IMPRESSION MATERIALS AND

PROCEDURES FOR
REMOVABLE
PARTIAL DENTURES

李惠娥教授
電話: 0975356237
E-mail:huerle@kmu.edu.tw
學習目標
 介紹印模材料的種類
 如何選擇配合口腔狀況的印模材料
 印模的過程與應注意的事項

學習資源:
1. McCracken’s Removable Partial Prosthodontics. 13th ed. 2016,
pp. 219-230
2. Stewart’s Clinical Removable Partial Prosthodontics. 4th ed. 2008,
Quintessence Pub Co, pp.351- 366
IMPRESSION MATERIALS
Rigid materials
-- Plaster of Paris
-- Metallic oxide Paste
Thermoplastic materials
-- Modeling Plastic
-- Impression Waxes and Natural Resins
Elastic materials
-- Hydrocolloids
-- Rubber-base
IMPRESSION MATERIALS
Rigid Materials
--- Plaster of Paris
--- over 200 years
--- making accurate transfer of abutment
casting or coping in the fabrication of FPD
--- modified impression plaster used for bite
taking
 IMPRESSION MATERIALS
Metallic Oxide Paste
--- not used as primary impression
--- not used for remaining natural teeth impression
--- not used in stock impression tray
--- used as secondary impression for CD
and distal extension edentulous area of RPD
--- used as impression material for relining distal
extension denture base
IMPRESSION MATERIALS
Thermoplastic materials
--- Modeling Plastic
--- oldest impression material
--- used for border molding
--- different color – temperature range
--- red（red-brown）material in cake
that softens at about 132℉
正確的軟化方法
錯誤的軟化方法
軟化的compound 置於stock tray 上 放入口腔成形後
即可成 簡易的 custom tray
IMPRESSION MATERIALS
--- Modeling Plastic
--- red, gray, green modeling plastic in
stick form in border molding an
impression
--- green is the lowest fusing of the plastic
--- red and gray have a higher and broader
working range
IMPRESSION MATERIALS

--- Impression Waxes and Natural Resins

--- mouth-temperature waxes
--- Iowa wax and Korecta wax
--- as secondary impression or relining the
distal extension edentulous ridge to
obtain support form
--- flow sufficiently in the mouth to prevent
displacement of tissue
IMPRESSION MATERIALS

--- Impression Waxes and Natural Resins

--- flow as long as in the mouth and permit
equalization of pressure and prevent
displacement
--- Iowa wax will not distort after removal
from the mouth at ordinary room
temperature
IMPRESSION MATERIALS
Elastic Materials
--- Reversible Hydrocolloids（agar-agar）
--- fluid at high temperature
--- gel at reduction in temperature
--- used for fixed prosthesis
--- accuracy when properly used
 IMPRESSION MATERIALS
Elastic Materials
--- Irreversible Hydrocolloids
--- for making diagnostic cast, orthodontic treatment cast,
master cast for RPD
--- 共同特性
★ be poured immediately ★ low tear strength
★ less surface detail ★ presence of moisture
★ low dimensional stable ★ nontoxic, nonstaining
★ pleasant taste and odor ★ inexpensive
★ acceptable disinfected with spray of 2% acid glutar-
aldehyde, stored in 100% humidity and poured within 1hr.
Alginate 調拌凝結作用的程式
 IMPRESSION MATERIALS
Elastic Materials
--- Mercaptan Rubber-base Impression Materials
--- Thiokol
--- secondary corrected or altered cast imp.
--- to be accurate, 3mm uniform thickness
--- rebound for 7 to 15 min. after removed from
mouth, and pour immediately (long-term
stability is poor)
--- unpleasant odor and stain clothes
IMPRESSION MATERIALS

--- Mercaptan Rubber-base Impression

Materials
--- moderate inexpensive
--- high tear strength
--- long working and setting time（8-10min）
--- smoother texture
--- longer setting time, better to border
molding
IMPRESSION MATERIALS

