Basic principles in impression making 7

COMPLETE DENTURE IMPRESSION TECHN IQc: f<
IRA E. KLEIN, l3.lI.S.
New York, N. Y.
A
HISTORY OF COMPLETE denture construction is both educational anti
stimulating. It is interesting to note that many years ago dentists were
discussing and advocating varying techniques to overcome the same basic problem:~
that we modern dentists are confronted with today.
George1 stated in 1869 that plaster was the impression material of choice be-
cause it was more plastic than wax or gutta-percha and little pressure was required,
thus preventing displacement of the soft tissue parts.
Austin’ stated in 1866 that plaster impressions of the lower jaw should bc
taken when ridges are well defined; but when the ridges are absorbed, waz; or
gutta-percha is preferable.
Franklin” described the first corrected impression in 1866. He used wax
for the preliminary seat followed by a plaster wash for more accuracy and to pre.
vent expansion of the plaster when used in bulk.
White” stated in 1894, “Since the object in taking an impression is to obtain ;I
correct representation of the parts as they are in normal condition, there is needed
a substance, plastic at ordinary temperatures, and which will admit of having the
parts concerned pressed into it without the use of force enough to cause pain or
disturb the relative position and form of the different surfaces. It must also possess
sufficient body or hardness to be retained in the tray under the pressure necessary ~(1
obtain the impression of the parts. It must harden or solidify in a brief time.”
The Green brothers” brought out a new impression material, modeling com-
l~ound, at the turn of the century. Young’ stated in 1907 that “compound is warmed
to a consistency at which it will adapt itself readily to the shape of the mouth. it
is placed on a tray and pressed down to get an ordinary impression. It is allowed
to stand, and the outside is chilled and pressed down a second time so that the hard
ridge cuts just a little deeper into the impression material and remains practicall!
unchanged, while the soft tissues down on the side of the gum, about where the
border of the plate comes, are compressed slightly. Thus, the plate margins will
be sealed all around, and this converts the lower surface of the plate into a suction
pad.”
Fish’ formulated the basic peripheral outline of modern full dentures in an
article in 1931.
Presented as a television clinic before the Greater New York Dental Meeting, Dec. 10, 1953
Received for publication Feb. 7, 1955, revised by the author June 7, 1955.
7.19

740 KLEIX .oJyi:E:; %G
Dirksen and his group at the University of Iowa developed a wax which be-
came popular for peripheral extension of impressions in the late 1930’s. Swenson,*
in collaboration with Trapozzano, outlines a technique of impressions using the
University of Iowa wax for peripheral extension.
Slack” introduced a new plastic impression material called Muco-Seal, and a
technique to go with it. It incorporated coverage of the sublingual space for better
retention of the lower denture.
Wright,” in June, 1948, advocated the use of alginate base impression ma-
terials for full denture impression in selected cases.
I should like to mention that the dental profession is indebted to men like
Hight,” House, Stansbery,” Wilson, Tench,ls Boucher,” Pryor,i6 and others, for
their contributions to the science and art of full denture impression technique.
ORAL ANATOMY
Upper Peripheral Anatomy.-
1. Maxillary frenum. This is resistant tissue in the midline and must be re-
lieved to its full extent.
2. Labial arches. These are the peripheries on each side of the relieved
maxillary frenum which rise in a convex arch form.
3. Buccal frenum. This is movable resistant tissue in the region of the first
bicuspid and must be relieved to its full extent (Fig. 1) .
4. Zygomatic process. The denture border dips in this region (approxi-
mately in the second bicuspid and first molar zone) to avoid impingement upon
this resistant bone.
5. Buccal vestibule. The border in this region is most important for retention.
The space between the ridge and the cheek must be filled to its full height and
width.
6. Vibrating line. This is the junction of movable and nonmovable portions
of the palate, and forms the posterior limits of the denture (Fig. 2).
7. Pterygomaxillary notch. This is the first cleft posterior to the maxillary
tuberosity enabling the denture to be sealed laterally into the soft tissue (Fig. 2).
Upper Surface Anatomy.-
1. Incisive papilla. This raised bit of soft tissue on the ridge posterior to
the position of the junction of the central incisors must be reheved to prevent pres-
sure on the nasopalatine nerves and the blood vessels. Failure to relieve the
incisive papilla may cause a burning sensation in the palate (Fig. 1).
2. Torus palatinus. This bony mass in the midline should be relieved if it is
present. If not, a relief in this area is not indicated (Fig. 1).
Lower Peripheral Anatomy.-
1. Mandibular labial frenum. This is usually resistant and must be relieved.
2. Labial arches. The denture border is convex on either side of the man-
dibular labial frenum (Fig. 3).
3. Mandibular buccal frenum. This resistant and movable tissue is to be
relieved to its full extent (Fig. 3).

