DM 037: PROSTHODONTICS 3

Module #10

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Date:
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Lesson title: MANDIBULAR IMPRESSIONS Materials:

Lesson Objectives: Ballpens, erasers, pencils and
1. Learn the mandibular impression procedures and module 10
techniques.
2. Learn the principles, objectives and fundamentals of References:
mandibular impression  Prosthodontic Treatment for
Edentulous Patient, 13th Ed
3. – Zarb, Hobkirk, Eckert,
Jacob
 Essentials of Complete
Denture Prosthodontics, 3rd
Ed – Sheldon Winkler
 Textbook of Complete
Dentures 6th Ed – Rahn,
Ivanhoe
 Prosthetic Treatment of the
Edentulous Patient 5th Ed –
Basker, Davenport,
Thomason

Productivity Tip:
DON’T OVERTHINK. You will just have a headache. You have all the time in the world. Don’t overload
your brain by thinking too many things at once. Stop thinking about your boyfriend. Let them think about you.

A. LESSON PREVIEW/REVIEW

Introduction (2 mins)

Hello students! Welcome to module # 10 “MANDIBULAR IMPRESSION PROCEDURES. After

familiarizing the anatomical landmarks that needs to be considered when taking
mandibular impressions, we will be reviewing the principles, objectives and fundamentals
in making impressions for the mandible. This module will also cover mandibular
impression techniques, methods and impression materials of choice.

B.MAIN LESSON

Activity 2: Content Notes (13 mins)

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 DM 037: PROSTHODONTICS 3
Module #10

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Date:
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MANDIBULAR IMPRESSION

CLASSIFICATION OF MANDIBULAR IMPRESSIONS

1) SELECTIVE PRESSURE IMPRESSIONS (also known as modified functional impression technique)

These are made in trays that have more space in them for the final impression material in some places
than in others. The places that have less space/relief will transmit more pressure from the denture when in
function to favorable part of the bone (such as the buccal shelf and the retromolar pad - the primary &
secondary stress-bearing areas of the mandible) & less pressure to unfavorable parts (such as sharp ridge or
bony spicule and anterior part of the mandibular ridge – the nonstress-bearing or relief areas). In the stress-
bearing areas, the impression material is thinner and thicker in the nonstress-bearing/relief areas. This will
require a heavier body or less fluid type of impression material.
*** Where is pressure applied in selective pressure technique?
*** Where is relief or less pressure applied in selective pressure technique?
***What type of imp material is used in this technique?

The disadvantage of this technique:

When the dentures are brought into initial contact/occlusion, the midlines of both upper and lower are not in
alignment and becomes aligned when pressure is exerted from full contact. With this, the lower denture
creates frictional movement between the mucous membrane and the denture and risk in injuring the tissue.
Initial denture contact creates a misaligned
midline

Midline aligns later when more pressure is

exerted

2) PRESSURELESS IMPRESSIONS (also known as MUCOSTATIC or ANATOMIC impression)

These are made with the least possible displacement of soft tissues covering the residual alveolar bone. They
incorporate a large amount of space between the tray of the soft tissues of the basal seat and consequently
require a very fluid type of impression material.
*** Where is pressure applied in mucostatic technique?
***What type of imp material is used in this technique?

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 DM 037: PROSTHODONTICS 3
Module #10

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Date:
________________

The disadvantage of this technique:

When the dentures are brought into initial contact, the midlines of both upper and lower are in alignment and
may or may not misalign when pressure is exerted from full contact. Since pressure is exerted on all surfaces
simultaneously, presence of sharp areas like sharp ridges may cause discomfort or pain during function.

Initial denture contact creates an aligned

midline. During full contact or more
pressure is exerted on the denture, the
midline may or may not misalign.

