A STUDY AND PROCEDURE GUIDE by. Brien R. Lang, D. D. S., M. S.. Professor and Chairman. Department of Complete Denture. William C. Godwin, D. D. S. ESSENTIALS OF COMPLETE DENTURE SE:RVICE. tisidelaso.gqR:D.D.S. '. The Ohio State University, College of Dentistry, Columbus, Ohio. This article. Start by marking “Boucher's Prosthodontic Treatment for Edentulous Patients” as Want to Read: Be the first to ask a question about Boucher's Prosthodontic Treatment for Edentulous Patients. Trivia About Boucher's Prostho.
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[George A Zarb; Charles L Bolender; Gunnar E Carlsson; Carl O Boucher;] Relining or rebasing of complete dentures / George A. Zarb -- retention of. Trove: Find and get Australian resources. Books, images, historic newspapers, maps, archives and more. PDF | Impression Techniques and Materials for Complete Denture Boucher CO () Complete denture prosthodontics--the state of the art.
Long-term immersion has been shown to alter the accuracy of both polyether and VPS. Recommendation has been made that these materials be only spray disinfected to avoid imbibition and dimensional changes Johnson et al. Impression materials have since been changed Wadhwani et al. Studies demonstrated that impression material accuracy was unaffected by immersion disinfection if the recommended time of disinfection is used.
Overall accuracy of polyether and addition silicone materials stayed acceptable Kern et al. Linear dimension variations after disinfection were clinically insignificant Lagenwalter et al.
In order to demonstrate the superiority of new materials and techniques on traditional procedures, some authors compare the number of post-insertion appointments required. They found no significant difference Firtell and Koumjian, ; Troendle and Troendle, MEDLINE, Elsevier, and hand searches were conducted for articles on selected aspects of impression materials and techniques for complete dentures with a focus on the best available evidence. If publications of the highest levels, i. Most textbooks advocate a two-stage procedure: There are many materials for the final impression, such as gypsum, zinc oxide and eugenol ZOE paste, polysulfide rubber, polyether, polyvinyl siloxane, and alginate.
Preferences vary much among dentists. However, there is no evidence that one technique or material produces better long term results than another. Many general practitioners use a single alginate impression as the definitive impression for the construction of complete dentures, which conflicts with the teaching in practically all dental schools. It is, therefore, of interest that an RCT found neither patient-assessed nor dentist-evaluated differences between dentures fabricated according to a traditional or a simplified method.
The simple technique used alginate in a standard tray for the definitive impression, whereas the traditional technique included an individual tray with border molding and polyether for the final impression Kawai et al. Although impression materials differ in many aspects and a variety of techniques exist in taking the impressions, there is no evidence to conclude that the clinical long-term outcome of dentures fabricated using varying materials and methods would differ significantly.
These and other aspects of variation in methods and techniques are discussed in a review of an evidence base for complete dentures Carlsson, We should recognize that a variety of dental impression materials are still currently being used. The majority of which originated for use in non-dental-related fields. The elastomers were developed as an alternative to natural rubber during World War II.
These materials have since been modified chemically and physically for use in dentistry. Initially, this group consisted exclusively of polysulfide impression materials.
Subsequently, condensation-cured silicones were developed. Today, two of the most popular elastomers used in dental practice are the polyethers and addition-reaction silicones, or vinyl polysiloxanes Wadhwani et al.
The popularity of the elastomer materials is understandable, given the combination of excellent physical properties, handling characteristics, and unlimited dimensional stability De Araujo and Jorgensen, Polyvinylsiloxane putty and light-body impression material are well suited for making complete denture impressions. Obviously, good results are obtained with less expenditure of time as well as less discomfort and inconvenience for the patient, especially in the hands of an inexperienced operator Lu et al.
In addition, the odor, taste, and color of the polysiloxane materials give them good patient acceptability.
