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A Technique for Border Moldin Edentulous

Impressions Using Vinyl Polysi oxane P


Material
N a n 9 R. Chafii?,DDS, MS, Lyndon F. Cooper, DDS, PhD,2
and David A. Felton, DDS, MS:

A technique for making selective tissue placement final impressions for complete dentures
using vinyl polysiloxaneand custom trays with peripheral relief is presented. This technique is an
alternative to the conventional method of border molding using modeling plastic impression
compound.
J Prosfhod 7999;8:129-134. Copyright 6 7999 by The American College of Prosthodontists.

INDEX WORDS: complete dentures, selective pressure, peripherally relieved custom tray

C OMPTETE DLNTURE PROSTHODOYTICS


can be a tcchnically demanding endeavor for
any practitioner. The final impression is one of the
the mucostatic and pressure techniques. The denture-
supporting area is divided into primary, secondary,
and non-stress-bearing areas. Relief is probided in
critical steps in the fabrication of a complete den- the non-strcss-bearing areas, while no relief is pro-
The objective of the complete denturc impres- vided in the stress-bearing arcas.
sion is to accurately record the entire denture- While all techniques can be uscd to fabricate
bearing area to produce a stable and retentive successful complete dentures, the selective-place-
prosthesis ~7hilemaintaining patient comfort, esthet- ment technique is widely used today.3 One of the
ics, and preservation of the remaining tissues. most demanding and time-consuming port ions of
Several techniques have been advocated to achieve this technique is the border-molding step that estab-
an optimal final impression. The mucostatic tech- lishes the impression borders to assure optimal
nique uses the principle of making an impression of extensions for the final prosthesis. Through the usc
the tissues in an undistortcd, nonstressed state4This of a vinyl polysiloxane impression system (Imprint 11,
theoretically will result in a denture that is adapted 3M Dental Products, St. Paul, MN) in conjunction
to the tissues in an unloaded state, preventing com- with a selective-placement technique, predicable re-
pression of the tissucs at rcst as well as bone sults can bc achicved in making a properly extended,
resorption. Conversely, the pressure technique uses accurate final imprcssion.
the principle of making an impression of the tissues
The use of a vinyl polysiloxane impression systcm
under controlled pressure, as when a patient closes
has several advantages over the traditional modeling
under Some opponents of the pressure
plastic imprcssion compound with a polysulfide wash
technique claim that the pressure exerted on the
impression technique.
tissues will restrict blood flow, creating bone resorp-
tion and tissue irritation, as well as cause rebound ol 1. Thc automix dclivcry systcm is easy to use, with
the prosthesis while it is not in function.] The lrss waste of material.
sclcctivc-placement technique uses a combination of 2. The material can be accurately applied only to the
areas to be border molded.
3. The automix system also provides for a consistent
mix of matcrial with cach application.
4. Thcrc is no nccd for additional cquipment such as
a water bath set at the correct tempcraturc or a
torch to pcrmit adcquatc manipulation of the
materials.
5. Infection-control procedures are simplified thrvugh
the use or the disposable mixing tips rather than
needing to sterilize/disinfect the water bath and
torch.

Jvui-nal qfImsthodvntics, Vol 8,Ab 2 (June), 1999:pjj 129-134 129


130 Llwder Molding Ehntulous Irn$vwsionS Chaffee, Coopq and Felton

A technique will be described for making final impres-


sions using a custom tray with peripheral relief and a
vinyl polysiloxane heavy-body/light-body impression
material systcm for a selective-placement impres-
sion.

Technique
Final Impression Trays
This technique uses a custom imprfssion tray with
pcripherd relief. An advantage of the tray design
used with this technique is that it eficiently carries
impression material to the mouth. This type of tray
can be used to make a selective-tissue placcment
impression in which some tissues can be recorded in
a relaxed state (Fig 1, areas B and Pj, while other
Figure 2. Maxillary cast with areas for peripheral relief
tissues are recorded with a determined amount of outlincd.
placement (Fig 1, area C). The purpose of this type of
impression is to allow the anatomy and tissue tone to
form the impression, leading to a stable and retentive positioning of the tray during the bordcr-molding
denture. procedure.
The custom tray with peripheral relief can be 1. Outline the depth of the mucobuccal fold in pencil
made using light-polymerized urethane dimethacry- on the preliminary cast. Using the pencil, draw a
late (Triad, Dentsply International Inc, York, PA). second line at the height of contour of the denture-
Wax relief is used to provide the space between the bearing area. The second line. is usually positioned
tissuc and the tray. The wax relief will create a 4 to 6 mm h m the first line. Two separate,
controlled space to allow an even thickness of heavy- continuous lines will result, and the area between
body impression material to be placed during the the two lines will be the area of wax relief (Fig 2).
border-molding procedure. The unrelieved areas of 2.Adapt one thickness of softened base plate wax
the tray will provide for reproducible and stable (TruWax, Dentsply International Inc) over the
entire cast. Use a sharp knik to cut the wax at
right angles along the pencil lines. This will result