SELECTIVE PRESSURE TECHNIQUES:

1. FIRST TECHNIQUE - BORDER-MOLDED SPECIAL TRAY (refer to module #8)
2. SECOND TECHNIQUE-ONE-STEP BORDER-MOLDED TRAY (refer to module #8)
3. THIRD TECHNIQUE - CUSTOM TRAY DESIGN BASED ON THE PREVIOUSLY WORN DENTURE.
In this technique, the patient's original denture is refitted with a treatment liner. The optimized fitting
surface of the denture or the denture bearing (tissue contacting) area is reproduced in stone. A wax
spacer is placed to cover the entire cast, 3 to 4 mm short of the borders. A custom tray is fabricated
over the spacer, and a final impression is made in the tray.

Clinical experience suggests that any of these three techniques will produce an impression that fulfills
biomechanical objectives. However, when advanced residual ridge resorption in the anterior mandible is
present, and particularly if it is accompanied by high unfavorable soft tissue attachments (which minimize the
amount of gingiva available for direct stress bearing), the first and third techniques are easier to apply.

General Requirements for Biomaterials Used to Make Complete Dentures

1. The material must be biocompatible (i.e., with minimal harmful effects on the oral tissues):
• Nontoxic, nonirritating
• Nonallergenic, noncarcinogenic
• Chemically minimally degradable or its degradation processes are biocompatible
2. The material must fulfill clinical objectives by possessing appropriate optimal physical properties:
• Adequate mechanical properties such as hardness, elasticity, and strength
• Adequate wear resistance

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 DM 037: PROSTHODONTICS 3
Module #10

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• Adequate thermal coefficient of expansion and conductivity properties

• Acceptable esthetic properties
• Ease of cleansing
• Relative ease of fabrication and manipulation
• Readily available and economical to use
• Allows for easy and inexpensive maintenance such as repairs and additions

Optimal Qualities for Prosthodontic Impression Materials

• They should have low enough viscosity to adapt to the oral tissues, yet be viscous enough to be contained
in the impression tray.
• The material should have adequate wettability of the oral tissues to allow for accurate adaptation and
capturing of the oral structures and tissues.
• The material must have a pleasant taste and odor.
• In the mouth, the material should set into a rubbery or rigid solid in a reasonable amount of time.
• Upon removal from the mouth, the set impression should show adequate elastic recovery with no
permanent deformation.
• The material must have adequate strength to avoid tears or breakage upon removal from the mouth.
• The impression should be dimensionally stable after setting and until pouring of the cast.
• The impression can remain dimensionally stable to be repoured after removal from the cast.
• The material must be compatible with the cast material.
• The material must be biocompatible, nontoxic, and without irritant constituents.
• The material must be of a color and opacity that allows for proper evaluation of the impression by the
dentist.
• The material could be readily disinfected without significant loss of accuracy or loss of mechanical
properties.
• The material must have an adequate shelf life for storage.
• The materials, associated processing time, and equipment should be cost-effective.

Types of impression materials used:

1.) Non-Elastic Impression Material
A.) Impression or modelling compound (type I and II)
B.) ZOE Impression material
C.) Plaster (not used anymore)
2.) Elastic Impression Material
A.) Hydrocolloids (Reversible=Agar and Irreversible=Alginate)
B.) Elastomeric – Polysulfide, Condensation silicone, Addition silicone, Polyether)
***Examples of non-elastic imp materials?
***Examples on elastic imp materials?

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 DM 037: PROSTHODONTICS 3
Module #10

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Date:
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Zinc Oxide Eugenol (ZOE) Impression Paste Applications

• Mainly used for final impressions of edentulous ridges with minor or no undercuts
• As a wash impression with other impression materials, such as impression compound
• As an occlusal registration material
• As a temporary liner material for dentures
• As a surgical dressing
****What are the uses of ZOE?

Zinc oxide, in the presence of moisture, reacts with eugenol (oil of cloves) to form zinc eugenolate, a
chelate (the process is called chelation). The setting reaction is accelerated by the presence of water, high
humidity, or heat. Some of these factors can be controlled by the dentist to decrease or increase the setting
time. The materials are classified as hard or soft pastes according to their consistencies, hardness, and
setting times (10 and 15 minutes, respectively). Initial setting time for both types is 3 to 5 minutes.
Noneugenol pastes, containing carboxylic acids in place of eugenol, also are available. This avoids the
stinging and burning sensation of eugenol experienced by some patients.
*** Zinc eugenolate = Zinc oxide + Eugenol + ???
***What is the product called when Zinc oxide is mixed with Eugenol?
***What accelerates the setting reaction/time of ZOE?
***Site (2) disadvantages of using ZOE imp?

