CLASSIFICATION

Depending
on the
theories of
impression
making.

Depending Depending
on the on the
material used technique

classification

Depending
on the Depending
purpose of on the tray
the type
impression
Depending on theories of impression making

Mucostatic

Mucocompressive

Selective pressure

2
 Mucostatic or Passive Impression

 First proposed by Richardson and later popularised by

Harry Page.

 The impression is made with the oral mucous membrane

and the jaws in a normal, relaxed condition. Border
moulding is not done here.

 The impression is made with an oversized tray.

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 Impression material of choice is impression plaster.

 Retention is mainly due to interfacial surface tension.

The mucostatic technique results in a denture, which
is closely adapted to the mucosa of the denture-
bearing area but has poor peripheral seal.
 Mucocompressive Impression
(Carole Jones)
 Records the oral tissues in a functional and displaced form. The
materials used for this technique include impression
compound, waxes and soft liners.

 The oral soft tissues are resilient and thus tend to return to
their anatomical position once the forces are relieved.
Dentures made by this technique tend to get displaced due to
the tissue rebound at rest. During function, the constant
pressure exerted onto the soft tissues limit the blood
circulation leading to residual ridge resorption.
5
Selective Pressure Impression (Boucher)
 In this technique, the impression is made to extend over as
much denture-bearing area as possible without interfering
with the limiting structures at function and rest.

 The selective pressure technique makes it possible to

confine the forces acting on the denture to the stress-
bearing areas. This is achieved through the design of the
special tray in which the non stress-bearing areas are
relieved and the stress-bearing areas are allowed to come
in contact with the tray. 6
 Open mouth impressions
The open mouth impression is built in a tray which
carries the impression material of choice into the
desired contact with the supporting tissues and into an
approximate relation to the peripheral tissues when
the mouth is opened and without applied pressure.

The rationale behind this method is that the dentures

do not dislodge when subjected to biting force.
The open mouth methods provide clearance for the
tissues that are pulled over the edges of the dentures as
in function of speech.

It develops a contour of impression surface which is in

harmony with the relaxed supporting tissues, and which
may be out of perfect adaptation with these tissues
when the denture is subjected to occlusal loading.
Closed mouth impression technique

These require wax occlusal rims to be fabricated on

the preliminary cast .

The patient is made to close on these rims and a

generous clearance is made for the various frenula so
that the patient can manipulate his tissues by closing,
grimacing, sucking and swallowing to form peripheral
borders.
Depending on the tray type

Stock tray

Custom
tray

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Type of tray

Some dentists use a stock tray and an impression

material such as alginate , impression plaster or
impression compound is used .However such
impressions are generally overextended and serve as
primary impressions.
On casts made from these primary impressions,
special/custom trays are fabricated. The tray is tried
in the mouth and modified and the final impressions
are made using zinc oxide eugenol or other such
materials.
Depending on the purpose of the
impression

Diagnostic

Secondary Primary

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 Diagnostic Impression
 The negative replica of the oral tissues used to prepare a
diagnostic cast.

 Used for study purposes like measuring the undercuts, locating

the path of insertion.

 Is made as a part of treatment plan and to estimate the amount

of pre-prosthetic surgery.

 Articulate the casts on tentative jaw relation and evaluate the

inter-arch space. 14
 Primary Impression
(PRELIMINARY IMPRESSION)

 An impression made for the purpose of diagnosis or for the

construction of a tray.

 There should be at least 5mm clearance between the stock

tray and the ridge.

 The tray should extend over hamular notch and maxillary

tuberosity. Mandibular tray should cover retromolar pad.

 Tray can be extended using modelling wax.

Impression compound, Alginate, Impression plaster
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 Secondary Impression
(WASH IMPRESSION)

Involve:

 Fabriction of custom tray.

 Border molding.

 Developing the posterior palatal seal.

 Making the wash impression.

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Depending on the material used
Reversible
hydrocolloid
impression.

Irreversible
hydrocolloid
impression.

Modeling
plastic
impression.

Plaster
impression.

Wax
impression.

Silicone
impression.

Thiokol rubber
impression.
(Polysulphide) 17
 Impression techniques may be classified
depending on:

a) Amount of pressure used

1. Pressure technique
2. Minimal pressure technique
3. Selective pressure technique
b) Based on the position of the mouth while making
impression
1. Open mouth
2. Close mouth
c) Based on the method of manipulation for border
molding.
1. Hand manipulation
2. Functional movements
 Pressure theory or mucocompressive
theory:

• This theory was proposed on the assumption that

tissues recorded under functional pressure provided
better support and retention for the denture.

• Greene in 1896 gave this concept

Primary impression made with impression
compound

Special tray made using shellac base plate.

Second Impression is made in this tray using

compound

Bite rims with uniform occlusal surfaces are then

made.
Areas to be relieved are softened and the
impression is inserted in mouth and held under
biting pressure for one or two minutes.

