P L AC E M E N T O F T H E

POSTERIOR TEETH
 P L AC E M E N T O F T H E P O S T E R I O R
TEETH
• Masticatory movements in the dentate state
are controlled by the cooperation of the
teeth, TMJ and muscles which are regulated
by the central nervous system. If the teeth are
lost, the masticatory system will be disrupted,
but the muscle activity continues as before. So,
if the occlusion restored using artificial teeth,
masticatory movements will recover after
after a short time.
• Making a successful denture requires the
artificial teeth placed in the position of the
natural teeth. However, regarding the
artificial tooth arrangement, generally
relationship of the teeth to the ridge is
considered and the lever system which is
created between teeth and ridge seems to
be the only thing that dentists pay attention
to.
P L AC E M E N T O F T H E P O S T E R I O R
TEETH
• The optimum denture stability is obtained when the artificial
teeth are placed on, or lingual to the residual ridge.
• However, the alveolar ridge resorption is to the lingual direction
which means the position of the artificial teeth is positioned
lingually. The tongue space will be decrease. Besides, the
support of lips and cheeks are inadequate. As a result, the
tongue will push the denture and the denture become unstable,
the phonetics and esthetics will also be severely affected.
 T H E P L AC E M E N T O F T H E P O S T E R I O R
TEETH
• The natural teeth are known to erupt in a place where the inward forces of the lips and
cheeks are balanced by the outward forces exerted by the tongue. Therefore, the
movements of the surrounding tissues influence the position of the natural teeth.
• After eruption, the natural teeth continue to be in a harmony with the surrounding tissues in
this position
THE LEVEL OF
OCCLUSAL PLANE
• The level of upper teeth varies but the lower teeth position must
be placed in proper place because of the stability and
effective chewing. The tongue brings the food onto the occlusal
plane and than holds the food between upper and lower teeth.
The tongue press the food outward and the buccinator presses
inward.

• The incisal edges of the anterior teeth placed at the level of the
lower lip. The level of the occlusal plane is where the natural
teeth were placed, that is the functional level in which the cheek
and tongue can cooperate to perform mastication smoothly.
INCISION BY THE
ANTERIOR TEETH
• If the teeth are arranged by referring the natural tooth
position, the anterior teeth will be placed much more
anterior to the alveolar crest. If the food is bitten using
these anterior teeth, the posterior border of the denture is
drop easily due to the leverage, with the fulcrum of the
crest.

• The direction of the biting force with the anterior teeth is

similar to that of the removing denture, so that the
antagonizing force is too small.

• So the patient is instructed about the mentioned mechanism

and told not to bite with the anterior teeth.
• But some patients bite the foods with anterior teeth without
dropping the denture. How is possible?

• The patient can control the magnitude and the direction of

the force during biting, and they are somewhat able to
resist the dislodging force of the denture.

• When the denture wearers become accustomed to dentures,

during biting, they seem to support the upper denture by
the dorsum of the tongue and press the lower denture
downward using the tip and ventral surface of the tongue.

• This will enhance the stability of the denture. However, the

anterior ridge, that can’t tolerate excessive force, shows
increased bone resorption when pressure is applied, thus it
is better not to use he anterior teeth for incising.
• The anterposterior relationship of the upper
and lower anterior teeth, is the horizontal
overlap is decided by the residual ridge.

• The lower and anterior teeth should not be in

contact in centric occlusal position in any case.

• If they contact, the denture losses its retention.

• Besides, the contact between anterior teeth

causes bone resorption at the anterior part
because of the excessive forces.
• Mark the midline on the wax rim
according to the patient face.
Midline must be divided the face
into two equal part.
• After completing the maxillary wax
rim record base. The next step is
making the mandibular wax rim
record base.
• The wax rim is placed at the center
of the record base.
• Posteriorly, the occlusion rim
intersects 1/2 - 2/3 up the
retromolar pad.
• Anteriorly, the wax rim is place at
the same level with the lower lip.
• Regulate the mandibular wax rim
that touches the all part to the
maxillary wax rim at the same time.
Determination of
the vertical
dimension
Determination of the vertical
dimension
Refers to the length of the face.