I /p p\ I in a well-defined border of wax. Remove the wax


on the crest of the ridge as well as on the land
arcas of the cast. The wax relicfwill remain on the
cast located between the pencil lines.
3. Apply a thin coat of Model Release Agent (Dentsply
International Inc) over the entire cast and wax
relief. Adapt Triad TruTray custom tray material
(Dcntsply International Incj over the entire cast
and wax relief. Jt is important that the material is
well adapted at the margin of the wax relicf and
that the trapping of air under the material is
avoided. Trim any excess material with a sharp
knifc. Add a handle to the tray if desired.
4. Polymerize the adapted material on the cast using
a light-curing unit initially for 1 minute. Remove
Figure 1. Cross-sectional view of maxillary and mdndibu- the cast from the curing unit and allow the
lar casts indicating the areas of peripheral relief (B), areas
material to cool to prevent the wax rclief from
of selective pressure between the impression tray and
bearing surfaces of the denture (C), and peripheral exten- melting. Return the cast to the curing unit and
sion ofthe denture. (From Fclton?) cure in increments of 1 minute, always allowing
,June 1999, Volume 8, Number 2 131

Figure 3. Area of peripheral


relief should exhibit a well-
defined finish line.

the cast to cool between cycles, uiitil a total curing border of the entire maxillary tray in one application.
time of 5 minutes is reached. Subsequent correction applications can be used as
5. Remove the tray frorn the cast. Remove thc wax needed.
relief from the tray. Clean the tray to remove any
1. Apply tray adhesive (3M Tray Adhesive, 3 M Den-
residual Air Barrier Coating or wax. Trim and
tal Products) to the peripheral relief areas, the
finish the borders of the tray. The tray should
borders, and the external surface of the tray.
exhibit a definite finish line between the relieved
2. Load a cartridge of heavy-body material (Imprint
and unrelieved areas of the tray. If needed, the
II, 3h.I lkntal Products) into the dispenser. Blecd
definition ofthe finish line can be improved using
the cartridge to ensure that both the catalyst and
an acrylic bur (Fig 3).
base material are flo\.vlng freely from the car-
tridge. Attach a mixing tip to the cartridge.
Final ImpesSons Syringe heaty-body material onto the peripheral
relief areas of the tray and across the posterior
The 1naxillar)- final impression tray should have a seal area (Fig 4).
relieved area at the peripheral border and at the
3. Place the impression tray into the patients mouth.
slopes of the ridges, but be unrelieved at the area of
Ensure that the tray is properly seated. There is
the crest of the edentulous ridge. The unrelieved ample working time to apply the material care-
area will permit the tray to be rcpcatedly positioned
in a stable manner while the border-molding proce-
dure and final impression are being completed, as
well as selectively displace the tissucs of the primary
denture-bearing areas, Before making an impres-
sion, always seat the tray and note the relationship to
the border structures. The tray must not displace the
alveolar (movable) mucosa. Reduce areas that arc
overextended until 1 to 2 mm o f underextension
exists around the entire border except in the area of
the posterior extension of the maxillary tray. This
posterior extension should be evaluated to end at the
location of the vibrating line,

Border Molding the Maxillary Impression Tray


The objective of border molding is to customize the
impression tray to establish the niaximal extension
and accuracy of the peripheral seal with no functional
impingement of the tissues. With this technique, Figure 4. Applying heaby-body impression material to
heavy-body material will initidly be applied to the peripheral relief areas and posterior palatal seal area.
fully to the tray. Once the tray is positioncd within
the patients mouth, the working time of the
matcrial is 2 minutcs. During the working time,
border muld each area of the periphery as usual.
The setting time of the matcrial is 4 minutes.
Once the material is sct, remove the tray from the
patients mouth.
Inspect the border-molded tray for areas where
the tray has bled through thc matcrial as a rcsult
of overextension of the tray or for deficient areas
on the periphery. An advantage of this material is
the ability to modity the tray and the impression
material simultaneously using an acrylic bur. Re-
duce any trai overextension with an acrylic bur.
Apply additional heavy-body matcrial in any arcas
Figure 6 . Heay-bod) material applied to lingual border
requiring correction. Reinsert the tray and re- mandibular tray.
border mold.
Once the tray is successfully border molded, re-
move any cxcess material that has flowcd onto the Masseteric notch (Fig 6). Coax the patient to relax
unrelieved areas of the tray using a sharp knife the tongue when inserting the tray. An advantage
(Fig 5). of this technique is the ability to accurately re-
position the partially border-molded tray during
Border Molding the Mandibular
each application. The setting time of the material
Impression Tray
is 4 minutes. Once the material is set, remove the
Apply tray adhesive (3hl Tray Adhesive, 3M Den- tray from the patients mouth. Follow the instruc-
tal Products) to the pcriphcral rclief areas, thc tions for step 4 of the maxillary impression to
borders, and the external surface of the tray. correct for under- or overextension of the border-
Assemble the impression cartridge and dispenser molded tray.
as previously described. Once the lingual border of the tray is successfully
Border mold the mandibular tray one area at a border molded, remove any excess material that
time, begmning v i t h the lingual borders of the has flo~7cdonto thc unrclievcd arcas of the tray
tray including the lingual frenum, sublingual fold using a sharp knife.
spaces, mylohyoid arcas, rctromylohyoid areas, Continue the border-molding procedure by cnm-
and distal extcnsions, as well as the area of the pleting one side of the labial flange. When border
molding the mandibular tray, cach segment should
be completed separately to prevent loss of mate-
rial when inserting the tray into the patients
mouth. Once the material has sct, rcmovc the tray
from thc patients mouth and inspect. Make any
necessary corrections as previouslydescribed. Com-
plete the horder-moldingprocedure of thc remain-
ing labial flange areas of the impression tray as
described above (Fig 7).

