IMPRESSION

TECHNIQUES IN
RPD

PRESENTED BY-
PRASHAL LAHARE
 CONTENT

• DEFINATION
• RPD IMPRESSION VS COMPLETE DENTURE
• IMPRESSION TRAYS
• CLASSIFICATION OF IMPRESSION MATERIAL
• METHODS OF IMPRESSION MAKING
• RECENT ADVANCES
• CONCLUSION
 DEFINITION
IMPRESSION : A negative likeness or copy in
reverse of the surface of an object ; an
imprint of teeth and adjacent structures for
use in dentistry

GPT – 8
PARTIAL DENTURE IMPRESSION : A negative
likeness of a part or all of a partially
edentulous arch

GPT – 8
RPD IMPRESSION VS COMPLETE
DENTURE

COMPLETE DENTURE
IMPRESSION
The edentulous mucosa with
underlying bone only

PARTIAL DENTURE
IMPRESSION
Relative soft yielding tissues
(the oral mucosa) + hard
unyielding substance (the
remaining teeth)
 IMPRESSION TRAYS

• A receptacle in to which suitable impression

material is placed to make negative likeness or
a device that is used to carry, confine and
control impression material while making an
impression
 CLASSIFICATION

Impression
trays

Stock trays Custom

trays
 CLASSIFICATION
OF IMPRESSION MATERIALS
 Plaster
Compoun
Non d
elastic
Waxes
Agar
Zno
Impressio eugenol
n Alginat
materials Aqueous e
hydrocolloi Polysulphid
ds e
Elastic
Addition
silicone
Non
aqueous Silicone
elastomers s Condensati
Polyethe on silicon
r
THE METHOD OF IMPRESSION
MAKING

Residual
ridge

Anatomi Function
c form al form

FUNCTIONAL
ANATOMIC FORM
FORM
 Anatomic Functional
impression impression
s s
Irreversible Fluid
hydrocolloi waxes
ds
Elastomeric Metallic
impression pastes
materials
Elastomeric
impression
Reversible materials
hydrocolloids
Soft
reliners
SUPPORT OF DISTAL EXTENSION
BASED PARTIAL DENTURE

Minor support

Abutment
teeth

Major support

Elastic fibrous
connective tissue
pad
 FUNCTIONAL IMPRESSION
• The term functional impression means recording the
functional form of the residual ridge tissue & to
obtain uniformity of support when the functional
load is applied
Accuratel
Record y
Distribute
and relate delineate
the load
the the
over as
tissues periphera
large an
under l extent of
area as
uniform the
possible
loading denture
base
NEED OF FUNCTIONAL IMPRESSION

The displaceability of the

mucosa of residual ridge is
not uniform

In cases of distal extension

based partial denture

Short span distal extension

bases
FACTORS INFLUENCING THE SUPPORT
OF DISTAL EXTENSION BASE

Contour & quality of residual

ridge

Extent of residual ridge

coverage by the denture base

Type & accuracy of

impression registration
 Accuracy of fit of denture
base

Design of partial denture

framework

Total occlusal load applied

Factors influencing support of Distal Extension Base:

A number of factors are considered to determine to what extent the soft

tissue supporting the denture base should be displaced during the impression
procedure.

1) Quality of soft tissue covering edentulous ridge:

- The soft tissues covering the bony residual ridges are composed of tissues
that are compressible to varying degrees. The more displaceable tissue
present over the edentulous ridge, the less support for the denture base can
be derived from that ridge. A firm tightly attached mucosa will offer the
greatest support. Excessive soft tissues can be surgically removed.
2) Type of Bone Making up denture bearing area :

Cancellous bone (crest of maxillary and mandibular ridge) compared with

cortical bone is less able to resist vertical forces because its irregular surface
acts as an irritant to the overlying soft tissue if vertical stress occurs.
Irritation leads to
- chronic inflammation.
- patient discomfort
- resorption of Cancellous bone

3) Design of partial dentures:

By using additional components of partial dentures the rotational forces taking
place around the fulcrum line passing through the most distal or posterior rests
can be decreased. Rotational movements can be controlled by use of indirect
retainers anterior to the fulcrum line.
4) Amount of tissue coverage of denture base:
To counteract the tissue component of the rotational force, the denture
base must cover the maximum amount of surface area of the edentulous ridge.
Broader the coverage of edentulous ridge, the greater will be the distribution of
the load securing against it per unit of area.