Borders are molded by asking the patient to

perform functional movements.
 Demerits of the theory

1. Excess pressure could lead to increase alveolar

bone resorption.
2. Excess pressure was often applied to the peripheral
tissues and the palate.
3. Dentures which fit well during mastication tend to
rebound when the tissue resume their normal
resting state.
4. Pressure on sharp bony ridges results in pain.
 Applied aspects:

• The technique tells that border tissues are recorded

in their functional positions and denture cannot be
dislodged during functional movements of jaws.
• The pressure applied is more and directed towards
the palate and peripheral tissues. So the retention
will be for short time and will be lost as soon as the
bone undergoes resorption.
• Usually this technique is used for preliminary
impression making as it gives a positive peripheral
seal and tissues are recorded in function. Amount of
pressure applied is for short duration and the areas
can be relieved during the final impression.
Minimal pressure or mucostatic theory –

The main advantage of this technique is its high regard for tissue health & preservation.

• 1946 Page gave the concept of mucostatic based on

Pascal’s law.
 Technique

• A compound impression is made.

• A baseplate wax space is adapted.
• A special tray is adapted over the wax spacer.
• Spacer is removed and an impression is made with a
free flowing material with little pressure.
• Escape holes are made for relief.
 Demerits

• The short denture borders are readily accessible to the

tongue which might provoke irritation.

• The lack of border molding reduces effective peripheral seal.

• The short flanges may reduce support for the face.

• The shorter flanges prevent the wider distribution of

masticatory stresses.

• The shorter flange would mean less lateral stability.

 Applied aspect:

• The technique holds good in the sense it helps in

preservation of tissue health.

• In practice with short flanges the oral musculature is non

supported and stresses are not widely distributed.

• Food can slip beneath the denture and tongue can

readily access the denture borders.

• This technique is useful in impressions of flabby and

sharp or thin ridges.
 Selective pressure theory
• Advocated by Boucher in 1950 it combines the
principles of both pressure and minimal pressure
technique.

• In this technique idea of tissue preservation is

combined with mechanical factor of achieving
retention, through minimum pressure which is
within physiologic limits of tissue tolerance.

• This theory is based on a thorough understanding

of the anatomy and physiology of basal seat and
surrounding areas.
 Demerits

• Some feel that It is impossible to record areas with

varying pressure.

• Some areas still recorded under functional load, the

dentures still faces the potential danger of
rebounding and loosing retention.
 Applied aspect:

• Inspite of some of its apparent drawbacks all the

impression techniques based on the selective
pressure technique are still popular.

• Final impressions using this technique are made

where relief areas are provided and pressure is
distributed on the stress bearing areas.
Open mouth technique

Made with tray held by dentist and mouth open

Muscle movements may be emphasized and

can be seen by the operator
Closed mouth technique

The rationale behind this technique is that the

supporting tissues are recorded in a functional
relationship.

Requires occlusal rims to be made

Border molding done and final impressions made

Hand manipulation

Dentist uses hand manipulation for movements of

lips and cheeks

Functional movements

Patient makes functional movements such as

sucking, swallowing, licking or grinning
SPECIAL IMPRESSION TECHNIQUES

IMPRESSIONS OF UNSUPPORTED MOVABLE TISSUES

IMPRESSION PROCEDURE FOR THE SEVERELY

ATROPHIED MANDIBLE

WAX BASE DEVELOPMENT FOR COMPLETE DENTURE

IMPRESSIONS
• In conditions where
patients have worn
maxillary complete
denture opposed only
by mandibular anterior
teeth.
 PROCEDURE

• A primary impression is made and

a cast is poured.

• An indelible pencil is used to

outline the unsupported movable
tissue.

• A single custom tray is made, and

an opening is cut in the tray as
indicated by the transfer of
indelible pencil line.
• Modelling plastic is adapted bilaterally on the
posterior aspect of the tray to act as handles.

• The tray is adjusted in the mouth, and a routine

border molding is formed.
• The tray is painted with
an adhesive and a
regular body impression
is made.

• The excess material is

trimmed to the outline
of the aperture
• The completed base impression is returned to the
mouth.

• This impression does not touch the unsupported

tissues.
• Then a highly mucostatic
impression material,
impression plaster is
brushed on the
unsupported movable
tissue.

• The initial layer precludes

entrapment of air and
enables visualisation of the
unsupported tissue.
• A separating media is
applied to the
impression plaster and
the master cast is made
AN IMPRESSION PROCEDURE FOR THE SEVERELY
ATROPHIED MANDIBLE : JPD 1995 ; 73(6); 574-577
• The objective is to maximize the supportive aspect of
the available denture foundation by two approaches

- Functional

- Anatomic
• Peripheral borders are developed functionally with
the mouth closed

• The final phase of impression is made with the

mouth open to satisfy the anatomic approach
 PROCEDURE

• A maxillary final impression is made and cast is

poured

• Construct a record base for the maxillary cast and

develop a flat wax occlusal rim.
• Make a preliminary impression of the mandible and
make a lower tray to be used initially as a record
base with a flat wax occlusion rim.