Elastic Materials
--- Polyether Impression Materials
--- good accuracy
--- good surface detail
--- good wettability and easy cast form
--- low to moderate tear strength
--- shorter working and setting time
--- unpleasant taste (absorb moisture)
--- pour within 2 hours, can’t immersed in disinfect solu’
IMPRESSION MATERIALS
Elastic Materials
---Silicone Impression Material
--- more accurate & easier to use
--- moderate working time (5-7min.)
--- pleasant odor, excellent recovery
--- moderately high tear strength
--- can be disinfected in any disinfecting
solu’
--- ideally, should be poured within 1hr.
 IMPRESSION MATERIALS
Elastic Materials
---Silicone Imp. Material (addition type)
--- most accurate
--- less polymerization shrinkage
--- low distortion
--- fast recovery from deformation
--- moderately high tear strength
--- no smell or taste
--- sulfur, aluminum sulfate retraction solu’ may inhibit
polymerization
Heavy body type、Injection type of Silicone
Regular type of Silicone
IMPRESSION OF THE PARTIALLY
EDENTULOUS ARCH
Anatomic form of the teeth and surrounding tissue--- thermoplastic
and metallic oxide impression material are excluded for recording
the anatomic form
--- permanently deformed by removal from
tooth or tissue undercut
--- hydrocolloids as impression material ---
giant step forward in dentistry
PRINCIPAL DIFFERENCES BETWEEN
REVERSIBLE AND IRREVERSIBLE

Reversible hydrocolloid
--- from gel form to a sol by heat
--- physical change is reversible
Irreversible hydrocolloid
--- become a gel via a chemical reaction
--- physical change is irreversible
IMPORTANT PRECAUTION IN
HYDROCOLLOID IMPRESSION
Should not be exposed to air – 避免shrinkage
Should not be immersed in water or disinfectant
--- 吸水膨脹
Should be protected from dehydration --- in a
humid atmosphere or wrap in a damp paper --- 15
min.內要倒模
Retarding effect (exudate) on gypsum product
--- chalky cast surface
IMPRESSION PROCEDURES

 Saliva control
 Tray selection
 Tray preparation
SALIVA CONTROL
Thick, mucinous saliva
--- mouthwash with ½ teaspoon of
bicarbonate of soda
Copious saliva
--- ice water rinse
--- place gauze or cotton roll
--- antisialagogue – 30 min.before impression
--- Clonidine 0.2mg(central sympatholytics)
--- Propantheline bromide 15mg
TRAY SELECTION

Stock tray
Custom tray（individual tray）
Selection of tray size
Tray selection
TRAY PREPARATION

The modified stock tray

--- individual tray
Altering of the stock tray
Forming the stock tray
--- adapt with utility wax
 Tray preparation

tray
 A. Maxillary impression tray with palatal portion built up with baseplate wax
to prevent impression material from sagging away from palatal surface.

B. Mandibular impression tray with periphery wax added to lingual flanges

to prevent tissues of the floor of the mouth from rising inside the tray .
The posterior end of the tray is extended with periphery wax to cover the
retromolar pad regions.

Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 224

IMPRESSION PROCEDURES

Mixing Alginate
Loading the tray
Placement the tray into the mouth
Holding the impression
Removal of the tray
Evaluation of the impression
IMPRESSION PROCEDURES

Impression Sequence
--- mandible first
--- mandible is “Equanimity”
 IMPRESSION PROCEDURES

Procedure help to prevent gagging

--- seating the p’t in an upright position with
occlusal plane parallel with the floor
--- correcting maxillary tray, maintained
positive contact against posterior palate
--- not overfilling the tray with Alginate
IMPRESSION PROCEDURES

Procedure help to prevent gagging

--- seating the posterior of tray first and then
rotating the tray into position
--- asking the p’t to keep the eye open
during the impression procedure
--- asking the p’t deep breathe through the nose
IMPRESSION PROCEDURES
Procedure help to prevent gagging
--- asking the p’t to keep the eye focused on
some small object
--- giving all instruction to the p’t in a firm
control manner
--- having the p’t use astringent mouth rinse
and cold water rinse before the impression
 A. Stone is introduced at one posterior region of the impression, with care
taken to trace the stone moving into each tooth as it rounds the arch.

B. Additional stone is not needed until the stones has reached the
opposite – most posterior tooth.

Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 225

 A. Desired outline of the tray is drawn on the diagnostic cast.
The tray must include all teeth and tissues that will be
involved in the removable partial denture.