1. Buccal shelf. This is a convex arc from the buccal irenum to the anterior
portion of the retromolar pad, bounded laterally by the external oblique line and
medially by the residual ridge. The bone structure of the buccal shrli j.q err!
dense and presents an excellent bearing area (Fig. 3j
5. Distobuccal corner. This region, buccal to the retromolar pad! is g:‘(tv-
rrned by the inward pull of the masseter muscle. rt swings sharply tn3-;lrtl :h(-
lingual (Fig. 5j.
Fig. 1.
Fig. 2.
Fig. 1.-Landmarks in the upper jaw. A, Anterior palatine (incisive) papilla. B, Torus
palatinus. C, Buccal frenum with the caninus muscle.
Fig. 2.-Posterior landmarks. A, Pterygomaxillary notch. R, Vibrating line.
6. Posterior border. The distal border of the retromolar pad is the posterior
termination of the lower denture.
7. Distolingual turn. This region is governed by the extent of movement of
the palatoglossus muscle and the superior constrictor muscle of the pharynx. It is
convex, and its posterior termination is even with the posterior termination of the
retromolar pad (Fig. 5).

742
Fig.
Fig.
Fig.
3.
4.
5.
Fig.
trianguul
Fig.
Fig.
-The lower jaw. A, Mandibular labial arch. B, Mandibular buccal frenum
muscle.
-Posterior landmarks. A, Buccal shelf. B, Retromolar pad.
-Distal landmarks. A, Distobuccal corner. B, Distolingual turn.
with the

‘oltmr 5
Numhrr 6
COMPLETE DENTURE IMPRESSIOK TEC: N NIQUE ; 4.4
8. Middle lingual. The flange usually extends below the mylohyoid ridge anti
is governed by the extent of movement of the nlykJhyCJid muscle as the tongue jk
moved into the cheek of the opposite side.
9. Sublingual flange. The flange, lingual to the anterior portion (pi the
ridge, is extended to cover the tissue to varying degrees, depending on the position
and type of mandibular lingual frenum and the position of the orifices of thr sub-
maxillary ducts.
a. If the lingual frenum is broad and close to the crest of the ridge, the sub-
lingual flange will cover the frenum only for the usual lingual muscle trim, but the
space on either side of the frenum will be covered approximately Th inch beyotld
the normal mucolingual turn.
1). If the lingual frenum is narrow and close to the crest of the ridge, the
frenum is allowed freedom of movement in the impression, but the area on eithrt
side is covered 76 inch beyond the usual mucolingual turn.
c. If the lingual frenum is posterior to the ridge, the tissue is covered f/h inA
beyond the mucolingual turn.
Lower Surface Ana.totny.-
1. Torus mandibularis. This nodule (or nodules) of bone on the lingual
side of the ridge in the first or second bicuspid region has a thin covering of soft
tissue.
EXAMINATION AND HISTORY OF PATIENT
Radiographic Examination.-
1. Note retained roots and cysts.
2. Note the texture of the supporting bone.
Clinical Exaknation.-Observe the following conditions if they exist :
1. Undercut bony areas along the ridge.
2. Undercut, bulbous, and low-hanging tuberosities.
3. The size and extent of the torus palatinus and torus mandibularis.
4. The type of saliva. Thin saliva does not seal a denture well. Thick ropy
saliva is annoying to the patient.
5. The type of ridge, knife-edged, flat, full and bulging, or soft due to the
absorption of bone.
6. The type of soft tissue, Note the lack of resiliency, excessive resiliency or
normal resiliency of the soft tissues.
7. The tongue size.
8. The muscle attachments.
9. The lip length.
10. The sublingual space. The position and size of the mandibular lingual
frenum and the location of the ducts of the submaxillary and sublingual glands are
important diagnostic facts.
11. ‘The retromylohyoid space. This is the space lingual to the retromolar pad.
Occasionally, this space is eliminated when the tongue moves forward or upward,
thus preventing the formation of a lingual flange in this region. The efficiency of
such a denture is reduced.