The dentist appreciates the ease with which they can be used Komiyama et al. Distinct trends for increasing use of polyvinylsiloxane and polyether for border molding procedures and impressions of edentulous arches were observed.
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They are well suited for making complete denture impressions. The material can be easily and evenly applied on the tray borders with one insertion of the tray. They demonstrate excellent accuracy, and the fewest dimensional changes after multiple pours. There is agreement in the relative order of increasing hydrophilicity for elastomeric impression materials; silicone is less hydrophilic than polysulfide, which in turn is less hydrophilic than polyether. Polyether and hydrophilic addition silicone produced casts with more soft tissue details than low-viscosity polysulfide or ZOE.
Polyether rubber is intermediate in stability to polysulfide or silicone systems and polyvinylsiloxane. Not all addition-reaction silicone impression materials tested were compatible with all of the Type IV gypsum products used in this study.
Some materials did reproduce detail on the impression surface but failed to transfer the detail to the cast. National Center for Biotechnology Information , U. Journal List Saudi Dent J v.
Saudi Dent J. Published online Jul Elie E. Author information Article notes Copyright and License information Disclaimer. Production and Hosting by Elsevier B. All rights reserved. Abstract This article reviews the current trends in materials used for complete denture impression. Elastomers, Complete denture, Impressions. Introduction An impression is a record, a facsimile of mouth tissues taken at an unstrained rest position or in various positions of displacement Devan, Current trends surveys Patient studies demonstrate that millions of individuals without complete dentitions will require prosthodontic treatment well into the 21st century Burton, ; Petropoulos and Rashedi, Clinical implications 3.
Mixing Despite all the advantages that elastomeric materials possess, a thorough understanding of the composition, physical properties, and manipulative variables of these materials is essential to achieve predictable success Chee and Donovan, Custom tray The silicone, polysulfide rubber, and polyether impression materials can record the shape of soft tissues accurately if they are adequately supported by an accurately fitted tray Williams et al.
Dimensional change In the dental practice, pouring of the impression is often delayed due to time constraints, and the majority of impressions are sent to a commercial laboratory for pouring Harrison et al.
Hydrophilic behavior There are also definite differences in the hydrophilic behavior of the most popular elastomeric materials that are used for final impressions for complete dentures. Soft tissue detail An impression of an edentulous area is a negative reproduction of tissue positions recorded at the moment of setting of the impression material Firtell and Koumjian, Viscosity Viscosity is one of the factors that influence surface detail reproduction.
Type IV gypsum compatibility and wettability Differences in dimensional stability, wettability, and surface hardness have been identified for gypsum casts poured against various elastomeric impression materials Panichuttra et al. Disinfection Disinfection procedure recommendations have changed throughout the years on the basis of research and technique effectiveness.
Post-insertion adjustments In order to demonstrate the superiority of new materials and techniques on traditional procedures, some authors compare the number of post-insertion appointments required.
Discussion and conclusions MEDLINE, Elsevier, and hand searches were conducted for articles on selected aspects of impression materials and techniques for complete dentures with a focus on the best available evidence.
In conclusion: References Abado G. Effect of disinfectant agents on dimensional stability of elastomeric impression materials. Pressure generated on a simulated mandibular oral analog by impression materials in custom trays of different design.
Annual review of selected dental literature: Clinical evaluation of polyvinylsiloxane for complete denture impressions. A mandibular impression technique for displaceable tissue. The results of a brief survey of complete denture prosthodontic techniques in predoctoral programs in North American Dental Schools.
Complete denture prosthodontics — the state of the art. Evaluation of accuracy of the wash impression technique to rebase and replace the resilient part of a soft-lined denture.
Prosthodontic treatment for edentulous patients
Current trends in removable prosthodontics. Type IV gypsum compatibility with five addition-reaction silicone impression materials. Facts and fallacies: Polyvinylsiloxane impression materials: Impression materials for complete and partial denture prosthodontics. North Am. Wettability of elastomeric impression materials an voids in gypsum casts. Accuracy and dimensional stability of a silicone rubber base impression material.
