gg complete+dentures+2+secondary+impressions.pdf
TRANSCRIPT
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7/29/2019 gg COMPLETE+DENTURES+2+SECONDARY+IMPRESSIONS.pdf
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Dr.MichaelBrandonLewis
RegisteredSpecialistProsthodontist
BDS(Hons)DClinDent(Pros)MRACDS(Pros)
W:www.michaellewis.com.au
APPOINTMENT2:SECONDARYIMPRESSIONS.
GOALSOFTHISAPPOINTMENT:
Takesecondaryimpressions
EQUITPMENTREQUIRED:
Proswrap Specialtrays SSWhite OrangeSolvent Gauze Light-bodyPVSGreenstick(asrequired)
Vasaline(asrequired) Alginate Scalpel
PROTOCOL:MAXILLAPRIMARYIMPRESSION
1. Inspectspecialtraysonprimarycastswithyourtutorandtrimanyobviousoverextension
2. Tryinspecialtraysintraorallyandcheckforstability3. Disclosespecialtray:
a. Loadtheperipheryofthemaxillaryspecialtraywithlight-mediumalginate(1powder:1.2waterratio)andtakeabordermoulded
impression
b. Sectionthroughthealginateverticallytoinspecttheheightofalginateabovethedentureperiphery.Weareaimingfor3mm
clearancec. Markanyareasofoverextensionwithyourtutor,andadjusttrayasrequired
d. Retakedisclosingimpressionuntilsatisfiedwithsulcularclearance4. CaptureperipheriesinZinc-oxideeugenol:
a. MixequalquantitiesofSSWhiteimpressionpasteandcatalystuntilhomogenous
b. Beadalongperipheryofimpressiontray(includingpostdamregion)
c. Taketheimpressionfrombehindthepatientdonotstandinfrontofthem.
d. Retractthecheekusingamirrorandmaneuvertheimpressiontraysuchthatitslinksintothepatientsmouthwithaminimumof
discomforte. Freetheupperlipsothatitrestsoverthetray,andisnottrappedbythelabialborderofthestocktray
f. Seattheimpressiontrayusingapuddlingmotion
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7/29/2019 gg COMPLETE+DENTURES+2+SECONDARY+IMPRESSIONS.pdf
2/3
Dr.MichaelBrandonLewis
RegisteredSpecialistProsthodontist
BDS(Hons)DClinDent(Pros)MRACDS(Pros)
W:www.michaellewis.com.au
5. MouldperipherywhilstZincoxidesetssetsusingfunctionalmovements.Thesemayincludethepatient:
a. Makingoohsounds/puckerlipsregistersbuccalsulcus,buccalfrenumandlingualfrenum
b.Makingeeesounds/broadsmilingregisterslabialsulcusandbuccalfrenum
c. GetpatienttoshiftjawsidetosideMouldshamularnotchregion
6. Offeryourpatientarinseandinspectthefinalimpression7. Inspectperipheriesandretakespecificareasifdeficientyoucanaddzinc-oxidetozinc-oxide!
8. Wipedownperipheryofzincoxideusingorangesolventonasquareofgauzethisremovesthesurface0.5mmandmakesspaceforthePVSwashimpression
9. ApplyPVSadhesivetothespecialtray10.Offeryourpatientarinseandinspectthefinalimpression
PROTOCOL:MANDIBULARPRIMARYIMPRESSION
Unlikethemaxilla,themandibularedentulousprimaryimpressionistakenintwo
stepsfirstinathick,puttylikealginate,whichisusedtocustomizeastocktray,
thenoverextensionistrimmedandrelinedusingawashtechniqueusingalight-
mediumalginate.
1. Selectanappropriatesizeedentulousstocktrayandcheckforappropriateintraoralclearance.
2. Place4stopsinbluebeadingwax.3. Tryintraorallyagainandindentbluewaxagainsttheridge.Ensurestableseatingagainstallstops.Ensurethattheridgeiscenteredinthetraywithevenspaceforimpressionmaterialtoflow.
4. Sprayimpressiontraylightlywithadhesiveandairdry.5. Mixathick,putty-likeconsistencyofalginate(1powder:0.5waterratio)andtakeimpression:
a. Taketheimpressioninfrontofpatientb. Retractthecheekusingamirrorandmaneuvertheimpressiontraysuchthatitslinksintothepatientsmouthwithaminimumofdiscomfort
c. Freetheupperlipsothatitrestsoverthetray,andisnottrappedbythelabialborderofthestocktray
d. Getthepatienttoraisetonguetoallowmaterialtoflowintothelingualsulcus
e. Presstheimpressiontrayverticallydownuntilseatedonthestops6. Mouldperipherywhilstalginatesetsusingfunctionalmovements.Thesemayincludethepatient:
a. Makingoohsounds/puckerlipsregistersbuccalsulcus,buccalfrenumandlingualfrenum
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7/29/2019 gg COMPLETE+DENTURES+2+SECONDARY+IMPRESSIONS.pdf
3/3
Dr.MichaelBrandonLewis
RegisteredSpecialistProsthodontist
BDS(Hons)DClinDent(Pros)MRACDS(Pros)
W:www.michaellewis.com.au
b. Makingeeesounds/broadsmilingregisterslabialsulcusandbuccalfrenum
c. GetpatienttoshiftjawsidetosideMouldsthemassetericnotchregion
d.GetthepatienttoopenandcloseMouldsthemassetericnotchregion
7. Offeryourpatientarinse.8. Usingascalpel,removeoverextendedalginate.Basicallyweusethefirst,thickmixasafiller.Someareasoftheedentulousridgearedifficultto
compress(i.e.thealveolarridge),whilstotherswilldistendfreely(the
sulcus).Wewanttoremoveanyareawhichhasbeenoverextendedandthentorelineinthenextstepusingalight-mediumalginate
a. Trim5mmofsulcusperipheryeverywhereitislikelythattheseregionswillbeoverextended.
b. Removeexcessivealginatewidththatwillballoonoutimpression
c. Removealginateintheretromolarregiond. Roundallreductionsastoavoidtransitionlinesbetweenputtyandalginatewashes
9. Spraycustomisedstocktrayusingfix.Gentlyairdry.10.Takeawashimpressionovercustomisedstocktrayusingalight-mediumalginate(1alginate:1.2waterratio).Performfunctional
movementsasbefore.
11.Offeryourpatientarinse.12.Inspectimpressions.
HOWTOASSESSIMPRESSIONS:
Wehaveadequatelycapturedalldenturebearingsurfaces Thesulcushasbeencapturedinamucostaticstate Absenceofbubbles/voids
SECONDARYTRAYPRESCRIPTION:
1mmspacedtray(1sheetofpinkwax) 4embracingstopsinthecanineandfirstmolarregionTrayperiphery3mmshortofsulcus
Postdambuildintospecialtray Noholesorperforations Handleprotrudingat45degrees,sothatitisnotpushingthelipout