GOOD MORNING

HELP THEM

INTRODUCTION �TO�

COMPLETE DENTURES

UNDERSTAND THE EDENTULOUS PEOPLE

THE EDENTULOUS PEOPLE���������������

“The dentist must meet the mind of the patient before he meets the mouth”

Devan

COMPLETE DENTURES

���������COMPLETE (TOTAL) REHABILITATION�OF MISSING ORAL STRUCTURES

OBJECTIVES

• Preservation
• Comfort
• Esthetics
• Phonetics
• function

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RESORBED LOWER RIDGE

EDENTULISM

• Mental depression
• Esthetic compromise
• Phonetic problems
• Masticatory insufficiency
• Health concern
• Aging & fear

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MENTAL ATTITUDES

• Philosophic
• Indifferent
• Critical
• Skeptical

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DENTIST & PROSTHESIS

SKILL

EFFORT

KNOWLEDGE

LABORATORY ACCURACY

ESSENTIAL PHASES OF CD SERVICE

1. Education and motivation

2. Preparing pt for CD

3. Impressions

4. Jaw relations

5. Teeth arrangement

6. Laboratory procedures

7. Placement

8. Follow up care

KNOWLEDGE

• Anatomy
• Physiology
• Histology
• psychology

THANK YOU

�������� GOOD MORNING

COMPLETE DENTURE

IMPRESSIONS

UNDERSTAND THE EDENTULOUS PEOPLE

EDENTULISM

• Mental depression
• Esthetic compromise
• Phonetic problems
• Masticatory insufficiency
• Health concern
• Aging & fear

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THE EDENTULOUS PEOPLE���������������

• Nutritional deficiencies
• Parkinsonism
• Hypertensive
• Diabetic
• Financial constrains
• Anaemic
• Arthritis
• Dependent

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U R REQUESTED TO PROVIDE COMPLETE DENTURES!

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HELP THEM

TRAIN THEM

EDUCATE THEM

AND

LET THEM HAPPY

�������� GOOD MORNING

COMPLETE CONFIDENCE

PATIENT EXPECTATIONS

4. Tight dentures

3. Eat better

2. Improve speech

1. Improve appearance

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CONCEPTS OF NEW CD PATIENTS

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Unaware about the difficulties

Denture teeth = Natural teeth

Dentures last forever

OTHER POSSIBILITIES

• Over dentures
• Implant dentures

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��TYPES OF� COMPLETE DENTURE� IMPRESSIONS

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• Mucostatic
• Mucocompressive
• Minimal pressure
• Selective pressure

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PROSTHESIS

SKILL

EFFORT

KNOWLEDGE

LABORATORY ACCURACY

ACCEPTABLE � IMPRESSION PROCEDURES

IMPRESSION COMPOUND�PRELIMINARY IMPRESSIONS

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It is a slightly (1-2 mm) over extended and mucocompressive impression of the basal seat.

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It should record all the anatomical structures of supporting and surrounding tissues.

Oral examination

Tray selection

Tray positioning & loading

Snap Impression

Refining The Impression

Labial frenum

Labial vestibule

Buccal frenum

Buccal vestibule

Coronoid notch

Pterygomaxillary region

Hamular notch

Refined preliminary �maxillary impression

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It is a slightly (1-2 mm) over extended and mucocompressive impression of the basal seat.

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It should record all the anatomical structures of supporting and surrounding tissues.

Mandibular ridge

Tray selection

Tray positioning & loading

Initial placement

Add material

Labial frenum & labial flange

Buccal frenum

Refining

Buccal flange

Lingual frenum

Alveololingual sulcus

DISCUSSION … Anatomical structures

Revision

• Tray positioning/Snap impression
• Add material
• Shape it
• Mould it
• Refine it

ALGINATE IMPRESSIONS

PRELIMINARY CAST

• LARGER IN DIMENSION THAN MASTER CAST
• ALL TISSUES ARE IN A COMPRESSED STATE

BORDER EXTENSION

CUSTOM TRAY

• 3-4 mm short of the sulcus
• Should be rigid
• Should have smooth borders
• Wax relief and spacer

Soft tissue

• Thickness of the BASAL SEAT varies from

0.5 - 3mm in different areas

Selective pressure

Minimally compressible areas (0.5-1.5mm):

Not compressed

Vital areas:

Not compressed

Compressible areas (1.5-3mm):