5) Amount of occlusal force:

- Total amount of occlusal force applied to a denture base on a distal
extension ridge influence the amount of support-required to stabilize that
denture base.
- Maximum coverage of all available ridge is necessary.
- Narrowing the food table of the artificial teeth will help reduce the load
transmitted to the denture base.
6) Denture-Bearing area:
To distribute forces of occlusion to the ridge efficiently forces must be directed
to portions of the ridge capable of withstanding that force. Since the ridge
crests of both maxillary and mandibular areas are of cancellous bone, other
areas must be looked for primary support of the denture base.

7) Maxillary edentulous ridge:

The buccal slopes of the ridge can withstand stresses because its covered
by a layer of cortical bone. The buccal slope will resist the lateral forces,
reducing the total force. As undesirable, the majority of denture base support
for maxillary distal extension partial dentures must come from the ridge crest.
The mucosa covering the crest is usually firm, dense tissue that is capable of
resisting occlusal forces to a large degree.
8) Mandibular edentulous ridge-
The very dense cortical bone forming the buccal shelf area,
bordered by the external oblique line laterally and the crest of the
ridge medially makes this area an excellent primary stress bearing
site. The buccal shelf area is perpendicular to the vertical forces
making it well able to tolerate the stresses.
 Preliminary impression:

In the first stage of partial dentures construction, its necessary to

obtain casts from a preliminary impression of the teeth and the
denture related tissues and record the anatomic forms accurately
so that prosthesis is designed to follow a definite path of removal
and insertion so that support, stability and retention on the
abutment teeth may be precise and accurate.
Preliminary impressions are usually made in alginate material
using stock trays. Tray modification can be done with impression
compound to the deficient areas in the tray.
Step by step procedure for making a hydrocolloid impression:
1) Select a suitable, sterilized perforated or rim lock impression
tray large enough to provide 4-5mm border thickness of the
impression material.
2) Build up the palatal portion of wax tray with wax or modeling
plastic to ensure even distribution of impression material to
prevent material from slumping away from palatal surface.
3) The lingual flange of mandibular tray may need to be
lengthened with wax in retromylohyoid area or extended
posteriorly.
4) Place patient in upright position with the involved arch parallel
to the floor.
5) Mix the material and place it in the tray avoiding entrapping of
air.
6) After loading the tray, place some impression material with
fingers in areas such as rest preparations or abutment teeth and
also in palatal and rugae area.
7) Seat tray first in side away from you, then the anterior area and
then the side near you.
8) Hold tray immobile for 3 minutes with light finger pressure over
left and right premolar areas.
9) After releasing the surface tension, remove the impression
quickly in line with long axis of the teeth to avoid tearing or
distortion.
10) Rinse the impression free of saliva with and examine
it. Spray the impression thoroughly with a suitable
disinfectant and convex it immediately with a damp
paper towel.
Cast should be poured immediately to avoid dimensional
changes.
Possible causes of an inaccurate cast of a dental arch:
1. Distortion of the impression:
a)By using a tray that is not rigid.
b)Partial dislodgement from the tray.
c)Shrinkage caused by dehydration.
d)Expansion caused by imbibition.
e)Attempting to pour the cast with stone that is too
resistant.
2) Increase water powder ratio will result in a weak cast.
3) Improper mixing - also result in a weak cast or one
with chalky surface.
4) Trapping of air.
5) Soft or chalky cast surface that results from retarding
action of hydrocolloid absorption of necessary water for
crystallization by dehydrating hydrocolloid.
6) Premature separation of cast from impression.
7) Failure to separate the cast from the impression for
an extended period of time.
Master impressions:
• Master impressions are only recorded after a decision
has been made on the design of the partial denture.
• Any restorative work, scaling, tooth or tissue
preparation should be completed and the tissues
should be clinically and radiographically healthy.
• The master impression should always be recorded in a
tray which has been designed and constructed on a
preliminary cast.
• The tray should allow substantial thickness of
impression material between the fitting surface and
denture bearing tissues.
• Periphery should not extend beyond the junction of the
reflected and attached mucosa, which would lead to
displacement of the tissues of sulci during border
molding if needed. The tray should be strong and
inflexible and acrylic resin used for the purpose.
• The pressure applied to the tissues will be dependent
on the viscosity of the impression material used.
• Hydrocolloids are of low viscosity. Heavy bodied polysulphides
offer maximum viscosity and other materials provide
intermediate values. Thus by selecting the impression material,
the operator has a means of controlling the level of pressure
applied to the tissues.
• Where long edentulous tissue areas are present, especially free
when ended, the application of carefully positioned wax stops to
the fitting surface of the tray in a crest of ridge position will aid
correct location of the trays.
Cast pouring:

- Once impression has been removed from mouth rinse it under

cold running water to remove any mucus or blood adhering to
the surface.
- Impression should have a well-formed periphery with
adequate coverage of the denture bearing area.
- Impression should be covered by a damp napkin and a cast
poured within fifteen minutes of its removal from mouth (if its
alginate) (or else dimensional stability will occur through
syneresis and strain release within the gel).
Distortion of flexible impression materials can be caused during pouring of cast
if
i) consistency of stone is too thick
ii) if vibration is excessive
iii)if impression inverted and pressed firmly down on heat of stone on the
bench.

Choice of material to be used in preparing the master cast depends on

procedure to be used for denture construction.
- For a polymeric denture base (e.g., acrylic resin) cast should be poured using
a prosthetic grade of artificial stone.
-For a metal framework design a die grade of artificial stone is preferred.
Special impression procedure:
In certain circumstances we need to take an
impression which records the tissues under loading
conditions which simulate those arising in masticatory
functioning of the appliance.
A dual impression technique for bilateral free-end
saddle dentures can be used in an attempt to equalize
the loading between mucosa and abutment teeth during
function.
METHODS OF FUNCTIONAL
IMPRESSION
SELECTED
PHYSIOLOGIC PRESSURE
IMPRESSION TECHNIQUE
McLean's
method
Hindel’s
modification for
McLean's method
Functional
relining method
The Fluid wax
technique
PHYSIOLOGIC IMPRESSION
TECHNIQUE
• This technique records the ridge
position by placing an occlusal
load on the impression tray as the
impression is being made.
• Produce a generalized
displacement of the mucosa to a
greater or lesser degree.
• This displacement record the
tissue in the configuration it would
assume when occlusal loading is
applied to a partial denture in
function.
MCLEAN’S PHYSIOLOGIC METHOD
McLean “The basic problem of partial denture
stabilization is to equalize the resilient and non
resilient support”

• Recording the tissues of the residual ridge would

eventually support a distal extension denture
base in the functional, or supporting form and
then this functional impression is related to the
remainder of the arch by means of a second
impression
• Custom tray over a preliminary cast

• Functional impression of extension area under

occlusal load
• Hydrocolloid impression over the first
impression made under finger pressure

DISADVANTAGES

Finger pressure not equal to

biting pressure
Closely affect the direct
retention
 HINDEL’S MODIFICATION

• Impression is made with a modified tray

applying finger pressure
• HINDLE’S FINGER LOADING
DISADVANTAGES:
• Tissues are in constant stage of compression
• Ischemia and bone resorption
• Premature contacts at rest

THE MAIN PURPOSE OF THESE TECHNIQUES

WAS TO RELATE AN IMPRESSION OF THE
EDENTULOUS RIDGE TO THE TEETH UNDER
A FORM OF FUNCTIONAL LOADING
FUNCTIONAL RELINE METHOD
LAYER OF RELIEF GIVEN DENTURE IS PROCESSED &
FITTED

• It should be worn for a trial period of a week & all needed

adjustments are done
• Relief metal is stripped off from the acrylic
• low fusing modeling compound is added in increments
 Border 1 mm modeling plastic
molding done is removed from the
intaglio surface
Occlusion
altered
Fine line of
demarcation
between the
Impression made using fluid
old and new
wax, zinc-oxide eugenol pastes
resin
or elastomeric impression
material
Advantage is the soft tissue displacement can be
controlled. Greater the relief, less will be tissue
displacement.
Disadvantage- failure to maintain the correct
relationship between the framework and the teeth
during impression procedure and failure to
maintain accurate occlusal contact following the
reline.
 FLUID WAX TECHNIQUE
• The term fluid wax refers to waxes that are firm
in room temperature and have the ability to
flow at mouth temperature
• THE MOST FREQUENTLY USED WAXES ARE