744 KLEIN
J. Pros. Den.
November. 1955
Medical History.-This should include the following pertinent facts :
1. A record of any current illness.
2. A record of any past illness.
3. A record of a typical diet.
It is necessary to realize the importance of the proper preparation of the
edentulous mouth to avoid serious difficulties in the construction of complete den-
tures. Many times, a simple surgical procedure spells the difference between
success or failure. The examination is also important in preparing the patient
for any possible esthetic disadvantage. We should at all times evaluate the clinical,
radiographic, and medical history evidence. The reason why certain procedures are
necessary should be explained to the patient, together with the limitations of the
case. I have found that mounted study casts are extremely useful to me in mak-
ing my diagnosis, treatment plan, and prognosis. I highly recommend their usage
because a patient is better able to comprehend what we are explaining to him.
IMPRESSION TECHNIQUE
The Preliminary Compound Upper Impression.-
1. The type of tray: The aluminum tray should be thin, stiff, and easily
modified with pliers, scissors, or fingers.
2. The tray size: The tray is inserted and first seated posteriorly and then
anteriorly so that, when the tuberosities are covered, the anterior ridge of the
patient fits into the anterior ridge indentation of the tray.
The objectives of the proper tray selection are to use the tray as a convenient
carrier of compound which will not interfere with muscular movements when the
impression is being made and to localize the compound mass over the bearing
areas.
3. The stacking of compound:
a. Two cakes of Kerr’s medium-fusing compound are softened in the compound
heater with the temperature of the water at 160” F.
b. The compound is kneaded carefully to prevent the trapping of air and
then is placed on the tray.
c. The compound is sculptured to the approximate shape of the ridges and
vault.
d. The compound is luted to the tray by pin-pointing the flame from a Hanau
torch at the junction of the tray and the compound.
The objective of proper compound stacking is to prevent the compound from
breaking away from the tray during the impression making.
4. The initial insertion:
a. The compound is dried and a flame from a Hanau torch is played over it.
b. The compound is placed in warm water in a water heater for tempering.
c. The compound tray is inserted into the mouth, the patient is told to close
the mouth, and then the tray is seated with firm but light pressure.

d. The impression is removed carefully without chilling (Fig. 6).
The objective of the initial insertion is to tlivide the bulk of compountl ~XWII~
SO that the impression can be worked out without the compound being penetmtecl
or the tray off-centered. The patient is told to close slightI>- before thp seating tll
prevent muscular interference from the cheeks and lilts.
5. 7’he beading of the cowapound:
a. The borders of the impression are squared by knife-trimming.
b. ,4 groove is cut into the median line to a depth of approximately 1 nlrn.
c. The flame from a Hanau torch is played on thr surface of the dried ~tn-
p0und. cart’ being taken not to collapse the flangrs.
Fig. G.-Preliminary impressions after the initial seating.
d. The compound is tempered in the water bath.
e. The compound tray is then inserted into the patient’s mouth and seated
with firm pressure exerted by the index finger at the center of the palate.
f. The patient’s nose is held, and the patient is told to breathe out through
the nose while the pressure is being exerted on the palate.
g. The compound impression is removed carefully without chilling (Fig. 7 i.
The objective of the beading of the compound is to obtain a deeper seating
with as little overdisplacement as compound permits. The warm compound can
flow toward the knife mark or out over the borders, thus reducing the flowing time
and the distance of flow. Breathing through the nose will cause the movable palatr
to press downward against the surface compound for good detail.
This step completes the treatment of the basal seat area. The groove is
usually completely filled, and there is a bead of compound around the entire border.
If the groove is not completely filled, it can be filled with carding wax upon the co!:+

pletion of the impression. At this point we are assured that the compound has
flowed properly, and that we have minimized any overdisplacement of tissue.
6. The border trim:
a. The posterior OYbuccal border.
(1) The flanges of the impression are knife-trimmed 2 mm. below the out-
line of the mucobuccal fold.
(2) Green stick compound is added to the posterior section of one buccal
flange by heating the stick of compound in the flame, and dropping it on the border
compound. The flame from the Hanau torch is then applied carefully to the green
compound which is tempered in the water bath, and the impression is inserted into
the mouth. The patient is told to close before the impression is seated completely.
(3) The tray is held with a light pressure, and the patient is told to open and
close, to swing the mandible from side to side, and to force the cheek inward.
(4) These procedures are repeated on the opposite side.
Fig. ‘I.-The compound is beaded along the borders.
The buccal vestibules opposite the maxillary tuberosities are opened when the
patient closes, so that the compound can flow upward to seal this important border
region. When the patient opens, the coronoid processes of the mandible press
against these borders to establish their correct width. The other functional move-
ments will trim the border for proper height and width. The side-to-side move-
ment of the mandible will cause the coronoid process to press against the lateral
surface of the compound for proper external form.
b. The anterior OYfacial border.
(1) Green stick compound is added to the anterior flange.
(2) Upon insertion of the compound, the patient is told to pull the lip down-
ward as in sucking on a straw, and then to grin broadly.
These facial nzovements will allow the orbicularis oris muscle to muscle-trim the
anterior flange.

