PRIMARY IMPRESSION AND PRIMARY CAST

Transcription

1 PRIMARY IMPRESSION AND PRIMARY CAST Dr. Barbara Kispélyi Associate Professor Semmelweis University, Faculty of Dentistry Department of Prosthodontics

2 SEMMELWEIS UNIVERSITY FACULTY OF DENTISTRY DEPARTMENT OF PROSTHODONTICS

3 CURRICULUM: Prosthetic treatment of the edentulos patient - Chairside steps - Labside steps From web

4

5 Completely edentoulous patient elderly Prof. Fejérdy és mtsai: A felnőtt lakosság fogelevesztési dinamiikája Magyarországon Fogorvosi Szemle 1998

6 From: Basker et al.: Prosthetic treatment of the edentulous patient

7 THE COMPLETE EDENTULOUSNESS CAUSES: 1. Biological changes - mastiction 2. Social changes 3. Changes in appearance 4. Phonation 5. Psychic From web

8 GERONTOLOGY GEROSTOMATOLOGY GEROPROSTHETIC From web

9 MEDICAL AND DENTAL HISTORY Main complaint Medical history Dental History Clinical examination - extraoral - intraoral (stomato-oncologic examination!) Dr. Károlyházy Diagnosis Treatment plan Prognosis

10 SPECIALITIES: In medical history In dental history Psychological changes Social changes From web

11 IMPRESSION (IN GENERAL): An imprint of the teeth an adjacent surfaces, structures PRIMARY IMPRESSION: negative likeness of the denture bearing tissues From web

12 - overextended - static - taken by a stock-tray

13 STOCK TRAY Requirements: - rigid - size and shape - border extension - retain its shape

14 PARTS OF THE TRAY flanges floor handle From A. Abusallamah

15 TYPES I.: STOCK TRAY Material: -Metallic (aluminum, stainless steel) -Non metallic: - Plastic tray (can be sterilized) - Plastic tray (disposable) From web

16 TYPES II.: STOCK TRAY Perforated Non-perforated From web

17 TYPES III.: STOCK TRAY size form edentulous From web

18 TRAY SELECTION

19 TRAY SELECTION I.: From web

20 TRAY SELECTION II.: 3-5 mm of clearance with soft tissues Differencies in impression materials From: Basker et al.: Prosthetic treatment of the edentulous patient and from web

21 TRAY SELECTION III.: Maxillary trays should extend slightly beyond vibrating line Mandibular trays should cover the retromolar pads From web

22 TRAY MODIFICATION: Trays can be modified with wax or compound to extend the tray if desired From web

23 IMPRESSION MATERIALS FOR PRIMARY IMPRESSION

24 IMPRESSION MATERIALS FOR PRIMARY IMPRESSION: Alginate irreversible hydrocolloid Impression compound Elastomer impression materials Impression plaster From web

25 ALGINATE Inexpensive Easy to manipulate and secure Requires no special equipment Good viscosity high viscosity type is the best Dimension stability between circumstances Usually found in a box or In a bag basically presented as powder & we mix it with water with a measure cup

26 WORKING TIME AND SETTING TIME Working time: Regular set: 2-3 minutes Fast-set: minutes Setting time: Regular set: 2-5 minutes Fast set (by adding materials by the factory): 1-2 minutes From web

27 INFLUENCE THE WORKING AND SETTING TIME: water temperature Powder : Liquid From web

28 TROUBLESHOOTING ALGINATE IMPRESSION Premature set (hot water) Slow set (cold water) Voids (air bubbles with the mixing) Distortion (not accurate as may be we remove the impression while it still liquid) Excess alginate at back of tray(may be more alginate is placed) From web

29 PREPARATION OF THE MOUTH: 1. Before dentures are made Conditions involving the oral mucosa: - denture stomatitis - inflammatory papillary hyperplasia of the palate - angular cheilitis Conditions involving the bone: - Sharp and irregular bone - Undercat ridges - Tori - Pathology within the bone 2. Immediately before the impression From: Basker et al.: Prosthetic treatment of the edentulous patient and web

30 PATIENT PREPARATION BEFORE THE IMPRESSION: Correct position of the dental chair and patient Dry the mucosa Don t let patient close Prof. Fábián és mtsai: A fogpótlástan alapjai

31 TAKING THE IMPRESSION

32 MEASURING POWDER Fluff (shake) the powder, measure, tap and flatten the scoop with powder Use three scoops for syringe impressions From web

33 PRIMARY IMPRESSION: Find the correct position of the dental chair and patient Support the tray during setting - do not leave the patient Movement causes distortion Prof. Fábián és mtsai: A fogpótlástan alapjai

34 IMPORTANT CONSIDERATIONS TO ENSURE ACCURATE IMPRESSION 2-4 mm bulk material in tray Snap action removal from mouth Allow extra 1-2 minutes after setting to improve tear strength Stored in a moist environment to avoid loss of water evaporation and deformation Disinfect in less than 10 minutes to avoid dimensional instability Alginate syringe technique From web

35 ALGINATE SYRINGE TECHNIQUE: Retromylohyoid area Hamular notches Retrozygomal area From web

36 PRIMARY IMPRESSIONS FINAL STEPS: Evaluate impression - Criteria for acceptable alginate impression: - All anatomical landmarks and relevant soft tissue recorded - No large voids - Free of debris - No distortion Rinse thoroughly with water and spray with disinfectant to coat all surfaces, Hold in water From web