B. One thickness of baseplate wax is adapted to the cast

B and is trimmed to the penciled outline, which is 2 to 3 mm
short of the desired border. The posterior palatal seal
region is not covered by wax but will be included in
finished tray. Two thicknesses of baseplate wax cover the
teeth. A window is created in the wax spacer over the
incisal edges.
C
C. A model release agent is painted on the stone surfaces of
the cast that will be contacted by the resin.

D. The visible light-cured(VLC) resin tray material is removed

D from the light-proof wrap and shaped to the desired
outline in uniform manner.

Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 227

  A handle is added to provide a means to
place and remove the tray, as well as to
pass the tray from assistant to dentist. Its
form should consider the lip length and
need to manipulate the perioral region.

 Before the tray is placed in the curing

oven, an air barrier coating is painted on
the surface. The tray is then polymerized
as per manufacturers’recommendations.

 As soon as the material has hardened, the tray is removed from

the cast, and the wax spacer is removed from the rough tray. An
acrylic resin trimmer in the lathe is used to rough finish the tray.
Holes are drilled through the tray, spaced approximately 4.5mm
apart. These holes will serve to lock the impression material in
the tray. In addition,excess impression material is forced out of
the holes when the impression is made, thereby minimally
displacement of soft oral tissues. These two features will assist
in correctly orienting the individualized impression tray in the
mouth.
Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 228
 A similar technique to the one used for fabrication of the maxillary tray is used for the
mandibular tray.

A. Outline of the tray is penciled on a duplicate mandibular diagnostic cast.

B. A single sheet of baseplate wax is adapted to the outline of the tray, and another sheet of baseplate
wax is adapted over the teeth. A window is cut in the spacer to expose the incisal edges of the
lower central incisors serve as a stop in seating the tray.
C. A model release agent is painted on regions of the cast to be in contact with the resin.
D. A visible light-cured(VLC) tray material wafer is adapted over the cast and spacer.
E. A handle is formed with excess tray material , as previously described.
Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 229
 F. An air barrier coating is painted on the tray material and it is
processed as described .

G. Following processing, multiple holes are placed throught the tray.

Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 230

The “ leg lift” technique may be used to minimize gagging
during impression procedures.
THANK
YOU!
SUPPORT FOR THE
DISTAL EXTENSION
DENTURE BASE
李惠娥教授
電話:0975356237
E-mail:huerle@kmu.edu.tw
學習目標
1. Distal Extension Removable Partial Denture
之定義與support的關係
1. 影響Distal Extension Base其support的因素
2. Anatomic Form 印模的方法
3. 如何獲得Distal Extension Base 之functional support
的方法

學習資源：
1. McCracken’s Removable Partial Prosthodontics. 13th ed. 2016,
pp. 231-241
2. Stewart’s Clinical Removable Partial Prosthodontics.
3rd ed. 2003,Quintessence Pub Co, pp.351- 365
OCCLUSAL FROCE APPLIED TO
•Tooth-supported RPD – directed through the
rest and transmitted to the abutment
-- single impression record anatomic form

•Tooth-tissue supported RPD – force equitable

distribute to abutment and ridge
-- dual impression record functional form
(corrected form)
Anatomic Form
Functional form
FACTORS INFLUENCING THE
SUPPORT OF A DISTAL
EXTENSION BASE
•Contour and quality of the residual ridge
•Extent of residual ridge coverage by the denture base
•Type and accuracy of the impression registration
•Accuracy of the fit of the denture base
•Design of the RPD framework
•Total occlusal load applied
FACTORS INFLUENCING THE
SUPPORT OF A DISTAL
EXTENSION BASE
Contour and quality of the residual ridge
Extent of residual ridge coverage by the denture
base
Type and accuracy of the impression registration
Accuracy of the fit of the denture base
Design of the RPD framework
Total occlusal load applied
Primary support
 The doted portion outlines the crest of the residual ridge, which should be
recorded in its anatomic form in impression proceures. Similarly,
retromolar pads should not be displaced by impression. Buccal shelf
regions are outlined by a herringbone pattern, and selected additional
pressures may be placed on these regions for vertical support of the
denture base. Lingual slopes of the restoration; however, these regions
principally resist the horizontal rotational tendencies of the denture base
and should be recorded by the impression in undisplaced form

Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 232

primary support
 The crest of the maxilary residual ridge (herringbone pattern) is the
primary supporting region for the maxillary distal extension denture base.
Buccal and lingual slopes may furnish limited vertical support to the
denture base. It seems logical that their primary role is to counteract the
horizontal rotational tendencies of the denture base. The dotted portion
outlines the incisive papilla and the median palatal raphe. Relief must be
provided for these regions, especially if tissues covering the palatal
raphe are less displaceable than those covering the crest of the residual
ridge.

Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 233

FACTORS INFLUENCING THE
SUPPORT OF A DISTAL
EXTENSION BASE
Contour and quality of the residual ridge
Extent of residual ridge coverage by the denture base
Type and accuracy of the impression registration
Accuracy of the fit of the denture base
Design of the RPD framework
Total occlusal load applied
EXTENT OF RESIDUAL
RIDGE
Broader the residual ridge coverage
-- the greater of the distribution of the load
-- result in less load per unit area
Kaires has shown
-- maximum coverage of denture-bearing
area with large, wide denture base can
withstand vertical and horizontal stresses
 Comparison of two removable partial dentures for the patient. The
denture on the right has severely underextended bases. Its replacement,
with properly extended bases, is on the left. Occlusal forces are more
readily distributed to denture-bearing areas by the replacement denture.

Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 233

 FACTORS INFLUENCING THE
SUPPORT OF A DISTAL
EXTENSION BASE
Contour and quality of the residual ridge
Extent of residual ridge coverage by the denture base
Type and accuracy of the impression registration
Accuracy of the fit of the denture base
Design of the RPD framework
Total occlusal load applied
 Comparison of anatomic and functional ridge forms.

A. Original master cast with the edentulous area recorded in its

anatomic form, using elastic impression material.

B. Same cast after the edentulous area has been repoured to its
functional form as recorded by the secondary impression.

Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 234

TWO FORMS OF
RESIDUAL RIDGE
• ANATOMIC FORM—SURFACE CONTOUR OF
THE RIDGE WHEN IT IS NOT SUPPORTING AN
OCCLUSAL LOAD

• FUNCTIONAL FORM– SURFACE CONTOUR OF

THE RIDGE WHEN IT IS SUPPORTING A
FUNCTIONAL LOAD
FUNCTIONAL FORM

Impression methods are direct to place more stress

on primary stress bearing region

Some loading--- occlusal loading, finger loading,

individual tray, consistency of the recording medium

Thickness and structural characteristics of the soft

tissue overlying the residual bone
 Steffel has classified

Ridge and tooth supports can best be equalized by the

use of stress-breakers or resilient equalizers

Equalization of ridge and tooth support by physiological

basing—pressure impression or relining the denture
under functional stress

Extensive stress distribution for stress reduction at any

one point
Positive occlusal rests
An all-rigid, nonflexible framework
indirect retainers to add stability
well-adapted, broad coverage
FACTORS INFLUENCING THE SUPPORT OF

A DISTAL EXTENSION BASE

Contour and quality of the residual ridge

Extent of residual ridge coverage by the denture
base
Type and accuracy of the impression registration
Accuracy of the fit of the denture base
Design of the RPD framework
Total occlusal load applied
THE SUPPORT OFFACTORS
INFLUENCING A DISTAL
EXTENSION BASE
Contour and quality of the residual ridge
Extent of residual ridge coverage by the denture base
Type and accuracy of the impression registration
Accuracy of the fit of the denture base
Design of the RPD framework
Total occlusal load applied
 Acute dip of the short denture base is
compared with that of the long one in the upper
figure. In the lower figure, when the point of
rotation is changed from C to B by the loss of
more teeth, it can be seen theat a
proportionally greater area of the residual ridge
is used to support the denture base than
occurs when the fulcrum line passes through C.
The amount of movement is directly related to
the quality of tissue support. Line AC
represents the length of the denture base.