7. 7’111~fire-polish%g aj the comjvwzd: The inlpressiorl is dried thoroughi~ .
A brush flame from the Hanau torch is played lightly over the entire surface oi 111~
compound. The compound is tempered in warm lvater and then inserted with hr111
pressure. The patient is told to suck, bvrin, and more the mandil~le iroln side !o
side. This step will give greater detail and smooth out an!- minor defects i11t?ii.
compound. The impression is now chilled and rrnlovrd carefull>
7‘1~ Colupowzd I’reliwinaq Lower Iwprr.ssiorl.---
1. ‘l‘hr~ typr of fray: The aluminum tray s11011ltlIE thin and stiff arttl ~p;t--
I& of Ibring easily modified with pliers, scissors, or fingers.
2. 7‘hr trrr~~six: The tray is inserted and seated anteriorly first and IINI
brought dourn posteriorly. When the anterior ridge c~i the lnouth fits into the
ridge of the tray, the posterior borders of the tray must coincide with the post&or-
limits of the retromolar pads.
3. The tray wodificatiorls: The posterior portions of the tray are tilted up-
ward. The sublingual section is tilted upward. The lateral surfaces of the tray
are trimmed (if necessary) just short of the mucobuccal fold. The labial bortL?r
must he short of the nxlcobuccal fold.
-4 ,broj~r~ fiffillg tva.31is wed nzainly as a convenient carrier of compound ant1
to localize the mass of softened compound over the hearing areas. The tray is
trimmed to prevent impinging on the soft displaceable peripheral tissues during the
impression making. The posterior sections are tilted upward to allow for the riat
of the mandible and thus to maintain a similar amount of compound anteriorI-
and posteriorly.
4. The stacking of the comjozwd:
a. Two cakes of Kerr’s medium-fusing cotnponnd are placed ill the heater
with the temperature of the water at 160” F.
1). The ccompound is kneaded carefully, rolled into a q4indricnl form, ant1
stacked on the tray.
c. The compound is luted to the tray by pin-pointing the flame from thr
torch at the junction of the tray and the compound.
5. 7‘hc kitial imertion:
A. The compound is dried, and the flame from a11alcohol torch is pIa!& OUAI
the surface of the compound.
I). The tray is placed in the water bath for tempering the compound.
c. The tray is inserted into the mouth and seated with light pressure.
tl. The impression is removed carefully without chilling (see Fig. hi. The
initial inlpreSSi(Jll must estend to cover the entire retromolar pad.
TIZP objt~ctie~eof tlzr i&tin/ insertion is to divide the bulk of compound rvelll>
from front to hack and sicle to side, and to center the tray in the mouth.
h. The bctrding of tier compound:
a. A groove 1 mm. deep is cut into the compound along the groove made
hy the crest of the ridge ( Fig. 8).
b. The flame from the torch is played on the surface of the tlried compound.
care being taken not to collapse the flanges.

748 KLEIN J. Pros. Den.
November, 1955
c. The compound is tempered in the water bath.
d. The compound tray is inserted into the patient’s mouth with firm pres-
sure ; the index finger of each hand is held over the second bicuspid-first molar area.
e. The compound tray is removed carefully without chilling.
The objective of the compound beading is to obtain a deeper seating of the
impression with as little overdisplacement as compound permits. The warm com-
pound can flow toward the knife mark or out over the periphery ; thus the flowing
time and the distance of flow are reduced. This step completes the treatment of the
basal seat.
7. The border trim:
a. The posterior buccal border.
The distobuccal corner of the left side is flamed with the dry heat from the alco-
hol torch, and then tempered in the water bath. The buccal border opposite the
retromolar pad is trimmed by the patient’s closing while the impression is held in
place with a pressure exerted downward to counteract the closing. This will acti-
vate the masseter muscles to mold the distobuccal corner of the impression.
Fig. 8.-A groove is cut in the bottom of the groove made by the crest of the ridge, and the
borders are prepared for beading.
b. The middle buccal border.
The buccal shelf portion of the border, between the retromolar pad and the
buccal frenum, extends laterally to the external oblique ridge. This area of the
compound impression is flamed, tempered, and the impression is inserted. (If the
compound impression does not extend to the external oblique ridge, green stick
compound is added.) The patient is told to draw the cheek inward while the
impression is held in position.
c. The labial arches.
Green stick compound is added to the labial arches. This compound is then
flamed and tempered in the water bath and inserted in the patient’s mouth. The
patient is told to draw the lips inward, as if sucking on a straw, to mold this an-
terior flange border.