Effect of material bulk and undercuts on the accuracy of impression materials. Basic principles in impression making. Report of the committee on scientific investigation of the American academy of restorative dentistry. A retrospective comparison of two definitive impression techniques and their associated postinsertion adjustments in complete denture prosthodontics. Teaching an abbreviated impression technique for complete dentures in an undergraduate dental curriculum.
A selective-pressure impression technique for the edentulous maxilla. Predictable impression procedures for complete dentures. Mandibular complete denture impressions with fluid wax or polysulfide rubber: Functional impressions with thermoplastic materials for reline procedures. Methods and materials for the construction of complete dentures.
A comparison of the compatibility of elastomeric impression materials, type IV dental stones, and liquid media. Original technique for secondary impressions in complete removabl e dentures.
The Open Dentistry Journal
Harrison A. Prosthodontic techniques and the timing of complete denture procedures — a survey. Complete denture construction in general dental practice: Upper to the bone that supports it. The two principal func- incisors may be displaced labially with each biting tions of the periodontium are support and posi- thrust, and these tooth movements probably cause tional adjustment of the tooth, together with the proximal wear facets to develop.
The patient who needs complete denture only during the functional movements of chewing therapy is deprived of periodontal support, and the and deglutition and during the movements associ- entire mechanism of functional load transmission ated with parafunction i.
It has been calculated that the total time during The occlusal forces exerted on the teeth are which the teeth are subjected to functional forces of controlled by the neuromuscular mechanisms of mastication and deglutition during an entire day the masticatory system.
Reflex mechanisms with amounts to approximately Through normal function, the periodontal struc- Therefore the total time and the range of forces tures in a healthy dentition undergo characteristic seem to be well within the tolerance level of mechanical stress. The most prominent feature of healthy periodontal tissues. It must be emphasized 10 Part One On Being Edentulous Box sized the superbly evolved quantitative and qualita- tive aspects of periodontal ligament support for a Calculation of Total Time during functioning dentition.
The approximate area of 45 24 Hours When Direct Functional cm2 in each arch combines with viscoelasticity, sophisticated sensory mechanisms, and osteogene- Occlusal Force Is Applied to the sis regulation potential to cope with the diverse Periodontal Tissues directions, magnitudes, and frequencies of differ- Chewing ent forms of occlusal loading.
On the other hand, the unsuitability of the tissues supporting complete Actual chewing time sec per meal dentures for load-bearing function must be imme- Four meals per day sec diately recognized because the mucous membrane One chewing stroke strokes is forced to serve an identical purpose as the peri- per sec odontal ligaments.
Duration of each stroke 0. Researchers have computed deglutition the mean denture-bearing area to be These figures, par- with occlusal force ticularly the mandibular ones, are in dramatic con- trast with the cm2 area of periodontal ligament Between meals available in each dental arch Figure This minimal tolerance can be reduced still further by the presence of systemic diseases such as anemia, hypertension, or diabetes, as well as nutritional deficiencies.
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In fact, any dis- that the collective forces acting on a prosthetic turbance of the normal metabolic processes may occlusion are not likely to be controlled or attenu- lower the upper limit of mucosal tolerance and ini- ated as effectively as they appear to be by the natu- tiate inflammation. Consequently, the time-dependent Masticatory loads are much smaller than those response of complete denture tissue support will that can be produced by conscious effort and are in manifest itself differently from those changes the region of 44 lb 20 kg for the natural teeth.
In fact, maximal bite forces appear DENTURES to be five to six times less for complete denture The basic challenge in the treatment of edentulous wearers than for persons with natural teeth.
Patients ments are supported. The previous section empha- with prostheses frequently limit the loading of Chapter 2 Biomechanics of the Edentulous State 11 B Figure The area of periodontal ligament supporting an intact natural dentition has been computed to be approximately 45 cm2 in each arch A.