37 THE RESULT: From web

38 LABORATORY STEPS

39 CAST: The cast is a positive likeness of the denture bearing tissues PRIMARY CAST: Made according to a primary impression. Special tray is constructed onto it (after outlining the borders of the special tray at the dental office) Dr. Károlyházy

40 POURING A CAST Weighing powder, measure water Vacuum mix (less time, stronger cast) From web

41 POURING A CAST Casts should be a minimum of 12 mm in thinnest part Separate the alginate impression from the stone cast after 45 minutes From web

42 TRIMMING CASTS Trim the base on the model trimmer parallel to the residual ridges Leave the vestibular reflection intact for making a special/custom tray

43 THANK YOU FOR YOUR ATTENTION!

44 SPECIAL TRAY Dr. Barbara Kispélyi Associate Professor Semmelweis University, Faculty of Dentistry Department of Prosthodontics

45 Primary impression Primary cast Special tray From web

46 OUTLINE Primary impression Primary cast Dr. Kivovics From: Basker et al.: Prosthetic treatment of the edentulous patient and from web

47 ANATOMICAL LANDMARKS OF THE EDENTULOUS MAXILLA AND MANDIBLE

48 Mucous membrane From web

49 ANATOMICAL LANDMARKS AND THEIR CLINICAL SIGNIFICANCE IN EDENTULOUS MAXILLARY ARCH

50 MAXILLA LABIAL FRENULUM, BUCCAL FRENULUM From web

51 LABIAL AND BUCCAL VESTIBULE From web

52 DISTO-BUCCAL AREA CORONO-MAXILLARY SPACE

53 HAMULAR NOTCH From: Basker et al.: Prosthetic treatment of the edentulous patient

54 VIBRATING LINE From: Basker et al.: Prosthetic treatment of the edentulous patient

55 HARD PALATE From: Basker et al.: Prosthetic treatment of the edentulous patient

56 RESIDUAL ALVEOLAR RIDGE From: Basker et al.: Prosthetic treatment of the edentulous patient

57 RUGAE AND INCISIVE PAPILLA From: Basker et al.: Prosthetic treatment of the edentulous patient

58 MAXILLARY TUBEROSITIES From web

59 ANATOMICAL LANDMARKS AND THEIR CLINICAL SIGNIFICANCE IN EDENTULOUS MANDIBULAR ARCH From web

60 MANDIBLE LABIAL FRENULUM, BUCCAL FRENULUM, LINGUAL FRENULUM From: Basker et al.: Prosthetic treatment of the edentulous patient

61 LABIAL AND BUCCAL VESTIBULE From web

62 RETROMOLAR PAD From: Basker et al.: Prosthetic treatment of the edentulous patient

63 EXTERNAL OBLIQUE RIDGE From web

64 BUCCAL EXTENSION From web

65 LINGUAL POUCH From web

66 SPECIAL TRAY - Clinical applications - Parts - Types - Laboratory steps

67 Clinical application: SPECIAL TRAY: Completely edentulous patient Subtotal edentulous patient Removable partial denture Special anatomical situations Implantology Reconstruction prosthesis

68 PURPOSE OF SPECIAL TRAY: Minimize: Impression material distortion Uniform thickness Rigid tray Tisssue distortion Less viscous material Accurately adapted tray From: Basker et al.: Prosthetic treatment of the edentulous patient

69 AUXILIARY HANDLES: Parts: Intraoral Extraoral From web

70 Types: TYPES OF SPECIAL TRAYS: 1. Close fitting Used with very low viscosity impression materials, since it provide a thin layer after setting: - Zn-eugenol paste - very low viscosity elastomers 2. Spaced Used with high viscous impression material (3mm) - alginate - medium or high viscosity elastomers From web

71 CLOSE FITTING TRAY: From web

72 SPACED TRAY: From web

73 Materials: Resins: Thermoplastic materials - sellak SPECIAL/CUSTOM TRAY - Visible light curing resins - Self curing resins - Heat curing resins From web

74 RESINS: Rigid, retain its shape Not thermoplastic Types - self-curing (clear) - heat-curing (clear) - visible light curing

75 Sellak: Breakable (undercuts, wire-reinforcement) Thermoplastic (green stick, oroplastic impression materials) Cheap

76 Special tray: Sellak Light curing Self curing Heat curing Precision

77 SELLAK SPECIAL TRAY:

82 FÉNYREKÖTŐ AKRILÁT EGYÉNI KANÁL KÉSZÍTÉSÉNEK LÉPÉSEI:

84 VISIBLE LIGHT CURING RESIN SPECIAL TRAY:

89 SELF-CURING RESIN (CLEAR) SPECIAL TRAY:

95 SELF-CURING RESIN (CLEAR) SPECIAL TRAY: Molding process: 3-6 Bar 40 C minute

98 HEAT-CURING RESIN (CLEAR) SPECIAL TRAY:

100 HEAT-CURING RESIN (CLEAR) SPELIAL TRAY: C minutes

102 CONCLUSION: The best: Heat-curing resin (clear) special tray

103 OLD DENTURE - USE AS A SPECIAL TRAY! RELINE REBASE From: Basker et al.: Prosthetic treatment of the edentulous patient