Korrecta
wax no 4 IOWA wax

Korrecta wax no. 4 is slightly more fluid than

IOWA wax
 This method may be used to make a reline impression for an
existing partial denture or to correct the distal extension
edentulous ridge portion of the original master cast.
Objectives of this technique:
i) To obtain maximum extension of the peripheral borders of
denture base while not interfering with the function of movable
border tissues.
ii) To record stress - bearing areas of the ridge in their functional
form.
iii) To record non- pressure bearing areas in their anatomic form.
- A relief or 1-2 mm between the impression tray and ridge is desirable.
- Wax is placed in a water bath maintained at 51 oC- 54oC at which the wax
becomes fluid.
- Fluid wax is painted on the tissue side of impression tray.
- Care to be taken that the borders of the tray are not more than 2mm
short, as the wax does not have sufficient strength to support itself.
- The tray is seated in the mouth for 5-7minutes to allow the wax to flow
evenly.
- Wax surface will be glossy where tissue contact is present and dull
where there is no contact.
- The cast is poured as soon as possible because the wax is fragile and
subject to distortion.
Armantarium for fluid Undercuts
wax technique (51- 54̊ eliminated using
celsius) baseplate wax

Separating Framework
medium applied seated on the
to the cast cast
 Tray material adapted 1-2 mm Excess
relief between residual ridge material
and intaglio surface of tray removed
• Tray border smoothed using laboratory bur. Should be 2 mm short
of border extension required.

Fluid wax painted onto the Completed

intaglio surface of tray (1 - impression
2 mm)

• Assembly seated in patients mouth(5 -7 mins)

 SELECTIVE PRESSURE
IMPRESSION TECHNIQUE
• Objectives of the technique are:-

To direct
more force
The
to those
equalization Protect the
portions of
of support areas of the
the ridge
between the ridge which
which is able
abutment is least able
to absorb
teeth and to absorb
the stress
the soft force
without
tissue
adverse
response
 Tray outline
Framework tried on marked for
the cast extension

Framework with Areas in which relief

tray fabricated on it is to be provided is
with holes on its marked
ridge
Tray is being relieved Acrylic resin impression
before the final trays with holes
impression is made

Framework with tray Functional

tried in patient’s impression is
mouth made
TECHNIQUES FOR POURING THE
CORRECTED CAST IMPRESSIONS
Boxing with
a
plaster/pumi
ce mix &
wax.
Beading Beading
& with wax
boxing TECHNIQUE & the
with S two-
wax stage
pour
North
Carolina
techniq
ue
 ALTERED CAST TECHNIQUE
• Also known as corrected cast or split cast technique
ALTERED CAST : A final cast that is
revised in part before processing a
denture base—called also corrected
cast, modified cast
ALTERED CAST PARTIAL DENTURE
IMPRESSION : A negative likeness of a
portion or portions of the denture bearing
area(s) made independent of and after the
initial impression of the natural teeth.

• It is a modification of functional impression through

laboratory procedure
• Functional impression for this technique can be made using
any mentioned materials and techniques.
 Functional
Final
impression is
impression All rests
made
occupy
their
position
on cast

Edentulous Framework with

area cut on attached
master cast impression seated
on master cast
 Assembly from Borders are
underside of cast protected with
utility wax

Newly obtained
casts
 RECENT ADVANCES

• (CAD/CAM) technology has

increased the treatment
options available for
clinicians
• CAD/CAM technology can
simplify treatment
procedures and reduce time
and appointments, but
careful acquisition of data
with precise execution of
clinical procedures is
w T. Kattadiyil, et al intraoral scanning ofessential to(J success
hard tissues Prosthet Dent 2014;112:
 Conclusion

For tooth supported RPD a single pressure free impression can be taken that
record the teeth and their residual ridge in their anatomic form, but for tooth
tissue supported RPD a dual impression technique is used to equalize the
support derived from the edentulous ridge and that received from the abutment
teeth.
Thus an impression:-
- Must be able to record and relate the tissues under the same loading
- Distribute the load over as large an area as possible and
- Delineate accurately, the peripheral extent of the denture base.
• REFERENCE

• Mccracken’s removable partial dentures-11 th edn.

• Glossary of prosthodontic terms -8 th edn,
• O’Brien Dental Materials & their Selection 1997
• Stewart, rudd, kuebker : clinical removable partial prosthodontics.
• Kenneth d rudd, morrow: dental lab, procedure for removable
partial dentures
THANK YOU