It is maintained either by the occlusion of the teeth and named as

‘Occusal vertical dimension’. This is the vertical dimension in which
the centric relationship is recorded and transmitted to the articulator.
Or maintained by the balanced tonic contraction of the opening and
closing muscles of mandibular movements and named ‘vertical
dimension of physiologic rest position’.
There is a space between teeth on rest position and varies between
2-10 mm. This space is called ‘free way space’
 Determination
of the vertical
dimension

Vertical dimension of
rest position =
Occlusal vertical
dimension + Free way
space
Determination of
the vertical
dimension
• These two measurable lengths of the face are
important guides in making maxillomandibular
relation records. However, rest position of the
mandible is not constant throughout life.
• It can be affected by short-term variables, and
by long-term variables.
 • The position of the head affect the vertical dimension.

Head tilted back: Increased

Head tilted forwards: Reduced

Short term • The hyperactivation of the neck muscles that elevates

the neck decrease the vertical dimension.
variables
• Stress: Reduced

• Pain or new extruded teeth will make the vertical

dimension reduced.

• Drugs: Variable
Long term variables
• If the same dentures are worn for many years and are not
maintained, a reduction in the occlusal vertical dimension
occurs as a result of alveolar resorption and occlusal wear. The
rest position of the mandible adapts to this change and takes up
a position closer to the maxilla. As a result, the vertical
dimension decreased.
• Where these changes have taken place in young patients, it is
often possible to recover much of the lost vertical dimension
when new dentures are constructed. • However, with the
elderly patient, any attempt to restore the occlusal vertical
dimension to its original level may be met with problems.
• Bruxism make hypertrophic muscles which decrease the vertical
dimension.
 Establishing VD place the patient in an upright position.

Place marks on the tip of nose and the tip of the chin, on the greatest height of curvature.

Determination Patient sits comfortably and looking straight ahead.

of vertical Instruct the patient to lick lips and swallow and get relax and mandible comes to rest
position.

dimension- Measure the distance between two reference points.

Niswonger Phonetics Repeat the letter “mm-mm” and relax.

Method Facial Expression recognize the pts relaxed facial expression when the jaws are at rest.

Measure the distance between two points which were previously determined. The distance
must be 2-3 mm higher than the distance when the wax rim touch to each other.

*No one method for determining rest position can be accepted as being valid for all ptatients
therefore, it is advisable to use several methods and compare the results
Determination of vertical
dimension-
Willis Method

• Willis' method is the other VD

determination way, where the upper
facial height from the pupil of the eye
to the rima oris, is presumed to be
equal to the lower facial height, which
is the vertical measurement from the
base of the nose to the lower border of
the chin, when the teeth are in
occlusion.
Determination of vertical dimension-
Equal third conceps Method

• The face is divided into three equal

thirds.
• Chin-sunasal
• Sunasal-glabella
• Glabella-forehead
 THE EFFECT OF
MİSDETERMİNATİON
OF VERTİCAL
DİMENSİON
EXCESSIVE
VERTICAL
Clicking of the teeth
DIMENSION
(INADEQUATE Facial distortion, tense strained appearance
INTEROCCLUSAL
REST SPACE)
Difficulty on closing lips

Difficulty on swallowing

Soreness and discomfort under the denture

Increased ridge resorption due to occlusal trauma

INADEQUATE
VERTICAL
Reduced interarch distance when the teeth are in
DIMENSION
occlusion
(EXCESSIVE Overclosure is potentially damaging to the TMJ
INTEROCCLUSAL
REST SPACE)
Normal tongue space is limited

Facial distortion, chin is closer to nose, commissure

of the lips turns down, lips loose their fullness
Muscles of facial expression loose their tonicity,
face appears flabby
Angular cheilitis is sometimes attributed to
overclosure
DETERMINATION OF VERTICAL DIMENSION

• At the last stage just check the spelling of ‘S’.

• Count from 60-70.
ANTERİOR TEETH
SELECTİON
• Anterior teeth are primarily
selected to satisfy esthetic
requirements.
• Posterior teeth are primarily
selected to satisfy
masticatory requirements/
occlusion.
• Morphology • There are no rules but anatomic landmarks
• Size and manufactures aids that can be used as
guides.
• Color
• Tooth placement
GUIDES
• Preextraction records: evaluate the patient’ s old photos and
evaluate the patient’ s diagnostic casts.
• Postextraction records: Evaluate the existing dentures’ tooth
size, placement, shade, VDO, and occlusal plane.
• Patients’ facial characteristics and arch size.
• Before making a new denture, first evaluate the satisfactory
and dissatisfy parts of the old denture (color, shape…)
• Careful evaluation of existing dentures Patient’s perception
of their appearance. Your perception of the esthetic needs of
the patient.
GUIDES- TOOTH FORM
• The facial form of the patient classified into
square, ovoid, round or triangle. The form of
the teeth should be in harmony with the form
of face; square teeth are used for square face
and so on.
TOOTH FORM