If rotation of the distal extension be

occurs around the nearest rest, as the
rest is moved anteriorly more of the
residual ridge will be used to resist
rotation. Comoare the vertical arcs of
the long-dash broken line with the arcs
of the solid line.
Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 235
 The occlusal rest is placed on the mesioocclusal surface of the lower first premolar; this
will move the point of rotation anterior to the conventionally placed distoocclusal rest if
contact of the proximal minor connector on the distal guiding plane is designed to release
under function. The occlusal rest is connected to the lingual bar by a minor connector,
which contacts the small mesiolingual prepared guiding plane. Note the vertical extension
of the denture base minorconector contacting the distal guiding-plane surface. The
lingual guiding plane is prepared to extend from the occlusal surface inferiorly to
approximately one third of the height of the lingual surface and is as broad as the
contacting minor connector. The distal guding plane extends from the distal marginal ridge
gingivally about two thirds of the height of the distal surface. Such preparations must be
designed not to lock the tooth in viselike grip when the denture base moves toward the
residual ridge.

Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 236

FACTORS INFLUENCING THE
SUPPORT OF A DISTAL
EXTENSION BASE
Contour and quality of the residual ridge
Extent of residual ridge coverage by the denture base
Type and accuracy of the impression registration
Accuracy of the fit of the denture base
Design of the RPD framework
Total occlusal load applied
TOTAL OCCLUSAL LOAD
APPLIED

Reduction of the size of the occlusal table

↓
reduce the vertical and horizontal
forces
METHODS FOR OBTAINING
FUNCTIONAL SUPPORT FOR
DISTAL EXTENSION BASE

Selective tissue placement impression methods – altered cast

method
Functional impression technique
-- uniformly firm ridge consistency
 The framwork must be evaluated to assure complete seating, full
contact with the remaining dentition for stabilization, support and
retention as planned, and to allow full natural tooth contact.

A. Several types of disclosing media may be used, such as stencil correction

fluid, rouge, and chloroform, and disclosing fluids, pastes, and waxes.
Here, a spray disclosing medium has been aplied and the framework
binds. It is imperative that the framework not be forced to place at this
initial seating.

B. A portion proximal plate is preventing complete seating.

C. The framework is carefully adjusted as over-adjustment can result in a

poorly adapted framework.
Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 239
 D.The framework seats completely after adequate adjustment. This
may require repeated disclosing and carful adjustment; however, if
improvement is not seen with each framework modification there
should be concern regarding frame accuracy.

E.Following complete seating and verification of appropriate tooth

contacts by component parts(i.e., rests, proximal plates, stabilizing
components) the occlusion must be checked and the framework
adjusted until natural tooth contacts that exist without the framework
seated are achieved with the framework in place. All adjusted regions
can be carefully polished with rotary rubber points.

Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 239

 A secondary impression for the distal extension mandibular
removeable partial denture is made in individual trays attached
to the denture framework.

A. The framework has been tried in the mouth and first the mouth
cast as planned.

B. The outline of acrylic-resin trays is penciled on the cast.

Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 237

 C. One thickness of baseplate wax is adapted to outlines to act as
spacers so that room for the impression material exists in the
finished trays. Windows are cut in the wax spacers corresponding to
regions on the cast contacted by minor connectors(tissue stops) for
denture bases.

D. The framework is warmed and pressed to position on the relieved

master cast. All regions of the cast that will be contacted by
autopolymerizing acrylic-cured(VLC) resin are painted with tinfoil
pressure as described .Excess material over the borders of the cast
is removed with a sharp knife while the material is still soft.

Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 238

 E. Acrylic-resin material is adapted to the cast and over the
framerwork with finger pressure as described. Excess material
over the borders of the cast is removed with a sharp knife while
the material is still soft.

F. Polymerized acrylic-resin trays and framwork are removed from

the cast, and trays are trimmed to outline the wax spacer.

G. Borders of the trays will be adjusted to extend 2 mm short of the

tissue reflections. Holes will be placed in the trays corresponding
to the crest of the residual ridge and retromolar pads to allow
escape of excess impression material when an impression is
made.

Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 238

 Selection tissue placement impression technique. A, Tray attached at the frame
try-in , which in B is seen incompletely seated. C, Completed border molding,
which defines the primary bearing areas of the buccal shelves bilaterally. This
bearing area and the lingual extension are seen in the final impression (D),
which can be seen to be in contact with use of the pressure indicating paste (E).

Reference:McCracken’s Removable Partial Prosthodontics,12th ed. Pp 240