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PHILOSOPHICAL ( Ideal attitude)
| PHILOSOPHICAL ( Ideal attitude) | Accept the judgement of dentist without question, rational , sensible , calm and composed disposition |
| INDIFFERENT | Little concern for their oral health and seeks treatment because of their families. Requires some more time to understand and their attitude is very discouraging to dentists |
| CRITICAL/EXACTING | Previously has many CD sets and finds fault with everything. Medical consultation is always advisable |
| SKEPTICAL/HYSTERICAL | Previously had bad results with treatment and are doubtful about everything. These are in poor oral health with resorbed ridges and other unfavourable conditions. |
Impression Making Technique:
MUCOSTATIC OR PASSIVE IMPRESSION TECHNIQUE
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MUCOCOMPRESSIVE IMPRESSION TECHNIQUE
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SELECTIVE PRESSURE IMPRESSION TECHNIQUE
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| Proposed by Richardson and Henry page | Proposed by Carole Jones | Proposed by Boucher |
| Plaster of paris and Alginate is used | Impression compound and ZoE | Special tray with ZoE wash impression |
| 1. Records when the oral mucous membrane and jaws are in normal relaxed condition 2. Utilizes an oversized tray 3. Intimate contact of the tissues with denture is achieved but has poor peripheral seal 4. Thus denture will have good stability but poor retention | 1. Records oral tissues in a functional and displaced form 2. Good retention 3. Denture made by this technique tend to get displaced due to the tissue rebound at rest | 1. Loads acting on the denture are transmitted to the stress bearing areas 2. A special tray is designed such that the tissues contacted by the tray are recorded under pressure and the tissues not contacted with the tray are recorded at a state of rest |
Anatomical considerations:
MAXILLA:
Primary stress bearing area |
Residual alveolar ridge |
Secondary stress bearing area |
Rugae or anterior hard palate, maxillary tuberosity |
Tertiary stress bearing area and secobdary retentive area |
Posteriolateral part of hard palate |
Relieving areas |
Incisive papilla |
Primary retentive area |
Posterior palatal seal area |
Relieving areas |
Incisive papilla |
Primary retentive area |
Posterior palatal seal area |
MANDIBLE
Primary stress bearing area |
Buccal shelf area |
Secondary stress bearing area |
Slopes of edentulous ridge |
Primary retentive and primary paripheral seal area |
Retromolar pad |
Secondary peripheral seal area |
Anterior lingual border |
Relief areas |
Crest of residual ridge |
POSTERIOR PALATAL SEAL (PPS):
The function of posterior palatal seal is to ensure a complete seal, thus helping in retention of the denture.
The correctly placed posterior palatal seal will not impinge upon the non displaceable tissues of the hard palate, nor will it limit the muscular movements of the soft palate. It will however, create a partial
vacuum beneath the maxillary denture
Functions of posterior palatal seal:
▪ Slightly displaces the soft tissues at the distal end of denture to ensure a complete seal that helps in retention of denture
▪ Prevents ingress of food and saliva beneath denture base
▪ Prevents excess impression material from running down the patients throat
Vibrating line passes from one pterygomaxillary arch notch to the other. It passes 2mm in front of fovea palatine and is always on soft palate. Distal end of denture is 1-2mm posterior to vibrating line.
▪ Anterior vibrating line
Imaginary line lying at the junction between the immovable tissues over the hard palate and slightly movable tissue of the soft palate. Anterior vibrating line is always located on the soft palate.
Measured by asking patient to say "ah" in short vigorous bursts and valsalva maneuver
Cupid bow in shape.
▪ Posterior vibrating line
Imaginary line located at the junction of the soft palate that show limited movement and the soft palate that shows marked movement
Q. Impression material of choice in patients with submucous fibrosis is
A) Zinc oxide eugenol
B) Addition silicon
C) Condensation silicon
D) Plaster of paris
Ans. B, Addition silicon, Impression can be takken with a putty material , loaded into a stock tray and can place it directly in the mouth.