• The selection of teeth into an esthetic system governed by the

age , sex and personality of the patient.
• Sex: For male, rugged with square teeth and bold central
incisors. For female, pronounced curvatures, rounded point
angles
• Personality: vigorous or delicate “ Personality tooth ” the
maxillary lateral incisors vary more in size, form and
position than any other tooth
• Age: For young, tapered, ovoid, rounded teeth.
Middle old, square, sharp corners.
• With the increasing age, the
teeth incisal shape becomes
plane surfaces, the rounded
distal and mesial sides
becomes sharpe corners.
TOOTH COLOR

The color of the artificial tooth changes from person to person. The color shows varieties depends
on:
• hair color,
• eyes’ color,
• race,
• skin color.
• patient desire
Dark and opaque teeth should be used for elderly patient, light and translucent used for young
patient.
TOOTH COLOR
• Check the shade of the patients existing denture and
discuss their desires with respect to the tooth shade.
• Would they prefer the same shade, a shade that is lighter
or darker.
• Place the guide up against the pts. face and select a shade
that blends with their skin tone, hair color and eye color.
• Once you have selected a color allow the patient view it
against their lip with a mirror and get their approval.
SIZE OF THE ANTERIOR TEETH

• Must harmonize with face and arch size.

• Any disproportion in arch size influences the length, width and position of the
teeth.

• Vertical distance between the ridges use a tooth long enough to minimize the
display of the denture base.

• Mark high lip line and canine lines on the occlusion rim at the time the jaw relations
are recorded.
• The canine-canine dimension is determined by the corner lines of the mouth.

• These guidelines provide information about the gingivoincisal length and total
mesiodistal width of the maxillary six anterior teeth.
SIZE OF THE ANTERIOR TEETH

• Sometimes modifying the shape, size and color may be

necessary.
• If patient has an existing denture, the information about
the tooth characteristics can be obtained from it.
• In every case, the consent of the patient and any
accompanying must be obtained.
THE PLACEMENT OF
ANTERIOR TEETH
• The placement of the artificial teeth is arranged in the
position previously occupied by the natural teeth.
• The patient will become easily accustomed to this position
because the tactile sensations from the tongue, cheeks and
lisps are not altered from that of the dentate stage.
• If this position is different too much from the previous
position, the tactile sensations will be altered causing
difficulties in speaking and eating.
• So, the lost teeth are simply replaced in their original position
with artificial teeth.
THE PLACEMENT OF
ANTERIOR TEETH
• The position was tentatively established during the clinical
refinement of the maxillary occlusal rim to provide adequate
lip support and proper phonetics.
• The upper lip must be supported adequately.
• Deep wrinkles and small vertical lines on skin emphasize the
the aging appearance. Furthermore, the lips become more
thinner and the nasolabial fold changes directions to
approach the corner of the mouth and the demarcation
between lips and cheeks becomes unclear.
THE PLACEMENT OF ANTERIOR TEETH
• After the extraction, resorption of maxilla is from
buccal-labial side towards the lingual side.
• Consequently, the alveolar crest will be positioned
posteriorly according to the bone resorption.
• Many clinician ignore the resorption pattern and
think that the artificial teeth must be placed the crest
of the ridge, leading the stability of the denture.
• This is the main reason of the improper lip support.
However, this is not only worsening the esthetic
outcomes but also decrease stability and retention.
• The incisal papilla is the most stabile
anatomic landmarks. The provides a good
guide for the horizontal position of the
natural teeth.
• The labial surface of the natural central
incisors are placed 8-10 mm in front of the
incisive papilla.
• Also the incisal papilla is placed on the
line passing between the canines.
SMILE LINE

Follow contour of lower lip

Avoid reverse smile line

Young female has greater curvature of

smile line

Older males have less curvature of smile

line
PHONETIC
CONSIDERATION
• Labiodental sounds: “f ” “v” are produced by
contact between the maxillary incisors and the
posterior one-third of the lower lip.

