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Dual impression technique for
fabrication of maxillary complete
immediate denture
Ashish Kumar Srivastava, Ujjal Chaterjee, Madhu Ranjan, Arunoday Singh
Website:
www.sidj.org

DOI: Abstract:
10.4103/2454-3160.202218 Conventional complete denture apart from all its merits has the prominent disadvantage of leaving the patient
for a brief period of edentulous state till definitive prosthesis can be fabricated. Therefore, the concept of
immediate denture is to preserve the jaw relation, keep the patient habituated to the complete denture and in
the process preserve the esthetic concern of the patient. In the process, the psychological well‑being of the
patient is preserved as the patient is not without teeth for any prolonged period. The challenge in this technique
is to record the edentulous and dentulous portion of the arch in conjecture with each other so that the final
impression is closest to the intraoral situation, enabling us to provide the best results in short‑and long‑term
of complete denture fabrication.
Key words: Dual impression technique, esthetics, immediate denture

T he significance of accurate impression

in any field of prosthodontics cannot be
emphasized in this short discussion. The ultimate
goal of designing prosthesis lies in diagnosis and
treatment planning, the impression recording
procedure is the first step in the clinical aspect
of the execution of the plan. The principle
challenge in an immediate denture is recording
the impression in static and functional form.
Commonly, Kennedy Class I, Class II cases with
poor periodontal prognosis are planned for the
immediate denture.[1‑3] The concepts of recording
the edentulous posterior region with functional
impression and dentulous anterior region by the
static technique give increase to the unique dual
Department of impression technique.[4,5]
Prosthodontics Crown
and Bridge, Hazaribag Aim and objectives
College of Dental Dual impression technique takes into
Sciences and Hospital, consideration the combined aim of recording the
Hazaribagh, Jharkhand, remaining hard and soft tissue in the impression
India procedure. The distal extension edentulous
Address for
region has to be recorded with the remaining
correspondence: teeth to attain a homogeneous impression of the
Dr. Ashish Kumar entire maxillary arch.
Srivastava,
Department of
Prosthodontics Crown and Case Report
Bridge, Hazaribag College
of Dental Sciences and A 52‑year‑old male patient reported to the
Hospital, Hazaribagh,
Jharkhand, India.
Department of Prosthodontics Crown and
E‑mail: ashudent@yahoo. Bridge Hazaribagh College of Dental Sciences
com Hospital, with chief complaint of difficulty in
mastication. Clinical evaluation revealed loss
of all teeth in maxillary left side except lateral
incisor. The right side remaining teeth were
the central and lateral incisor, canine and first
premolar. All remaining teeth were mobile.
Radiographic examination revealed severe loss
of bone structure around all teeth. A combined
evaluation suggested poor periodontal prognosis
of the remaining natural teeth [Figure 1].
Treatment plan
The patient was advised to go for total extraction
and a maxillary complete denture. The concept of
immediate denture was explained to the patient.
The patient was comfortable with the treatment
plan as his job profile did not allow him to be
edentulous for long span.
Procedure
Impression
A two‑step final impression technique was
planned for the fabrication of the denture.
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How to cite this article: Srivastava AK,
Chaterjee U, Ranjan M, Singh A. Dual impression
technique for fabrication of maxillary complete immediate
denture. Saint Int Dent J 2016;2:42-5.

42 © 2017 The Saint's International Dental Journal | Published by Wolters Kluwer - Medknow
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Srivastava, et al.: Dual impression technique for immediate denture

A primary impression of the maxillary arch was made using The second tray was made to cover the edentulous portion of
alginate [Figure 2] and subsequently, a primary cast was made. the cast up to the posterior palatal seal area and was left short by
The cast was poured in dental stone. An impression of the 1 mm for border molding. This tray is nonperforated [Figure 4].
mandibular arch was made. The remaining teeth in the cast were
blocked out and a primary impression tray was made which
covered the teeth anteriorly and posterior extended toward
rugae area. 1mm perforations were made for the retention of
impression material. The posterior part of the tray had a large
hole to accommodate the handle of the second tray [Figure 3].