Impression Making
1. After thc custom tray is border molded, it must be
prcparcd for making the final impression. Apply
tray adhesive (3hI Tray Adhesive, 3M Dental
Products) to the internal aspect, the bordcrs, and
the external surface of the border-molded tray. A
Figure 5. Border-molded rnixillaiy custom tray. final wash impression will be made using light-
June 1999, Volume 8, Number 2 133

Figure 7. Border-molded mandibular tray.

body material (Imprint 11, 3M Dental Products). Figure 9. Cornpletcd maxillary filial impression.
Load the light-body material into the dispenser.
2. For each impression, dry the mouth thoroughly
with gauze. The gauze is easily removed before over the entire surface ofthe tray and borders (Figs 9,
seating the loaded impression tray. 10, and 11).
3. Load the tray witti a thin layer of impression
material. Coat the border-molding material as Discussion
tvcll as the inside of the t r q with the light-body
impression material (Fig 8). Two common errors in making a final denturc
4. Seat the loaded tray lightly to place. Have the impression are using an overcxtcndcd tray and using
patient bcgin border-molding movements in cycles too little border-molding i material.^ The quality of
of 20 to 30 seconds until the initial set of the the preliminary impression i s a major factor in the
inaterial at approximately 2 minutcs. success of the final denturc irnprcssion by perniittirig
identification of the proper extensions for the custom
The completed imprersion should have a thickness of tray.
heavy-body material in the arca of the peripheral The tray should be just short of the movable
relief with dn even thickness of light-body material mucosa. A short tray requires significant extension
using the border-molding matcrial. When an elasto-
mcric material is used in border molding, it may be

Figure 8. Light-body material applied to maxillaq border-


molded tray. Figure 10. Coinpletcd mandibular final impression.
134 Border Molding Edenlulour Impreuiolu a Chaffee, C o o p , and Felton

Figure 11. Cross-section of


master cast and final impres-
sion. (A) Custom tray. (B)
Heavybody material in area
of peripheral relief. (C) Light-
body wash material.

beyond the physical limits of the material to over- tray are removed using a sharp knife. Additional
come the deficiencies of a short tray. impression material is added to the peripheral areas
requiring corrcction when border molding is com-
pleted. Light-body impression material is applicd to
Summary
the border-molded custom tray to complete the final
A vinyl polysiloxane impression system (Imprint 11, impression.
3M Dental Products) in conjunction with a selective-
placement final impression technique can be used to
achieve acceptable results for edentulous impres- References
sions.
This technique uses a properly extended custom 1. Halperin AR, Graser GN, Rogoff GS, et al: Mastering the Art of
Compete Dentures. Chicago. IL;Quintessence Publishing,
tray with peripheral relief. Border molding is com- 1988. pp 3 1-80
pleted by applying heavybody impression material to 2. Felton UA, Cooper LF, Scurria MS: lredictable impression
the periphery of the custom tray. Areas ofoverexten- procedures for complete dentures. Dent Clin North Am 1996:40:
sion of the custom tray that are found after border 39-51
molding are corrected using an acrylic bur to remove 3. Zarb GA, Bolender CL, Carlsson GC: Bourhers Prosthorloiitics
Treatment for Edentulous Patients, ed 11. St. Louis, MO,
both the tray material as well as border-molding Mosby, 1997, pp 141-182
impression material. Areas of overextension of im- 4. Bohannan Hhk A critical analysis ofthe mucostatic principle.J
pression material onto the unrelieved areas of the Prosthet Dent 1934;4:232-241

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