• Linguodental sounds: “th” are produced by

extending the tip of the tongue 3-6 mm beyond the
incisal edges of the upper and lower anterior teeth
PHONETIC CONSIDERATION

• Linguopalatal sounds: The “s” sound is made by contact between the tip of the tongue and the
palate at the rugae area with a small space for the escape of air. If the space is too small a
whistle usually results and if the space is too broad and thin, the “s” sound is replaced by the
“sh” sound which sounds like a lisp.
LOWER ANTERIOR TEETH
POSITIONING
• After extraction, the mandibular bone resorption occurs to
the lingual direction, the crest of the ridge moves to
lingually.
• Therefore, in lower denture, the labial surface of the
anterior teeth situated anterior to the denture border.
• Thus, in an edentulous case, the lower anterior teeth must
be arranged labially to the so-called alveolar crest to
replace the teeth in the natural teeth position.
Complete Denture
 Complete denture

• Complete dentures a kind of removable

prosthesis which is made to the patient who
has no teeth.
 Complete Denture

• In order to properly construct a denture, one

must understand the anatomy and
physiology of the edentulous patient. A
thorough knowledge of the origins and
kinetics of the muscles of mastication, facial
expression, tongue and floor of the mouth is
essential.
 Consequence of tooth loss
• Maxillary loss is in vertical and
palatal direction in first year is
greater (0.1 mm/year) but • Residual ridge resorption
different from mandibular bone • Decreased masticatory function
resorption, that is 4 times higher • Loss of facial support and muscle
than maxillary. forces during tonus
mastication with natural
dentition may be up to 175 lbs; • Potential psycho-social effects
complete dentures, 22 to 24 lbs
 • The goals of dentures are to minimize the affect of
these functional, aesthetic and psychological
compromises.
• A denture wearer’s ability to chew food is reduced
to 1/4 or 1/7 of adults with natural dentitions
depending on the ages of the subjects and type of
Consequence food, however edentulous patients are quite
of tooth loss satisfied with their complete dentures, only 5-20%
of them are not.
• Denture satisfaction is influenced by various factors,
including denture quality, the available denture
bearing area, the quality of dentist-patient
interaction, previous denture experience and the
patient’s personality & psychologic well being .
Denture satisfaction is influenced by
various factors including

ü denture quality,
ü the denture bearing area available,
ü the quality of dentist-pt. interaction,
ü previous denture experience
ü the patient’s personality & psychologic well being.
Patient satisfaction also
depends upon expectations
and some patients may have
very unrealistic expectations.
For this reason, it is important
to guide and educate the
patient.

• Fully Satisfied
• Moderately Satisfied
• Dissatisfied
House Philosophical – Rational, sensible, organized and
overcomes conflicts (Expectations are real)

Classification Exacting – Methodical, precise and accurate; places severe

of Patients
demands (Must reach an understanding before starting
treatment)

Indifferent – Apathetic, uninterested, uncooperative and

lacks motivation; blames dentist for poor health; pays no
attention to instructions (Unfavorable prognosis)

Hysterical – Emotionally unstable, excitable, apprehensive

(Psychiatric help may be required)
 ANATOMY OF
MAXİLLA AND
MANDIBULA
In order to construct a ideal
proper denture, it is
mandatory to understand
the anatomy of mouth and
physiology of the
edentulous patient .
 • Retention : Resistance to vertical
displacement away from the bearing
surfaces
• Stability : Resistance to lateral displacement
• Support : Factors of the bearing surfaces
that absorb or resist forces of occlusion

Key Concepts in
Prosthodontics
• When the key anatomic landmarks and their
role with respect to retention, stability,
support, preservation and esthetics are
mastered, dentures can be fabricated as
integral parts of each patient’s oral cavity
and not just mechanical artificial substitutes.
 • Frenum are folds of mucous membrane and do not contain significant muscle
fibers. High frenum attachments will compromise denture retention and may
Maxilla-Anatomic require surgical excision (frenectomy).
Landmarks • Buccal vestibule when properly filled with the denture flange greatly enhances
stability and retention .
 • Canine eminance – This
prominent bone provides
denture support . A square
arch prevents a denture from
rotating and is thus the best
for denture stability .
• Incisive papilla – Is a pad of
fibrous connective tissue
overlying the orifice of the
nasopalatine canal . Pressure
in this area will cause a
disruption of blood flow and
impingement on the nerve,
causing the patient to
complain of pain or a burning
Maxilla-Anatomic sensation. The denture should
be relieved over this area.
Landmarks
Maxilla-Anatomic
Landmarks
• Tuberosity is an important
primary denture support
area . It also provides
resistance to horizontal
movements of the denture.
• Posterior palatal seal area is
distal to the junction of the
hard and soft palate at the
vibrating line .
Maxilla-Anatomic • Rugae is a raised areas of dense connective tissue in the anterior 1/3 of
the palate. This area resists anterior displacement of the denture and is a