Volume s
Number 6
COMPLETE DENTURE IMPRESSION ?‘I-CHNIQUE 7.$.‘!
cl. The lingual border.
The posterior lingual border is knife-cut until it is level with the ~nyloh~~id
ridge. If this flange is short of the mylohyoid ridge, green stick compound iv
added, flamed, tempered in the water bath, and the impression is inserted in t’ili.
patient’s mouth. The impression is removed and chilled. The green stick corn
pound is then cut level with the mylohyoid ridge. The inner surface of thr: CUT
lingual border is shaved to allow for a thickness of wax. The compound i-.
shaved on the inner surface of the lingual flange almost up to the crest ot’ the rids:e,
(Fig. 811.
Fig. 9.
Fig. 10
Fig. 9.-A tongue movement for trimming the wax on the lingual flange.
Fig. IO.-Another tongue movement for trimming the wax on the lingual flange.
e. The sublingual space.
The sublingual space or the space lingual to the mucolingual fold between the
location of the first or second bicuspid, from one side to the other, is knife-shaved
approximately 2 mm. The compound is shaved to the impression of the crest of the
ridge without cutting away the distal extension of the compound.
The compound of the retromolar pad area is shaved to allow for a thickness
of wax.
f. The wax lingual trkz.
(1) A stick of Kerr’s low-fusing impression wax (University of Towa Fern:-

ula) is softened in a flame or in the water bath. After the impression and the wax
have been dried thoroughly, the wax is luted to the cut lingual flange with a hot
wax spatula.
(2) The region of the retromolar pad in the compound is coated with the
same wax.
(3) The sublingual space is coated with the wax to a thickness of approxi-
mately 2 mm.
(4) The entire impression is then immersed for a few seconds in the water
bath with the temperature at 140” F.
(5) The impression is inserted into the patient’s mouth and held in position
three minutes. The tray is inserted further back with the distal ends higher
than usual, and then brought downward and forward.
(6) The patient is told to move the tongue from side to side ; up to the roof of
the mouth and straight out of the mouth (Figs, 9 and 10).
(7) The impression is chilled thoroughly with ice water while the patient
holds the tongue partly outside the mouth.
Fig. Il.-The completed mandibular preliminary impression.
(8) ‘The impression is removed carefully by being lifted upward and pos-
teriorly, and then outward (Fig. 11).
The sublingual space is covered, as much as muscle movement permits, for
greater retention of the mandibular denture. The tongue rests upon the lingual
flange, and this action tends to hold the denture in position. Coverage of the
sublingual space also permits the mandibular denture to rest on soft tissues, which
is desirable. The wax lingual trim will record a correct lingual roll and will
also prevent displacement of the soft tissues of the retromolar pads.

Volumr i
.Numlw 6 COMPLETE DENTURE 111PRESSIOS ‘I‘KCII 5 I(,) ; ,c,!
LABORATORY PROCEDURI-
The upper impression is boxed and a storle cast is constructed. A doublc~~-
thickness shellac baseplate is adapted to the upper cast. iA short handle is mtd~~
from a tongue depressor, and this is embedded into the baseplate (Fig. 12‘1. Thl‘
lower impression cannot be boxed because of the lingual wax trim, so extra G~V
E'ig. C.--The double thickness shellac base tray used for making the final maxill;~!~~
impression.
Fig. 13.-The clear acrylic resin tray used for making the final mandibular imprrl;sir?rr.
must be used in making the stone cast. A thin mis of the stone is vibratecl into tl;<
impression. As soon as the surfaces are coatetl, a heavier mix is vibrated into tlltz
impression until it is entirely filled. A mass of the stone with a puttylikr C~XI-
sistencp is placed on a glass slab, and the impression is carefully jiggled into it.
The buccal and lingual borders must be embedded in the stone. After the initi:tl
set. the stone is trimmed carefully to preserve the border roll.
A clear acrylic resin tray, with a short handle, is processed for malting tilt
lower final impression tray (Fig. 13 1.