Dental Impression Compound (Types I and II)

Impression compound, also called modeling plastic, is a thermoplastic material that is supplied in the form of
cakes (red) or sticks (green, grey, or red), with the colors representing different fusing temperatures.

Compound Types:
Type I (Lower Fusing Material)

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 DM 037: PROSTHODONTICS 3
Module #10

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Date:
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Cakes: As an impression material for completely edentulous patients, the material is softened by
heat, inserted into the tray, and placed against the tissues before it cools to a rigid mass. Sticks: As a border
molding material for the custom tray, the material is used before making the final impression.

Type II (Higher Fusing Material) (tray material)

Type II compound is used as a tray adaptation material, which requires more viscous properties. It is
used for making a primary impression of the soft tissues and then used as a tray to support a thin layer of a
second impression material, such as ZOE paste, hydrocolloids, or nonaqueous elastomers.

Composition and Manipulation

Dental compound is a mixture of waxes and thermoplastic resins (principal ingredients that form a matrix)
plus fillers that increase viscosity above mouth temperatures and provide rigidity at room temperature. It also

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 DM 037: PROSTHODONTICS 3
Module #10

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includes shellac, stearic acid, and gutta percha, which contribute to plasticity and workability.

Agar (Reversible Hydrocolloid)

Composition of Agar: Agar is supplied as a gel and contains the following ingredients:
• Agar (Red algae): gelling agent
• Borax: improves strength
• Potassium sulphate: gypsum hardener, provides a good surface for the gypsum casts
• Alkyl benzoates: preservatives
• Water: reaction medium, the principal ingredient in the set material (>80%)
• Coloring agents
• Flavoring agents
***What are the ingredients of agar? “Site each and their function”
***What is the main ingredient of agar? Note: this is a board question?

Alginate (Irreversible Hydrocolloid)

Alginate is provided as a powder, which contains the following ingredients:

• Potassium or sodium alginate: dissolves in water and reacts with calcium ions
• Calcium sulphate dihydrate: a reactor, reacts with potassium alginate to form a dihydrate insoluble alginate
gel
• Zinc oxide: filler particles, affects properties and setting time
• Potassium titanium fluoride: accelerator, counteracts the inhibiting effect of the hydrocolloid on the setting
of stone; ensures good quality surface of the cast
• Diatomaceous earth: filler particles, controls the consistency of the mix and the flexibility of the set alginate
• Trisodium phosphate: retarder, controls the setting time to produce either regular or fast-set alginates
• Coloring agents
• Flavoring agents
*** What are the ingredients of Alginate? “Site each and their function”
*** What is the main ingredient of alginate?

ELASTOMERS

Polysulfide Rubber
The Base:
 Polysulfide polymer is the principal ingredient.
 Fillers such as titanium dioxide and zinc are added. (Note: fillers are not involved in the chemical
reaction they are added to the polymer liquid to make a paste-like consistency or make the
material more viscous)
 Sulphate, copper carbonate, or silica is added for strength.
 The filler content varies according to the consistency of the paste.

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 DM 037: PROSTHODONTICS 3
Module #10

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 Dibutyl phthalate, a plasticizer, confers viscosity to the base.

The Accelerator/Reactor:
 Lead dioxide, hydrated copper oxide, or organic peroxide is used as a reactor.
 Sulfur, a promoter, accelerates the reaction.
 Oleic or stearic acid, a retarder, controls setting reaction.
 Working time: 5-7 minutes, considered the longest among elastomers
 Setting time: 8-12 minutes
 Pouring the cast: The impression must be poured within 30 minutes to 1 hour.
***What are the ingredients of polysulfide rubber? “Site each and their function”
***Working time of polysulfide?
***Setting time of polysulfide?