Landmarks
secondary support area.
• Hamular Notch, this narrow cleft extends from the tuberosity to the
pterygoid muscles. The pterygomandibular ligament attaches to the
pterygoid hamulus which is a thin curved process at the terminal end of
the medial pterygoid plate of the sphenoid bone. The hamular notch is
critical to the design of the maxillary denture. Improper molding of this
area could lead to soreness and loss of retention.
Maxilla-Anatomic
• Coronoid process, this anatomic structure belongs to the mandibula and
the movement of the coronoid process (open wide, protrude and lateral
movements) contoured the width of the distobuccal flange.

Landmarks • Fovea palatina, usually two, slightly posterior to the junction of the hard
and soft palates.
• Minor salivary glands, in the posterior third of the hard palate the tissue
is very glandular and displaceable. The impression surface may appear
irregular as the glandular secretions will adhere to the impression
material.
Maxilla-Anatomic
Landmarks

• Hard palate- consists of the two

horizontal palatine processes and
appears to resist resorption. For this
reason, it is a primary support area for
the maxillary denture.
• Midline palatal suture- extends from
the incisive papilla to the distal end of
the hard palate. The overlying mucosa
is tightly attached and thin, relief is
usually required to prevent soreness.
The underlying bone is dense and often
raised forming a torus palatinus.
Maxilla-Anatomic
Landmarks

• Major palatine foramen- the orifice of

the anterior palatine nerve and blood
vessels . Relief in this area is usually not
required due to the abundant overlying
tissues.
 Ideal Maxillary Ridge

• Abundant keratinized attached tissue

• Square arch U-shaped in cross-section
• Moderate palatal vault
• Absence of undercuts
• Frenal attachments distal from crestal ridges as much as possible
• Well defined hamular notches
Mandible-Anatomic
Landmarks

• Labial frenum, histologically and

functionally the same as in the maxilla,
mucous membrane without significant
muscle fibers. Located behind the lower
lip on the midline of mouth.
• Labial vestibule, limited inferiorly by
the mentalis muscle, internally by the
residual ridge and labially by the lip. (A
sulcus located between mental
foremans)
Mandible- • Alveolar ridge is a secondary support area. This is the anatomic landmarks
where teeth used to be. High rate of resorption when excessive pressure is
Anatomic applied to this area.
• Buccal frenum, histologically and functionally the same as in the maxilla,
Landmarks faced to the cheek. (Located behind the mental foreman)
Mandible-Anatomic
Landmarks
• Buccal Shelf – bordered externally by the external oblique line and
internally by the slope of the residual ridge. This region is a
primary stress bearing area in the mandibular arch and a primary
supporting area because it is parallel to the occlusal plane and the
bone is very dense which makes it relatively resistant to
resorption.
• The greater access to the buccal shelf makes more support for the
denture.
• The size and position of the buccal shelf varies relative to the
degree of alveolar ridge resorption .
Mandible-Anatomic Landmarks

• External Oblique Line – a ridge of dense

bone from the mental foramen,
coursing superiorly and distally to
become continuous with the anterior
region of the ramus.
 • Mental Foramen – the anterior exit of the mandibular canal and
Mandible-Anatomic the inferior alveolar nerve.
• In cases of severe residual ridge resorption, the foramen occupies
Landmarks a more superior position, and the denture base must be relieved
to prevent nerve compression and pain.
 • Retromolar pad is a relatively unchanging structure on the mandibular denture
bearing surface.
Mandible-Anatomic • The pad contains glandular tissue, loose alveolar connective tissue, the lower margin
of the pterygomandibular raphe, fibers of the buccinator, and superior constrictor
Landmarks muscles and fibers of the temporal tendon. The bone beneath does not resorb
secondary to the pressure associated with denture use. It is one of the primary
support areas.
Mandibular- • Masseter Groove – the action of the masseter muscle
reflects the buccinator muscle in a superior and medial
direction . The distobuccal flange of the denture should

Anatomic be contoured to allow freedom for this action otherwise

the denture will be displaced and patient will experience
soreness in this area.
Landmarks
Mandibular- • Mylohyoid Ridge; note the position of the mylohyoid
ridge as it varies relative to the degree of alveolar ridge
resorption before treatment. The mylohyoid muscle is

Anatomic attached here.

