Quick Technique for Impression Making of
Compromised Partially Edentulous Arch
Sun-Yung Bak1 and Won-suk Oh2*
1Clinical Assistant Professor, Department of Biologic and Materials Sciences and Prosthodontics, University of
Michigan School of Dentistry, Ann Arbor, Michigan
2Clinical Professor, Department of Biologic and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan
2Clinical Professor, Department of Biologic and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan
*Corresponding author: Won-Suk Oh, Dept of Biologic and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, 1011
North University, Rm K1014A, Ann Arbor, MI 48109-1078, Fax: 734-763-3453; E-mail:
@
Received: March 30, 2019; Accepted: April 16, 2019; Published: April 24, 2019
Citation: Sun-Yung Bak and Won-suk Oh (2020) Quick Technique for Impression Making of Compromised Partially Edentulous Arch.
J Dent Oral Disord Ther 8(1): 1-3. DOI: 10.15226/jdodt.2020.001106
Abstract Top
The diagnostic cast for the fabrication of a mandibular removable
prosthesis should demonstrate facial and lingual vestibules as well as
remaining teeth. However, impression making of a partially edentulous
arch is a challenge when combined by periodontally compromised
and mobile teeth and excessively resorbed residual ridges. This article
describes a method of tray modification for impression making of a
partially edentulous arch by creating a hole in the tray.
Keywords: Impression Making; Partially Edentulous Arch; Periodontally Compromised Tooth; Resorbed Residual Ridge; Tray Modification
Keywords: Impression Making; Partially Edentulous Arch; Periodontally Compromised Tooth; Resorbed Residual Ridge; Tray Modification
Introduction
The diagnostic cast for the fabrication of a mandibular
removable prosthesis should demonstrate anatomic landmarks
of retromolar pads and facial and lingual vestibules as well as
teeth and residual ridges [1,2]. However, impression making
of a partially edentulous arch is a challenge when combined by
periodontally compromised and mobile teeth and excessively
resorbed residual ridges [3-5]. The stock tray may not fit
adequatelyin the mouth due to different shapes and sizes of
partially edentulous arches. When inadequate, the tray is modified
with the flange extended by addinga wax or an impression
compound to the periphery [1].
An ideal stock tray should match the heights of the teeth and ridge crest of edentulous areas [1]. The tray should cover the teeth and edentulous areas of the ridge and extend along the facial and lingual vestibules. However, the choice of stock tray is limited because of various distribution patterns of remaining teeth and ridge resorption. The seating of the tray can be restricted by the teeth and fails to seat over edentulous areas of the ridge, in particular when combined by an excessive discrepancy in the vertical level with supraeruption of teeth and atrophic change of residual ridge.
This article describes a method of tray modification for impression making of a partially edentulous arch. A hole is made in the tray corresponding to the location of remaining teeth. The tray can be seated fully over the ridge with the teeth passing through the hole. This procedure is advantageous in reproducing the vestibules of an excessively resorbed arch and reducing the risk of displacement and removal of substantially compromised teeth in periodontal support [5].
An ideal stock tray should match the heights of the teeth and ridge crest of edentulous areas [1]. The tray should cover the teeth and edentulous areas of the ridge and extend along the facial and lingual vestibules. However, the choice of stock tray is limited because of various distribution patterns of remaining teeth and ridge resorption. The seating of the tray can be restricted by the teeth and fails to seat over edentulous areas of the ridge, in particular when combined by an excessive discrepancy in the vertical level with supraeruption of teeth and atrophic change of residual ridge.
This article describes a method of tray modification for impression making of a partially edentulous arch. A hole is made in the tray corresponding to the location of remaining teeth. The tray can be seated fully over the ridge with the teeth passing through the hole. This procedure is advantageous in reproducing the vestibules of an excessively resorbed arch and reducing the risk of displacement and removal of substantially compromised teeth in periodontal support [5].
Technique Top
1. Evaluate the partially edentulous mouth for planning of
prosthodontic treatment. Note the severe discrepancy in the
vertical level of the supraerupted and periodontally compromised
mandibular first premolar against the excessively resorbed
edentulous areas of mandibular ridge (Figure 1).
2. Select a plastic stock tray matching the size and shape of the partially edentulous arch. Identify an interference of the tray while it is being seated against the mandibular arch.
3. Create a hole in the tray corresponding to the location of the first premolar, using a tungsten carbide bur (E-cutter; Brasseler USA Inc). Note the tooth passing through the hole (Figure 2). Ensure the full seating of the tray over the ridge without disturbing the stability of the mobile tooth. Modify the extension of tray by adding a wax (Utility wax; Kerr Corp) or a thermoplastic impression compound (Impression compound; Kerr Corp) on the periphery, as desired.
4. Make a preliminary impression of the partially edentulous mandibular arch with an irreversible hydrocolloid impression material (Jeltrate; Dentsply Caulk) to generate a diagnostic cast for the design of a free-end base removable prosthesis.
2. Select a plastic stock tray matching the size and shape of the partially edentulous arch. Identify an interference of the tray while it is being seated against the mandibular arch.
