viscosity (orange) impression materials were used to record the maxillary impression used in this clinical situation. The high viscosity material was used to create the tissue stops and border molding, each being applied and allowed to set separately. The remaining three viscosities were applied sequentially in the predetermined areas of the tray, reinserted intraorally, and allowed to set simultaneously. After the material set and the impression was removed, the impression was sectioned longitudinally using a sharp blade to demonstrate the various layers of impression materials used and the relation to the anatomical area reproduced intraorally (Figure 13). Note the approximation of material layers and co-lamination of the various viscosities in the cross-sectional view, evident in the thinly layered sections. Based on informal testing, it was found that the different viscosities, applied and allowed to set simultaneously, could not be separated. However, the materials that were applied in separate layers (such as in a dual technique) exhibited more than adequate adhesion to each other and could only be separated with difficulty after several attempts. It should be noted that adhesion between impression layers was enhanced when the layers were dried before placing the subsequent layer. Even in the presence of slight moisture contamination, the co-lamination between layers was sufficient to pour and create the master cast. Conclusion Making acceptable final impressions when fabricating complete dentures is an important requirement for the successful treatment of an edentulous patient. Diagnosing the tissue condition and classifying the edentulous arch 11 should be determining factors when selecting an impression technique for a specific patient. 52 Building the Edentulous Impression Figure 11: The final impressions are boxed to create a dense master cast and to preserve the peripheral flanges carefully created intraorally.
The layering technique presented in this article represents an alternate impression technique for the clinician who thoroughly understands the basic principles in complete prosthodontics and has the clinical ability to evaluate and assess intraoral tissues of the edentulous patient. The clinician can use multiple viscosities of an impression material and a stock edentulous tray (in this example, a well-designed disposable edentulous impression tray) to border mold and create an impression of the edentulous arch efficiently and accurately, as an effective clinical solution for the contemporary practice of treatment of the edentulous patient. To contact Dr. Massad, call 888-336-8729, visit www.gdit.us or www.joemassad. com, or e-mail using the contact message form at www.joemassad.com. References 1. Bohannan HM. A critical analysis of the mucostatic principle. J Prosthet Dent. 1954; 4:232-241. 2. Addison Pl. Mucostatic impressions. J Am Dent Assoc. 1944;31:941-946. 3. Pendelton CE. The positive pressure technique of impression taking. Dent Cosmos. 1931;73:1045-1056. 4. Frank RP. Controlling pressures during complete denture impressions. Dent Clin North Am. 1970;14:453-470. 5. Boucher CO. A critical analysis of mid-century impression techniques for full dentures. J Prosthet Dent. 1951;1:472-491. 6. Massad JJ, Golijan KR. A method of prognosticating complete denture outcomes. Compendium. 1994;15:900-909. 7. Masri R, Driscoll CF, Burkhardt J, et al. Pressure generated on s simulated oral analog by impression materials in custom trays of different designs. J Prosthodont. 2002;11:155-160. 8. Anusavice, KJ. Phillips’ Science of <strong>Dental</strong> Materials, 10th ed. Philadelphia, PA: Saunders; 1998. 9. Albers, HF. Impressions. A Texbook for Technique and Material Selection. 2nd ed. Santa Rosa,CA: Alto Books; 1990. 10. Ferracane, JL. Materials in Dentistry Principles and Applications. 2nd ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2001. 11. McGarry TJ, Nimmo A, Skiba JF, et al. Classification system for complete edentulism. The American College of Prosthodontics. J Prosthodont. 1999;8:27-39 Reprinted from Compendium: Massad J, Lobel W, Garcia LT, et al. ‘Building The Edentulous Impression: A Layering Technique.’ 2006; 27(8):446-452. Copyright ©2006, with permission from AEGIS Publications, LLC. Figure 12: The master casts have been poured, allowed to set completely, and trimmed. Note the peripheral flanges have been preserved as the boxing procedure creates a “land area” around the periphery of the anatomical areas of the impression. Figure 13: The sectioned impression shows the multiple layers of impression material in cross-section. Building the Edentulous Impression53
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