THE FINAL IMPRESSIONS
Upper Final Impression.-The shellac tray is inserted in the patient’s mouth
in order to check its borders with the peripheral tissues. The maxillary frenum
and the buccal frenula are relieved if there is any impingement. If this is not done
cotrectly, the muscle roll of the borders cannot be recorded with the final zinc oxide
and eugenol paste impression. The relief of these areas can be made with a safe-
side Carborundum disc, a bur or vulcanite file.
The area of the zygomatic process is carefully observed to make sure that
the tray does not impinge on this resistant tissue. A clinical observation is made
by holding the tray in the hand and noticing if this area bulges outward from
the remainder of the border. The border is usually at right angles to the line of
sight, and an impingement on the zygomatic process is evident by an outward bulge
in this area.
The labial arches must be filled to their correct height and width. AS ex-
plained previously, the coronoid portion of the mandible constricts the buccal
vestibule opposite the tuberosity when the mouth is opened.
To test the tray height for this region, it is necessary for the patient to close the
mouth after insertion and to run the index finger over the border. If there is an
underextension, a space is felt. In this situation, low-fusing compound is added to
this flange, and the desired height is obtained by asking the patient to close and
open the mouth.
The labial arches on either side of the maxillary labial frenum are then tested
for height and width. Underextension can usually be detected by running a finger
along the border of the tray, and feeling a space between the tray and the mucobuccal
fold. Overextension can usually be observed by the facial appearance of the pa-
tient with the mouth closed. Any undue tension on the tissues in this region of the
mouth must be corrected before proceeding. It must be clearly understood that
tension can be caused by underextension, as well as overextension.
The posterior limitations of the tray must extend beyond the pterygomaxillary
notch on each side, and also beyond the vibrating line.
The check for the proper posterior extension of the final impression tray is
done as follows :
1. The posterior edge of the dry tray is marked with indelible pencil.
2. This mark is transferred to the tissues by insertion of the tray in the mouth.
3. The tissues distal to the tuberosities are palpated with a T-shaped burnisher
to observe the distal extension marks of the tray in relation to the position
of the pterygomaxillary notch.
4. The patient is asked to say “ah.” This will cause the vibrating line to
become visible. The vibrating line, or the junction of the movable and
nonmovable palate, must be within the confines of the tray.
Four holes are now drilled in the palate of the tray with a 557 crosscut fissure
bur. These holes will permit the impression paste to flow through and avoid the

COMPLETE DENTURE IMPRESSIOS l'I'C‘3ZSIQl-E 7j.2
.trapping of any air on the surface of the impression. also, the tray will be se:&
with a minimum of pressure being created inside it.
The patient’s palate is swabbed with cotton on an applicator, and the pat.ic:ru
is told to gargle with a solution of water and essence of caroid. This mixture in
made by adding one-half teaspoonful of essence of caroid to a glass of w:ltet’
The caroid will impede the formation of mucus on the palate which would c;!u::(
the undesirable pitting of the impression. The patient’s lips are coated will:
petroleum jelly.
Fig. 14.-The final maxillary impression
A zinc oxide and eugenol impression paste is used for the final impression. Tbth
proper proportions are mixed on a glass slab, and after thorough spatulation, the
mix is placed inside the shellac tray. The tray is inserted in the patient’s moutll
by placing the posterior part in contact with the tissues first and then bringing the
anterior part into contact. The tray is seated without undue pressure, and then
held by the index finger in the center of the palate. The patient is told to &be
and open the mouth ; to swing the mandible from side to side ; to draw the lips
and cheeks inward; to contour the lips as in smiling. After three minutes, the
impression is removed (Fig. 14).
The reasons I use a zinc oxide and eugenol impression paste for the final in+
pression are : (1) It flows very easily. (2) It remains plastic long enough to
allow the peripheral tissues to function for a detailed peripheral roll. (31 It elim-
inates any premature tissue contact acquired by the compound. (4) No separating
medium is required. (5) The impression can be reinserted for testing. (6) rt ii
not unpleasant or harmful to the patient. (7) Tt does not change form when set.
Lower Final Iglz@ession.-The clear acrylic resin tray is inserted into ~CXIC
patient’s mouth and tested for retention. The patient is told to move the tongue
outward, to each check, and to the palate. The tray should not be dislodged bv a.11:
of these movements.