• Make a jaw registration at a selected vertical

dimension of occlusion.
• Develop the border
extensions with tissue
conditioning material.

• Develop the lingual borders

with the mouth open and
have the patient make
essential tongue
movements.

• Also instruct the patient to

border mold the material
physiologically by producing
“ooo” and “eee” sounds
while biting on the occlusal
rim.
• Repeat the step as often as necessary to develop
proper extension.

• Relieve the tray wherever it shows through the

conditioning material before each subsequent
addition.

• Remove overextensions with a hot knife blade.

• Leave each application of
conditioning material in the
mouth approx. 10 minutes
to allow it to stabilize.

• After the desired extensions

are formed with the
conditioning material, make
the final second impression
with a polysulfide rubber
impression material with
the mouth open and use
standard border molding
procedures.
• Pour the cast
immediately to avoid
distortion of the
material.
• This procedure will provide the patient with a
denture that has function with maximum support
and stability.

• The greatest disadvantage of this procedure is the

amount of the time necessary to develop the final
impression. The average appointment time needed is
45-60 mins.
• Appelbaum and Rivetti : WAX BASE
DEVELOPMENT FOR COMPLETE DENTURE
IMPRESSIONS; JPD; may 1985; 53(5); 663-666
• The objective of the denture base development is
the retention and stability.

• The retention enhancing potential of the border seal

and the effect of properly contoured and polished
surfaces against a functioning musculature must be
recognised.
• Denture base retention is maintained by a constantly
changing interplay between the physical and
physiologic forces during speech, mastication, and
deglutition.

• The physiologic forces are mainly muscular and are

exerted by the lips, cheeks, and tongue.

• And the physical forces include cohesion, adhesion,

and interfacial surface tension, which operate in the
film of saliva between the denture and the tissues.
• Three objectives of base development to secure
optimum retention and stability must be attained :

1) The impression procedure and material of choice

should permit the detailed reproduction of healthy
mucosa and ridge bearing tissue at rest to secure
optimum retention by interfacial surface tension
acting on the base through the medium of saliva.
2) The base should be extended to, but not
encroach on, functional muscle attachments to
permit greater distribution of masticatory stresses
and a greater surface for the development of
interfacial surface tension, which leads to the
production of the border seal.
3) The base should be adapted to the musculature of
the oral cavity to secure active and passive muscular
fixation of denture base, because the importance of
muscle activity may transcend all other factors
responsible for denture retention.

The most important muscle in this regard are the

buccinator, orbicularis oris, and intrinsic and extrinsic
muscles of the tongue.
 Developing the base with mouth
temperature wax
• A preliminary functional impression tray with wax
occlusion rims is made with an opposing occlusion
rim or denture.

• The tray trimmed to relieve functioning muscle

impingements.

• A closed mouth impression with mouth temperature

wax is made to establish maximum coverage within
tissue tolerance.
• The IOWA wax is prepared in a container in a hot
water bath and is applied to the tray with a soft
brush. (firm contact produces glossy surface)

• After full ridge tissue contact is made, wax is applied

to the borders and is adapted to the functioning
musculature to develop the border and flanges of
impression tray.
• Essential actions :

- Protrusion and retrusion of the lips for the facial musculature

(“proo-wiss”)

- Moving the mandible laterally and protrusively to record

coronoid process of mandible

- Placing the tongue alternatively into the cheeks and by

wiping the lips by the tongue to develop lingual and
retromylohyoid flange of mandibular tray
• The impression is allowed to remain in the mouth
and allowed to remain for 8 to 12 minutes to permit
as close adaptation of the wax to all surfaces as
possible.

• During this period, the patient periodically performs

the approppriate muscle functions. And then ice-cold
water is poured into the mouth to chill the wax, and
the impression is carefully removed.
• Impression is boxed by plaster
and pumice and cast is poured.

• Separating media is applied on

the cast and after the separating
media has dried, an
autopolymerising soft resilient
liner is applied to the undercuts.

• Spacer is applied and a resin tray

is fabricated
• When the tray resin has set, the
bottom side of the cast is reduced
on a cast trimmer just short of
contact with the tray material.

• The cast with tray is placed in hot

water to soften the wax shim and
the cast is fractured with a
hammer to permit recovery of
the tray without damage
• Wax spacer is removed, and
excess resin is removed from the
tray.

• The final impression material,

metallic oxide paste is mixed
according to manufacturer’s
directions and loaded into the
tray.

• Impression material is wiped

along all the flanges of the
impression tray in contact with
functioning musculature.
• The patient is instructed to perform the previously
described muscular movements while the impression
material is developing its body.

• The tray is removed from the mouth after the

material has set and the impression is inspected.
• This technique permits the harnessing and stabilizing
effects of an active musculature to operate on the
ultimate denture base.

• The musculature imparts properties of retention and

stability to the base that will tend to provide the
greatest longevity for the residual alveolar ridge.