• Mylohyoid muscles formed the floor of the mouth and

Landmarks determines the lingual flange extension of the denture.

Mandibular- • Geniotubercle (Mental Spines)- present on the anterior
surface of the mandible and serve as the attachment
sites of the genioglossus and geniohyoid muscles . In
Anatomic patiens with severe ridge resorption the geniotubercles
may cause discomfort if they are exposed to the denture

Landmarks base.
Mandibular- • Lingual frenum – overlies the genioglossus muscle,
which takes origin from the superior genial spine. It
attaches the tongue to the lingual part of mandibula.

Anatomic • Sublingual Folds- formed by the superior surface of the

sublingual glands and the ducts of the submandibular

Landmarks glands
Mandibular-Anatomic
Landmarks
• Retromylohyloid space; lies at the distal
end of the alveolingual sulcus. Bounded
medially by the anterior tonsilar pillar,
posteriorly by the retromylohyoid
curtain which is formed posteriorly by
the superior constrictor muscle,
laterally by the mandible and
pterygomandibular raphe, anteriorly by
the lingual tuberosity of the mandible
and inferiorly by the mylohyoid muscle.
• The retromylohyoid space is very
important for denture stability and
retention.
Ideal Mandibular Ridge
COMPLETE DENTURE
FABRİCATİON
Preliminary
Impressions
• Impression is the ‘Copy the anatomy of
the structures using impression materials’
• Taking preliminary impression is used for
diagnosis and construction of custom
impression trays. The impression must
include the anatomic landmarks.
• First, a proper stock tray must be choosen
and control the borders of the tray into
the mouth. If necessary, extend the
border using wax.
• Warm the wax using fire or hot water,
cover the tray’s border and insert into the
mouth and reshape according to the
anatomy.
Preliminary
Impressions

• Alginate, irreversible hydrocolloid

impression material, is used for taking
preliminary impressions.
• Mix the alginate with water in a plastic
bowl using a spatula. Use less for the
maxilla to get thicker mix. It helps to
avoid from vomiting for the patients.
• Load the try, insert to the patients
mount and seat the try and hold it
firmly.
• Applied no pressure on to the tray.
Preliminary
Impressions

• Seating the tray on the mouth from

posterior to the anterior direction, this
prevents the escape of alginate to the
respiratory trac.
• Remove the tray when set is completed.
• Pour the impression with gypsum
immediately because of the shrinkage.
Custom tray
fabrication
• After forming the models, record the depth of
sulcus with pencil and scribe additional line 1mm
below the first scribe (bottom of the sulcus).
• Block-out the undercuts using wax.
• Isolate the model using separating material and
then coat the model 1-layer wax to form a space for
the impression material and cut the wax from the
second scribe.
• Adapt the light cure resin tray material on wax and
cure the
Custom tray
fabrication

• Isolate the model using separating

material and then coat the model 1-layer
wax to form a space for the impression
material and cut the wax from the
second scribe.
• Adapt the light cure resin tray material
on wax and cure after trimming of the
borders with knife.
• After curing, trim the borders with bur.
Custom tray
fabrication

• Tray periphery should be 2 -3 mm thick.

• The edges should be rounded.
• The rest of the tray should be about 1-2
mm in thickness.
• Tray handle should be 10mm high and
15mm wide and extend straight down
from the alveolar ridge.
Custom tray control
• First, patient must be informed not to
use the existing denture during 24 hours
before the final impression.
• Try the custom tray and adjust the length
of the flanges (borders) 2-3 mm short
from the vestibule depth.
• Check the adaptation of the tray to the
tissues.
• The needed space for the accurate
impression is 2-3 mm.
Custom tray
control
For Maxillary Impression tray we must
check;
• Posterior palatal seal area
• Incisive papilla
• Buccal and labial vestibule
• Hamular notch
• Mobile, hypertrophic tissue
• Palatal torus
Custom tray control
• The tray must extend 2-3mm beyond the
vibrating line and connect with the hamular
notch border.
• This border-line is essential to get the
hermetic seal (to close the air passage).
Custom tray control
• Check the frenulum clearance.
• Check the extension along the vestibule
Custom tray control
For Mandibular Impression tray we must check;
• Retromolar pad
• Retromylohyoid space
• Buccal shelf
• Vestibules
Custom tray control