Figure 2: Preliminary impresion

Figure 1: Preoperative intraoral view showing periodontally compromised teeth

Figure 4: Second tray to take impression of edentulous portion

Figure 3: First tray to take impression of teeth

a b
Figure 5: (a) Impression made of dentulous segment. (b) Impression
made of edentulous segment Figure 6: Dual impression

The Saint’s International Dental Journal - Volume 2 | Issue 2 | July-December 2016 43

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Srivastava, et al.: Dual impression technique for immediate denture
In the first step, the posterior edentulous arch border molding is
done and a wash impression of the area is recorded using light
body elastomeric impression paste for both steps. The alginate
loaded tray made for dentulous area is placed along with the
edentulous tray in the mouth [Figure 5a and b] and both trays are
removed simultaneously after the respected impression materials
have set. The trays were removed together and dental stone
poured and cast made [Figure 6]. The resulting cast was of dual
impression where dentulous area was recorded under anatomical
method and edentulous under functional method [Figure 7].
Figure 7: Master cast
Figure 8: Jaw relation
a b
Figure 9: Teeth arrangement. (a) Alternate trimming of teeth on the cast. (b) Replacing the trimmed teeth. (c) Completed teeth arrangement
44 The Saint’s International Dental Journal - Volume 2 | Issue 2 | July-December 2016
Jaw relation
Articulation and mounting were done in the conventional
method of preparing occlusal rims and recording the
jaw relation. Postarticulation the teeth arrangement is
determined [Figure 8].
Teeth arrangement and try‑in
Posterior teethes are placed and try‑in is performed. After
satisfying the steps of try‑in, we proceeded to replace the
remaining teeth. Alternate teeth on the cast are trimmed to
preserve the jaw relation and replicate the anatomical features
of teeth to be extracted. This method gives us a scope to
exactly place the artificial teeth as it was in the natural setup.
The denture is then waxed finished, flaked, and conventionally
cured [Figure 9a‑c].
Extraction
On the day of extraction, the maxillary denture is
ready. The remaining natural teeth are extracted under
local anesthesia, wound closure done by suturing and
hemostatic attained [Figure 10]. Postextraction the maxillary
denture is placed in the mouth and checked for retention,
occlusion [Figures 11 and 12]. The patient is instructed
to not remove the denture for 24 h. Next day, the denture
is removed and again placed in the mouth. The patient is
instructed to take good oral hygiene care. After 1 week, the
sutures are removed. Periodic check up is done to evaluate
bone resorption and loss of retention based on the final
healing status the decision to either reline the denture or
rebase the denture is taken.
Discussion
Immediate denture is defined as any removable dental
prosthesis fabricated for placement immediately following
extraction of natural tooth/teeth (GPT‑8). Immediate denture is
seen to be a very successful and acceptable means of providing
and restoring the functional habits in a patient without waiting
and.[1,2,6,7] It shows better acceptability to prosthesis compared
to conventional denture wearer who wait approximately
6–8 weeks postextraction. Follow‑up with relining or rebasing
has given good long‑term results. There are few impression
techniques proposed for the accurate recording of immediate
denture situations.[5‑12]
c
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Srivastava, et al.: Dual impression technique for immediate denture

The process of dual impression satisfies the requirements of

retention, stability, and support in the complete denture. It
involves the concept of a functional impression in the form
of border molding and recording the limiting structure as well
as recording tissue in the anatomical state. Thus, the resulting
impression is satisfactory to enable the function of denture as
per our goals.[6,7,12]

Summary
If planned and executed systematically, dual impassion
technique in immediate denture gives a good result for future
denture related the solution to the prosthodontics as well as
the patient. It is a novel method to fulfill the requirements of
Figure 10: Extraction of teeth at insertion appointment
complete denture without the patient having to be edentulous
for a prolonged time.

Financial support and sponsorship

Nil.

Conflicts of interest
There are no conflicts of interest.

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