thompsonleslie0 D2 | Complete Denture | Denture Impression and Treatment Sequence

First Visit

Preliminary impressions

Second Visit

Border molding and final impressions

Third Visit

Maxillo-mandibular relationships:

1. adjust max occlusal rim

2. adjust mand occlusal rim

3. selection of denture teeth

4. location of the posterior palatal seal area

Fourth Visit

Denture try-in

Fifth Visit

placement of complete denture

Laboratory procedures between visits (1-5)

1st-2nd visits:

- Pour/trim preliminary casts, fabricate custom trays

2nd-3rd visits:

- box final impression, pour/trim final casts, fabricate record bases and wax rims

3rd-4th visits:

- First: mounting casts on articulator using:

----- facebow record for the maxillary cast

----- centric record for mandibular cast

- Second: denture tooth setup starting with the anterior teeth and then the posterior

lab procedures between visits 1 and 2:

Pour/trim preliminary casts, fabricate custom trays

lab procedures between visits 2 and 3:

- box final impression, pour/trim final casts, fabricate record bases and wax rims

lab procedures between visits 3 and 4:

- First: mounting casts on articulator using:

----- facebow record for the maxillary cast

----- centric record for mandibular cast

- Second: denture tooth setup starting with the anterior teeth and then the posterior

during the 4th clinical appt, the try-in, what are the goals?

to verify:

- dental midline

- VDO and central midline

- esthetics and phonetics

after verification, dentures sent to quality assurance system for final approval before being sent to the lab where the case will be waxed, processed, finished and polished

Final Impressions

Key components include intra-oral adjustment of custom tray, border molding, and final impression.

Objectives of Impression

Support: Resistance to vertical forces; Retention: Resistance to removal; Stability: Resistance to horizontal forces; Esthetics for lips; Maintenance of oral tissue health.

Maxillary Border Molding

Includes labial vestibule, buccal vestibule, and posterior palatal seal.

Labial Vestibule (Maxillary)

Structures: Labial frenum, orbicularis oris; Movements: Lip elevation, extension outward/downward/inward; Patient instructions: Say Ouh!, Ah!, E!

Buccal Vestibule (Maxillary)

Structures: Buccinator muscle, coronoid process; Movements: Cheek manipulation (elevation, pulling in various directions); Patient instructions: Fish face, side-to-side jaw movement.

Posterior Palatal Seal

Location: Junction of hard and soft palate; Movements: Wide opening, saying ah, Valsalva maneuver; Purpose: Compensate for acrylic shrinkage, prevent food trapping.

Mandibular Border Molding

Includes labial vestibule, buccal vestibule, and alveololingual sulcus.

Labial Vestibule (Mandibular)

Similar movements to maxillary border molding; Additional consideration for mentalis muscle.

Buccal Vestibule (Mandibular)

Structures: Buccinator, masseter; Special attention to buccal shelf area; Masseteric notch formation during closure.

Alveololingual Sulcus

Sublingual crescent area, mylohyoid area, retromylohyoid area; Movements: Tongue protrusion, touching palate, side-to-side movements.

Final Impression Technique

Materials: Vinylpolysiloxanes or Polyether; Steps: Apply adhesive to tray, load impression material, place in mouth, perform border molding movements, allow setting, remove and evaluate.

Clinical Tips

Ensure proper tray extensions, verify peripheral seal, check for bubbles and voids, trim excess material with #15 Bard Parker blade, store impressions in sealed bag with water until next session.

what are the 4 house classifications of patients?

philosophical:

- one who willingly accepts the dentists judgement

exacting

- one who is involved, demanding and has many questions

indifferent

- one who has low motivation, appreciation and will easily give up

hysterical

- unstable and never satisfied

what kind of patient (house classification) has the worst prognosis?

indifferent

- one who has low motivation, appreciation and will easily give up

when selecting an edentulous impression tray, you want to be sure that what criteria is met?

it should be about 5mm larger

T or F: if only one hauler notch is included in the impression, you can continue without retaking it

FALSE

- you MUST include both hauler notches in your impression

FACT: you MUST capture retromolar pads AND retromylohyoid area on your impression

FACT: ALL IMPRESSIONS MUST BE DISINFECTED BEFORE LEAVING THE DENTAL OPERATORY