Archives of Dental Sciences 2010, Vol.

1, Issue 1, 84-86

Technique Update V.N. Malik and Ritesh Gaurav

Technique Update
Distal Extension Impression Technique. (Impression technique for distal extension in removable partial dentures)
V.N. Mallik, 1 Ritesh Gaurav, 2
1. 2. MDS, Professor and H.O.D. Department of Prosthodontics, Prosthodontics, Dr. B. R. Ambedkar Institute of Dental Sciences and Hospital, Patna MDS, Reader, Department of Prosthodontics, Dr. B. R. Ambedkar Institute of Dental Sciences and Hospital, Patna

Abstract To provide maximum support for removable partial dentures distal extension technique is applied. This technique provides minimal movement of the denture base and hence prevents the abutment teeth from acting as levers.

During anatomic impressions, excessive forces will be directed to abutment teeth and hence it will compress the tissues under denture base. To equalize the support derived from abutment teeth and residual ridges, a dual impression technique is used. This technique records the teeth in anatomic form and tissues in distal extension base in functional form. Various techniques are used for distal extension partial denture impression making: 1. McLeans Technique: This technique records tissue of ridge in functional form and then relates the remainder of arch by a second impression. Procedure: In this procedure, a custom tray with modeling plastic occlusal rims is made and a functional impression of distal base is made under biting force. Then an alginate impression is made with first impression kept in position under finger pressure. 2. Hindels Technique: In this method, first impression of the ridge is made with Zinc oxide eugenol. Then, a special tray is used for secondary impression to apply direct pressure through the holes of tray to underlying impression of the ridge. Advantages: It records the tissue under loading. Disadvantage: The area of pressure can cause alteration of tray position and subsequently premature contact of artificial posterior teeth in final denture.

3. Fluid Wax Technique: In this procedure a custom tray is made, its peripheral extensions are corrected and then border molding is done. Then, the tray is relieved for impression making. Procedure: Molten Wax is painted on tissue surface of tray, then the tray is seated in the mouth for 5 min. tissue movements are performed and the process is repeated until a glossy surface is obtained. One has to be careful that the wax has completely flown and finally the impression tray is removed after 12 min. 4. Selective Pressure Technique: In this technique, pressure is directed on the stress bearing area of ridge by selectively relieving the tray. The denture base is lightly adapted to tissues over crest of ridge to reduce the effect of occlusal loading but is closely adapted to tissues in buccal shelf area so that it can withstand forces. Disadvantages: Demarcation of tissues which are stress bearing and which are non-stress bearing is difficult. 5. Functional Reline Technique: In this procedure a functional impression is taken after fabrication of partial denture. Procedure: A soft metal spacer is placed over the ridge prior to processing the denture. A low fusing modeling plastic is lined over the tissue surface of denture based. On the denture base, heating, tempering and border moulding is carried out. Then, it is scraped by 1mm uniformly so that

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Archives of Dental Sciences 2010, Vol.1, Issue 1, 84-86

Distal Extention Impression Technique

V.N. Malik and Ritesh Gaurav

space for final impression of Zinc Oxide eugenol is created. Advantages: It controls displacement soft tissues by controlling the amount of relief provided. 6. Altered Cast Technique: The impression is obtained from fluid wax and selected pressure technique is poured to prepare master cast. This master cast is altered to accommodate new ridge impression hence called an Altered cast technique. Procedure: Master cast is outlined and then cut. Then, retention grooves are made on cut surface framework and is sealed with softened modeling plastic. The final cast is trimmed and used for complete denture construction. 7. Modified Hindels Technique: In this method, a single resin tray is made with relief on tooth areas where it is open on at the top. ZnOE impression is taken fro saddle area over box plate of tray around standing teeth. 8. Simplified Distal Extension Impression Technique: This is a convenient and less time consuming technique for recording anatomic and functional form of distal extension partial denture.(Fig.1)

Fig. 2: Diagnostic Cast and Special Tray

The spacer is then removed and several holes are drilled in the through out the tray. The borders of the wax tray are checked in the mouth for overextension. Then, adhesive is applied. (Fig.3 Impression is taken using putty silicone and simultaneous border moulding is done.

Fig. 3 Special Tray with Tray Adhesive

Fig. 4 Putty Impression

Fig. 5: Monophase Final Impression

Fig. 1 Bilateral Distal Extension

Step 2: The teeth portion is then scraped using sharp knife.(Fig.4) Step 3: Tray adhesive is applied for edentulous portion of tray. Medium viscosity impression material (monophase) is placed on both dentulous and edentulous portion of custom tray and subsequently impression is taken. A constant finger pressure is applied in saddle area during this procedure so that the tissues are recorded in functional state and teeth in anatomic state.(Fig.5)

Procedure: Step 1 : First, rim lock tray with wax extension is used for making alginate impression. A uniform 3mm spacer wax is placed on entire saddle area of the diagnostic cast. A custom tray is fabricated. (Fig. 2).

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Archives of Dental Sciences 2010, Vol.1, Issue 1, 84-86

Distal Extention Impression Technique

V.N. Malik and Ritesh Gaurav

Conclusion: Thermoplastic materials are dimensionally unstable as compared to Silicone materials. A clinician in todays busy practice doesn't have enough time to engage one self into traditional techniques. References 1. Hindels GW, Stress analysis in distal extension partial dentures. J Prosthet Dent. 7:197-205;1957. McCrackens Removable Partial th Prosthodontics-10 Edition/Glen P. Mcgivney, Alan B. Carr Mosby. Inc. Applegate OC. Essentials of Removable Partial Denture Prosthesis, ed 2 Philadelphia, 1960; W.B Saunders Co. McLean DW. The partial denture as a vehicle for function. J Am Dent Assoc. 23:1271-1278; 1936. Fitzloff RA: Functional impressions with thermoplastic materials for reline procedures, J Prosthet Dent 52:25-27, 1984. Wilson JH. Partial dentures-relining the saddle supported by the mucosa and alveolar bone. J Prosthet Dent. 3: 807-813; 1953. Kromer H.M Impression techniques for removable partial dentures. J Prosthet Dent 11; 84:1961. DeVan MM. Basic principles of impression making. J Prothet Dent. 2: 26-35; 1952. Skinner E.W. The science of dental materials, 8th edition, W.B. Saunders Co., Philadelphia. Mitchener RW. Omori MD: Putty materials for stable removable partial denture bases, J Prosthet Dent 53:435-436, 1985 McCracken WL. A comparison of toothborne and tooth tissue borne removable partial dentures. J Prosthet Dent. 3:375381;1953. Leupold RJ, Kratochvil FJ: An altered cast procedure to improve support for removable

partial dentures, J Prosthet Dent 15:672678, 1965. 13. Rapuano. J. A Single tray dual impression techniques for distal extension partial denture J Prosthet Dent 24; 1-46:1970. Tomlin H.R and Osborne J. Some observations on silicone impression materials. Br Dent J 105; 407-12:1958.

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