• The extension should be 2-3 mm short from

the frenum and the depth of the vestibules.
• Outline the retromolar pad with a pencil.
• Check that the tray properly extends onto the
pad and does not disturb upon the masseter
groove.
Final Impression
 • Preservation: The loss of the stimulation of the
natural dentition the alveolar ridge will resorb.
• Support: Maximum coverage distribute the
mastication force to a large area.
• Stability: Close adaptation to the underlying
mucosa is most important to reduce the
The horizontal movement of the denture.
objectives • Esthetics: Border thickness should be varied to
restore facial contour and proper lip support.
• Retention: Atmospheric pressure, adhesion
(bond strength between different materials),
cohesion (bond strength between same
material) (depends on peripheral seal)
mechanical locks, muscle control.
 There are three kinds of impression
techniques:
• Pressure applied technique
• Non-pressure applied technique
Impression • Selective pressure technique

techniques
The basic difference of final impression
techniques is the record of the soft tissue in a
functional position, an undisplaced or rest
position.
 • It is generally used for maxilla.
• It was logical to make impressions that
Impression would press the tissues in the same manner
techniques as chewing forces, thus ensuring contact
during chewing stroke.
• But at rest position, the tissues distord and
Mucocompresive change their structure and this makes the
technique- dentures misfit.
impression applied • Furthermore, these abused tissues will not
be able to long maintain the shape on the
technique impression day.
Impression If soft tissues that are displaced and recorded
in this position, they attempt to return to the
techniques original position when the forces are released.
The dentures will be unseated from their
bases by this tissue action. When tissues are
Mucocompresive held in a displaced position, the pressure
technique- limits the normal blood flow . When normal
impression applied tissues are deprived of their blood supply, the
technique result is resorption.
 The other name is pressureless impression.
This principle advocate the application of
impression without pressure but in practice it
Impression is not useful because of the lack of contact
techniques between tissue and denture.
There must be hermetic closure and adhesive
adhesion to obtain the stability and
Mucostatic resistance.
technique The vibration line is a pressable tissue and the
denture must be pressing the soft tissue to
avoid air-passage in order to get resistance.
Impression This impression technique is a combination of
extension for maximum coverage within tissue
techniques tolerance with light pressure or intimate
contact with the movable, loosely attached
tissues in the vestibules. The impression is
Selectivepressure refined with minimum pressure utilizing a
technique wash of light body impression material.
 After making the border seal, an impression of
the full mouth is taken using either zinc-oxide-
eugenol or medium body polyvinyl siloxane
(PVS) impression material.
Impression On setting, the impression is removed from
techniques the mouth and the extend of the displaceable
tissue is drawn on the impression surface. This
area, and the equivalent area of the tray, are
removed using a bur.
Selectivepressure
Holding the modified tray and impression
technique insitu, use a low-viscocity material (plaster or
light bodied PVS) and syringe these onto the
displaced tissue to record them in minimal-
displaced position.
Selective-pressure technique
Record Base and
Wax Rim
Fabrication
 The term centric relation (CR) is generally considered
to designate the position of the mandible when the
condyles are in an orthopedically stable position.
Earlier definitions described CR as the most retruded
position of the condyles. This position was
determined mainly by the ligaments of the TMJ, it was
described a ligamentous position.
It was a reproducible mandibular position that could
Centric Relation be used during the construction of complete
dentures.
At that time, it was considered the most reliable,
repeatable reference point obtainable in an
edentulous patient for accurately recording the
relationship between mandible and maxilla and
ultimately for controlling the occlusal contact pattern.
 The major muscles that stabilize the TMJs are
the elevators. The direction of the force
placed on the condyles by the masseters and
medial pterygoids is superoanterior.
Although the temporal muscles have fibers
that are oriented posteriorly, they
Centric Relation nevertheless predominantly elevate the
condyles in a straight superior direction.
These three muscle groups are primarily
responsible for joint position and stability;
however, the inferior lateral pterygoids also
make a contribution.
 Centric Relation
Tonus in the inferior lateral
pterygoids positions the condyles
anteriorly against the posterior
slopes of the articular eminences.
The complete definition of the most
orthopedically stable joint position,
therefore, is when the condyles are
in their most superoanterior position
in the articular fossae, resting against
the posterior slopes of the articular
fossae with the discs properly
interposed.
Anatomic
Planes
There are three planes
Sagittal plane (separate left-right)
Horizontal plane (separate up-down)
Frontal plane (separate front-back)
 Record base

