Immediate Complete Denture Impressions - DentalCEToday

Continuing EducationImmediate Complete Denture Impressions: Case Report and Modern Clinical Technique• To form the buccal notches, grasp the cheek with theforefinger and thumb at the corner of the mouth andpull upward and forward. Repeat this process on theopposite side.Following polymerization of the VPS, remove theimpression tray and inspect all peripheral borders toassure that appropriate anatomic and functional detail isrepresented. If the resin tray is apparent through the bordermolding material, adjust the tray by grinding. Finally, relieveall borders approximately one to 2 mm using a scalpelblade and/or rotary instrument in preparation for thedefinitive impression (Figure 16).Definitive ImpressionDispense low-viscosity VPS im-pression materials intothe mandibular impression tray (Figure 16). Inject extralow-viscosityVPS material around all residual teeth usingmanual syringes (Figure 17). As noted previously, extralow-viscosityVPS material possesses relatively low tearstrength 43 permitting easier recovery of the polymerizedimpression from the patient’s mouth without damagingperiodontally involved teeth. The relatively low stiffness oflow-viscosity VPS also facilitates recovery of the definitivemaster cast from the impression without damage.Following injection of low-viscosity VPS around allteeth, place and center the impression tray on the mandible(Figure 18) using the tray stops as guides. Repeat allborder molding manipulations (Figure 18). Uponpolymerization of the VPS, remove and inspect theimpression for appropriate anatomic, functional, andsurface details (Figure 19). Once satisfied with the qualityof the definitive impression, bead, box and cast theimpression 44 using a suitable vacuum mixed dental stone(Figure 19).CONCLUSIONThe provision of prosthodontic restorations immediatelyfollowing extraction of all remaining nonrestorable teeth isan important treatment option. Many patients in need of thistherapy are eager to receive aesthetic replacement of theirmissing teeth, but express concern about edentulism. Asnew denture wearers, these patients will require time toFigure 15. Themandibularimpression tray isplaced in the patient’smouth and bordermolding isaccomplished.Figure 16. Borderadaptation of themandibular impressiontray is carefullyinspected. All areas ofVPS tissues contactare reduced by one to2 mm using a bur orscalpel blade. The trayis then loaded with low viscosity VPS impression material inpreparation for the final impression.Figure 17. Extra-lowviscosity VPSimpression materialis injected aroundresidual mandibularteeth.Figure 18. Theimpression tray isseated on the mandibleand the patient isinstructed toaccomplish all bordermolding movements.accommodate to their situation. It is also expected thatthe post-extraction denture adjustment and maintenancephase of therapy will be challenging. Therefore, it isimperative that techniques be continuously developed tooptimize the accuracy of immediate dentures in an effort tofacilitate the difficult transition to edentulism.As we improve conventional approaches to common7