Compress within physiologic limit

T- Spacer

SPACER DESIGNS

• Boucher
• Rudd and morrow
• Sharry
• Bernard
• Halperin
• Mc Gregor
• Heartwell

SPACER THICKNESS

• Imp. Plaster – 2mm
• ZnOE – 0.5mm
• Alginate – 3mm
• Polysulfides – 1.5mm
• Silicones – 3mm

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Crestal relief

BORDER MOLDING

• Record the depth and width of the sulcus
• Include maximum area within physiologic limit

Lip support

POSTERIOR PALATAL SEAL

PRESSURE RELIEVING HOLES

FINAL IMPRESSIONS�(ZnOE WASH IMPRESSION)

�������Problems with ZnOE impressions

Brittle

Consistency

Mucous secretions

Improper pressure & voids

FINAL IMPRESSION�ZnOE V/S Elastomers V/S Alginate

UK

42% - 39% - 19%

US

30% - 50% - Not preferred

India

73% - 19% - 8%

DISCUSSION: Selective pressure wash impressions

EDENTULOUS

ELASTOMERIC IMPRESSIONS

ELASTOMERIC IMPRESSIONS

PRIMARY CAST

PRIMARY CAST

INNOVATIVE IDEAS�ON

IMPRESSION MAKING

Tray selection & Contouring

Mixing & loading

Initial positioning & contouring

Special tray

One step border molding

Labial side

Buccal and posterior area

Shaping the borders

Refining the borders

Correcting overextension

Relief

Pressure relieving holes

Light body material

Mandibular tray selection

shaping

Loading & initial placement

Border molding & refining

Overextensions

Crestal relief

SUMMARY

DISCUSSION

THANK YOU

ACCEPTABLE � IMPRESSION PROCEDURES� FOR COMPLETE DENTURES

CONVENTIONAL METHOD

Preliminary impression

Primary cast

T- Spacer

Crestal relief

Selective pressure impression technique

Minimally compressible areas (0.5-1.5mm):

Not compressed

Vital areas:

Not compressed

Compressible areas (1.5-3mm):

Compress within physiologic limit

Border molding

PRESSURE RELIEVING HOLES

FINAL IMPRESSIONS�(ZnOE WASH IMPRESSION)

�������Problems with ZnOE impressions

Brittle

Mucous secretions

Improper pressure & voids

Consistency

ELASTOMERIC IMPRESSIONS

PRIMARY CAST

T- Spacer

One step border molding

Disclosing over extension

Light body

Master impression

Mandibular �border molding

Verifying the extension

Correction of under extension

INNOVATIVE IDEAS�ON

IMPRESSION MAKING

Tray selection & Contouring

Mixing & loading

Initial positioning & contouring

Special tray

ONE STEP BORDER MOLDING

Shaping the borders

Refining the borders

Correcting overextension

Relief

Pressure relieving holes

Light body material

Selective pressure wash impression

shaping

Loading & initial placement

Border molding & refining

Overextensions

Crestal relief

THANK YOU

ORIENTATION OF OCCLUSAL PLANE

TENTATIVE JAW RELATIONS

TEETH SELECTION

Dentogenic concept / SPA factor

Give complete freedom to the patient.

Dentist can give suggestions.

ESTHETICS

PHONETICS

COMFORT

FUNCTION

�FINALISING THE VERTICAL HEIGHT

POST INSERTION PROBLEMS

• ALLERGY
• GAGGING
• SALIVATION

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• APPEARANCE
• REFUSE
• ROCKING
• SPEECH PROBLEMS

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• UNABLE TO SWALLOW
• CHEEK BITE
• TONGUE BITE
• CLICKING

DISLODGED UPPER DENTURE

• YAWNING
• SMILING
• COUGHING
• AFTER FEW HOURS

• FOOD ENTRAPMENT
• FLOATING DENTURE
• DISCOMFORT
• TMJ PAIN

• UNABLE TO CHEW
• PAIN AND SORENESS
• PERLECHE
• BURNING SENSATION

• NUMBNESS
• XEROSTOMIA
• MUSCLE FATIGUE
• DENTURE STOMATITIS

• DETACHED TOOTH
• GLOSSITIS
• FRACTURE DENTURE

YOU ARE THE ENTIRE OCEAN,� IN A DROP

NOW; YOU ARE NOT A DROP IN THE OCEAN

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