7.54 KLEIN J. Pros. Den.
Novembc, 1955
The stability of the tray is then tested. The forefinger is placed in the region
of the second bicuspid of the left side and an attempt is made to tip the tray ; the
same test is made on the right side. Placing the forefinger over the anterior ridge
and exerting downward pressure will tend to tip up the posterior portion of the
tray. The tray should not be dislodged by any of these movements if it is stable.
The tray is then tested for overdisplacement of the tissues. Blanched tissue,
indicating overdisplacement, can be observed through the clear acrylic resin tray.
This can be relieved by grinding with a stone or vulcanite bur.
Fig. 15.-The final mandibular impression.
The mandibular labial frenum and the buccal frenula are checked to make
certain that they are relieved sufficiently.
The tray is removed from the mouth and dried thoroughly. Petroleum jelly
is applied to the lips and chin, and the patient is told to rinse the mouth with the
solution of essence of caroid and water.
The zinc oxide and eugenol impression paste material is placed inside the
tray and over the borders. The tray is seated with light but positive pressure.
The patient is told to move the lower lip upward and inward as if drawing on a
straw, and to draw the cheeks inward. When the impression material can be in-
dented by fingernail pressure (while still holding the impression in position) the
patient is told to move the tongue outward, side to side, and to the roof of the mouth.
This step must be done very carefully because, if the impression material is allowed
to harden too much, it will be impossible to record the border of the lingual flange
accurately. Likewise, if the paste is too plastic, the lingual border will not be
accurate because the structures in the floor of the mouth will squeeze the paste
lingually. The impression paste must be just firm enough to offer resistance to the
movements of the muscles in the floor of the mouth to form an accurate border roll.
The final mandibular impression is removed after the impression material has set
(Fig. 15).

COMPLETE DEKTURE ISIPRESSIOS TF:C[HNIQT.E
,”. ”
1-,c
1.
2.
3
4:
.s.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
REFERENCES
George, R. K.: Plaster as an Impression Material. Am. J. Dental Science, Third Series
16-22, 1869.
Austin, J.: Metals Suitable for Dies and Counter-Dies, 11m. 1)en. Resiew 1 :I(>1 -;~*7,
1858.
Franklin, B. W. : Plaster Impressions and Other Things, Vulcanite, 2:153-157. l%-lX(Z.
White, J. W.: Objectives of Impression Taking, Dental Cosmos. 36:15-38, 1894.
Green, Jacob W.: Clinical Course in Dental Prosthesis. ed. 5, Detroit. 1916, Dental ?I;u!~~-
facturing Co.
Young, D. H.: The Carbon System of Constructing a Porcelain-Face Crown, 1)1,11:ai
Cosmos. 49:516-518! 1907.
Fish, E. W.: An Analysis of the Stabilizing tiactors in Full Denture Constructiorl, ;irit.
Dent. J. 52:559-570, 1931.
Swenson, Merrill G. : Complete Dentures, ed. 1, St. Louis. 1940, ‘The C. V. ?~1oshy i “cl..
pp. 1-32.
Slack, Fred A., Jr. : Positive Retention in Lower Dentures. Bull. Philadelphia (‘(1. 1). disc.
14:2-7, 1949.
Wright, Walter H.: Impressions of Alginate Materials, N. Y. J. Den. 18:204-215. i’&.
Hight, F. M. : Simple Technique to Obtain ?rlaximum Retention and Stability it: I.oz~,w-
Dentures, J.A.D.A. 12,:778-783, 1925.
Stansb;;;, $.Js. : The Negative Pressure bfethod of Impression Taking, J .!.I)... 12 :&ix
Ten&, R&e11 ‘W. : Impressions for Dentures, J.A.D.A. 21 :lOOS-1018. 1934.
Boucher. Carl 0. : Complete Denture Impressions Based IJpon the .1natomy oi *11c
Mouth, J.A.D.A. 31:1174, 1944.
Pryor, Walter J. : An Evaluation of Several Full Denture Impres~ioll ‘I‘ccllnirli:t+.
J.z%.D.A4. 37:159, 1948.
730 F~FT~I Aw.
NEW YORK, _I’. Y

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