• Record base is an interim denture base

used to support wax rims.
• An interim denture base used for
making centric relation records.
• An interim denture base used in making
trial dentures.
 Characteristics of an
Ideal Record base
• Strength and rigidity
• Accuracy. The record base should not rock
on the cast.
• Smooth, rounded well polished borders
• Thickness of borders and palate must
resemble those of the finished dentures.
Palate must be 1-2 mm thick; thickness
and contour of the denture borders are
defined by the land of the master cast.
The record base must not extend onto the
land of the cast.
 Materials Used for Making
Record Base
• Tray resin
Brittle but very accurate
• Autopolymerizing acrylic resin
Strong but less accurate
• Light cure resin
Accurate but brittle and expensive
Fabrication of Record Bases and Wax Rims

• Block out the undercut areas, ruga

region and other irregular areas.
• Isolate the master model using
separating medium.
• Using PMMA, make a record base
which adapted onto the model
accurately.
• After curing, remove the record base
from the model gently.
 Fabrication of Record
Bases and Wax Rims
• Gently remove all block-out wax from master cast
without damaging surface.
• Remove wax which may prevent seating of record base
from tissue surface.
• Trim excess PMMA.
• The peripheral portion of the record base polished.
• Ridge Lap portion must be thin enough to
accommodate the anterior teeth.
• Palate region should be consistent 1-2mm thick to
facilitate speech.
• The lingual portion of the mandibular record base must
be concave.
• Thick maxillary record bases and convex
contours of mandibular record bases impinge
upon the tongue space and prevent the
patient from articulating speech sounds in a
normal fashion .
 To determine the
Serve as a means of orientation of the
transfer of face bow incisors and the occlusal
transfer records plane when properly
contoured

The Purpose
of Wax To determine the
contours of the lips and
To determine the
vertical dimension of
Occlusion cheek occlusion

Rims
To determine the centric Serve as a general aid in
relation selection of teeth
 Wax Occlusal Rim
Place record base on the cast.

Heat a sheet of baseplate wax until the wax is very pliable.

Roll the wax into long tube.

Starting at the tuberosity, press the roll of wax against the crest of the ridge.

Seal the wax to the record base with a hot wax spatula. If necessary, fill in the voids with additional wax.

Make a smooth occusal surface. Form the buccal and labial contours with the hot plate(spatula) in a similar
manner.
If there are voids fill them with wax and repeat the process.
 The dimension of the
wax rim
• The occlusal portion of the rim should have the
following thickness
• Molar region – 8 mm
• Premolar region – 6 mm
• Anterior region – 3 mm
• Lingual contours must not impinge on the tongue
space.
Maxillary Wax Rim
Check List

• The labial and lingual surfaces must be smooth and

free of voids.
• The posterior section of the rim should be tapered
to avoid a contact from the retromolar pad.
• The curvature of the anterior portion must simulate
the curvature of the edentulous arch
Mandibular Wax Rim

• The mandibular wax rim is

fabricated in a similar manner,
however, the rim should be
centered over the crest of the
ridge. Lingual contours must
not impinge on the tongue
space.
Recording the
maxilla and
mandibula relation
 Natural teeth are suspended in alveolar bone by
Differences the periodontal ligaments. These structures
absorb the occlusal forces and work as a shock
between natural absorber.
teeth and
complete denture Denture teeth are part of the denture base which
rests on movable tissues.
occlusion
Premature, deflective contacts between artificial
teeth cause movement of the denture resulting in
damage to the supporting tissues, loose of
retension and stability.
The aim of complete
denture occusion

• Limit trauma to the supporting structures

• Preserve remaining structures
• Enhance stability of the dentures
• Restore Esthetics, Speech and
Mastication
Balanced Occlusion
• Balanced occlusion is the
contacting of the maxillary
and mandibular teeth in the
right and left quadrant in the
anterior and posterior areas
when the jaws are either in
centric or eccentric relations.
Wax rim contour in patients mouth

• First the maxillary record base must be

adjusted. Place the maxillary record
base and wax rim in the pts. mouth and
begin to contour it for proper
phonetics, esthetics lip support and
occlusal plane.
• With the lips at rest the wax rim should
placed 1-2 mm below the lip line.
From the sagittal plane adjust the wax
rim plane parallel to Camper’s plane.

Camper plane is a line between tragus

ala nasi and for this adjustment we use
‘fox ruler’.

From the frontal plane adjust the

occlusal plane of the wax rim parallel
to the interpupillary line using fox
ruler.
• Mark the midline on the wax rim
according to the patient face.
Midline must be divided the face
into two equal part.