When teeth are lost, and a patient becomes edentulous B , aspects of support for an occlusion are severely compro- mised both qualitatively and quantitatively. A variety of tolerance. Alveolar bone supporting natural teeth receives tensile loads Residual Ridge through a large area of periodontal ligament, The residual ridge consists of denture-bearing whereas the edentulous residual ridge receives ver- mucosa, the submucosa and periosteum, and the tical, diagonal, and horizontal loads applied by a underlying residual alveolar bone.
Residual bone is denture with a surface area much smaller than the that bone of the alveolar process that remains after total area of the periodontal ligaments of all the teeth are lost. When the alveolar process is made natural teeth that had been present. Clinical experi- edentulous by loss of teeth, the alveoli that con- ence underscores the frequently remarkable adap- tained the roots of the teeth fill in with new bone.
On the other 12 Part One On Being Edentulous hand, edentulous patients demonstrate very little simulating the role of the periodontium. This com- adaptation of the supporting tissues to functional promised support is further complicated because requirement. This movement is related to the patients is that wearing dentures is almost invariably resiliency of the supporting mucosa and the inherent accompanied by an undesirable and irreversible bone instability of the dentures during functional and para- loss.
The magnitude of this loss is extremely variable, functional movements. Because movement of den- a direct consequence of loss of the periodontal struc- ture bases on their basal seats can cause tissue tures, variable progressive bone reduction occurs.
Clinical experience strongly suggests a definite There are two physical factors involved in den- relationship between healthy periodontal ligaments ture retention that are under the control of the den- and maintained integrity of alveolar bone, thus the tist and are technique driven. The tissue support basal seat. In fact, the buccina- A Figure A, Panoramic radiographs showing the jaws of four edentulous patients.
Residual ridge reduction has occurred to variable extents. The difference between a and b represents the reduction in height of the alveolar ridges between stages of observation. The shaded area denotes resorption. C is a reproduction of progressive residual ridge reduction as reflected in a composite of five different lateral cephalograms. Furthermore, the design tissues the basal seat change, harnessing muscu- of the labial, buccal, and lingual polished surfaces lar forces in complete denture design becomes par- of the denture and the form of the dental arch are ticularly important for denture retention.
This causes displacement of the compound away from the tissues and creating space for alginate.
Care should be taken that the displacement is within the limits to create the space. This will enable mechanical retention of alginate Fig.
Extending the grooves upto the borders of compound impression will allow the alginate material to pass through. Following which apply alginate adhesive. The application of adhesive will reinforce the retention of alginate especially that the thickness of alginate is not sufficient to hold on its own.
Now, mix the irreversible hydrocolloid Tropicalgin, Roviogo, Italy according to the manufacturers specifications and load the primary impression compound tray, within the confine of the compound impression. Just before inserting the impression material, instruct the patients to gargle their mouth with astringent mouthwash to reduce the viscosity of the saliva.For the fabrication of an accurate custom tray a correctly recorded preliminary impression plays an important role.
Facts and fallacies: It is also important to notice that elastomeric materials demonstrate elastic recovery from undercuts De Araujo and Jorgensen, ; Nissan et al. Patients ments are supported. The patient who needs complete denture only during the functional movements of chewing therapy is deprived of periodontal support, and the and deglutition and during the movements associ- entire mechanism of functional load transmission ated with parafunction i.
It has been completely revised for this 11th edition, and includes chapters by several clinical educators of international stature. It judgment expertise required to fabricate complete provides, above all else, the challenge and satisfac- dentures. Nevertheless, it is not a panacea for the world presumed that their prosthodontic endeavors edentulous predicament Plate Bolender " ;. Custom tray The silicone, polysulfide rubber, and polyether impression materials can record the shape of soft tissues accurately if they are adequately supported by an accurately fitted tray Williams et al.
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