Condensation Silicones
The Base Paste
 High molecular weight polymer, such as polydimethylsiloxane
 Fillers, such as silica or calcium carbonate

The Liquid Accelerator

 A metal organic ester, such as tin octoate Orthoalkyl silicate Oil-based diluents
 As a paste, the accelerator would have thickening agents added to increase viscosity
 Working time: 3 minutes
 Setting time: 6-8 minutes
 Pouring the cast: The impression must be poured as soon as possible within the first 30 minutes
***What are the ingredients of condensation silicones? “Site each and their function”
***Working time of cond silicones?
***Setting time of cond silicones?

Addition Silicones
The Base
 Polymethylhydrosiloxane (low molecular weight polymer), fillers

The Accelerator
 Divinyl polymethyl siloxane Other siloxane prepolymers, fillers
 Platinum salt, as a catalyst
 Retarder, controls the working and setting times
 Working time: 2-4.5 minutes
 Setting time: 3-7 minutes
 Pouring the cast: The cast can be poured up to 1 week after making the impression.
***What are the ingredients of addition silicones? “Site each and their function”
***Working time of addn silicones?
***Setting time of addn silicones?

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 DM 037: PROSTHODONTICS 3
Module #10

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Date:
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Polyether Elastomer
The Base
 Polyether polymer Colloidal filler, such as silica Plasticizer, such as glycol ether or phthalate

The Accelerator
 Alkyl aromatic sulfonate, an initiator
 Filler
 Plasticizer
 Working time: 2.5 minutes
 Setting time: 4.5 minutes
 Pouring the cast: The impression can be poured up to 1 week of storage.
***What are the ingredients of polyether? “Site each and their function”
***Working time of polyether imp?
***Setting time of polyether imp?

C. LESSON WRAP-UP

Activity 6: Thinking about Learning (5 mins)

A. Work Tracker
You are done with this session! Let’s track your progress. Shade the session number you
just completed.

B. Think about your Learning

1.) Rate from 0-5 were 0 means “Hard as rock” and 5 means “Easy – like a hot knife slicing
through butter “, How difficult was this module?

2.) Was our learning target/objective met? Refer to objective/s and answer yes or no

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 DM 037: PROSTHODONTICS 3
Module #10

Name: Click or tap here to enter text. Class number:

_______
Section: Click or tap here to enter text. Schedule:
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Date:
________________

3.) In case this module gave you some difficulty, which part of this module did you encounter
such difficulty? Place NA if not applicable.

FAQs

1. Why is the retromylohyoid the most likely area to incompletely capture during mandibular
impression?

ANSWER: A. Because of the shape: The retromylohyoid area is an undercut so a material that has a low
viscosity is needed or some modification of the technique like the “syringe technique” should be employed and
also the shape of the lingual flange of the tray which mostly deflect the impression material away from the
area; B. Because of its location: the retromylohyoid is located distal to the floor of the mouth and posterior to
the mylohyoid muscle attachment, and C. Inadequate impression material in the lingual flange of the tray.

2. Why is it that even if we have the same patient as my classmate, I have fewer buccal frena registered
than she has?

ANSWER: Your classmate performed the border-molding technique better than you.

 This module will be collected at a designated time and place for checking and
grading.
 Download this module in pdf or docx and answer in the same format using
Microsoft word or pdf editor. Save the file. Rename the file in this format
Ebua.Allan.DM037.CD.Mod.1.docx or Ebua.Allan.DM037.CD.Mod.1.pdf send it to the
email address provided below.
 Phone calls/virtual calls/chat/ to students will be scheduled for work monitoring,
providing guidance, answering questions and checking understanding.

Contact Details

 Dr. Allan Rotello Sia Ebua

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 DM 037: PROSTHODONTICS 3
Module #10

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Date:
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 Mobile: +63-968-317-1218, +63-929-886-1569

 Facebook/Messenger: https://www.facebook.com/dr.allan.ebua
 Email: For submission of modules, use email below based on your section:
For DM037 – sec A1 send to: [email protected]
For DM037 – sec A2 send to: [email protected]
For DM037 – sec A3 send to: [email protected]

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