3. Create a hole in the tray corresponding to the location of the first premolar, using a tungsten carbide bur (E-cutter; Brasseler USA Inc). Note the tooth passing through the hole (Figure 2). Ensure the full seating of the tray over the ridge without disturbing the stability of the mobile tooth. Modify the extension of tray by adding a wax (Utility wax; Kerr Corp) or a thermoplastic impression compound (Impression compound; Kerr Corp) on the periphery, as desired.
4. Make a preliminary impression of the partially edentulous mandibular arch with an irreversible hydrocolloid impression material (Jeltrate; Dentsply Caulk) to generate a diagnostic cast for the design of a free-end base removable prosthesis.
Figure 1: Partially edentulous mandibular arch demonstrating severe vertical discrepancy of supraerupted and periodontally compromised first
premolar against excessively resorbed edentulous areas of ridge
Figure 2: Tray seated intraorally against atrophic ridge with first premolar passing through hole.
Discussion Top
The tray should be rigid to support an elastomeric impression
material [1]. The impression can be distorted when the support
is inadequate. In addition, the tray should extend to reach the
facial and lingual vestibules and cover the retromolar pads, in
particular when planning to fabricate a free-end base removable
prosthesis [2]. This objective can be a challenge when to making
an impression of a partially edentulous arch using a stock tray.
A variety of stock trays has been designed for impression making of a partially edentulous arch. Nonetheless, the choice is limited because of various distributions of remaining teeth and shapes of residual ridge [3]. The tray can be modified using a wax or impression compound in order to extend the flange along the vestibules of the arch [1]. However, this method can be cumbersome when combined by supraerupted and periodontally compromised teeth and excessively resorbed ridge. The patient has to open the mouth wide for intraoral placement of the tray during impression making.
The labial flange of a stock tray can be cut off when making an impression of a partially edentulous arch demonstrating periodontally compromised anterior teeth [4,5]. However, the application of this procedureis limited when the teeth are supraerupted and associated with an excessively resorbed edentulous areas of ridge. The current method allows the teeth to pass through the hole created in the tray and let the tray seat against edentulous areas of the ridge.
This method eliminates the need of wide mouth opening required when the flange of a tray is simply extended by adding a wax or an impression compound on the periphery. The positional stability of mobile teeth is not jeopardized by relieving the hydraulic pressure built during the impression making [6,7]. However, care should be taken to avoid a distortion of the impression material extruded through the hole. The impression may need a support when the hole is large for multiple teeth, using a silicone occlusal registration material.
A variety of stock trays has been designed for impression making of a partially edentulous arch. Nonetheless, the choice is limited because of various distributions of remaining teeth and shapes of residual ridge [3]. The tray can be modified using a wax or impression compound in order to extend the flange along the vestibules of the arch [1]. However, this method can be cumbersome when combined by supraerupted and periodontally compromised teeth and excessively resorbed ridge. The patient has to open the mouth wide for intraoral placement of the tray during impression making.
The labial flange of a stock tray can be cut off when making an impression of a partially edentulous arch demonstrating periodontally compromised anterior teeth [4,5]. However, the application of this procedureis limited when the teeth are supraerupted and associated with an excessively resorbed edentulous areas of ridge. The current method allows the teeth to pass through the hole created in the tray and let the tray seat against edentulous areas of the ridge.
This method eliminates the need of wide mouth opening required when the flange of a tray is simply extended by adding a wax or an impression compound on the periphery. The positional stability of mobile teeth is not jeopardized by relieving the hydraulic pressure built during the impression making [6,7]. However, care should be taken to avoid a distortion of the impression material extruded through the hole. The impression may need a support when the hole is large for multiple teeth, using a silicone occlusal registration material.
Conclusion Top
This method of creating a hole in the tray can expedite the
impression making of a partially edentulous arch, in particular
when combined by supraerupted and periodontally compromised
teeth and excessively resorbed edentulous areas of the ridge.
Using this method expedites the impression making procedure
for a partially edentulous arch for the design of a free-end base
removable prosthesis.
ReferencesTop
- Carr AB, Brown DT. McCracken’s removable partial prosthodontics. 13th ed. St. Louis. 2016:219-241.
- Jacobson TE, Krol AJ. A contemporary review of the factors involved in complete dentures. Part III: support. J Prosthet Dent. 1983;49(3):306- 313.
- McGarry TJ, Nimmo A, Skiba JF, Robert H Ahlstrom, Christopher R Smith, Jack HK, et al. Classification system for partial edentulism. J Prosthodont. 2002;11(3):181-193.
- Lee H, Park C. A method to make a preliminary impression of mobile teeth. J Prosthet Dent 2009;102(1):52-53.
- Comut AA. Tray modification for making impressions of mobile teeth. J Prosthet Dent. 2013;109(5):341-342.
- Tan KM, Singer MT, Masri R, Driscoll CF. Modified fluid wax impression for a severely resorbed edentulous mandibular ridge. J Prosthet Dent. 2009;101(4):279-282.
- Reddy SM, Mohan CA, Vijitha D, Balasubramanian R, Satish A, Mahendira K. Pressure produced on the residual maxillary alveolar ridge by different impression materials and tray design: an in vivo study. J Indian Prosthodont Soc. 2013;13(4):509-512.
