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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
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
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,
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
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
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