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 Table of Contents  
CASE REPORT
Year : 2016  |  Volume : 2  |  Issue : 2  |  Page : 42-45

Dual impression technique for fabrication of maxillary complete immediate denture


Department of Prosthodontics Crown and Bridge, Hazaribag College of Dental Sciences and Hospital, Hazaribagh, Jharkhand, India

Date of Web Publication15-Mar-2017

Correspondence Address:
Ashish Kumar Srivastava
Department of Prosthodontics Crown and Bridge, Hazaribag College of Dental Sciences and Hospital, Hazaribagh, Jharkhand
India
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DOI: 10.4103/2454-3160.202218

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  Abstract 

Conventional complete denture apart from all its merits has the prominent disadvantage of leaving the patient for a brief period of edentulous state till definitive prosthesis can be fabricated. Therefore, the concept of immediate denture is to preserve the jaw relation, keep the patient habituated to the complete denture and in the process preserve the esthetic concern of the patient. In the process, the psychological well-being of the patient is preserved as the patient is not without teeth for any prolonged period. The challenge in this technique is to record the edentulous and dentulous portion of the arch in conjecture with each other so that the final impression is closest to the intraoral situation, enabling us to provide the best results in short-and long-term of complete denture fabrication.

Keywords: Dual impression technique, esthetics, immediate denture


How to cite this article:
Srivastava AK, Chaterjee U, Ranjan M, Singh A. Dual impression technique for fabrication of maxillary complete immediate denture. Saint Int Dent J 2016;2:42-5

How to cite this URL:
Srivastava AK, Chaterjee U, Ranjan M, Singh A. Dual impression technique for fabrication of maxillary complete immediate denture. Saint Int Dent J [serial online] 2016 [cited 2017 Aug 18];2:42-5. Available from: http://www.sidj.org/text.asp?2016/2/2/42/202218



The significance of accurate impression in any field of prosthodontics cannot be emphasized in this short discussion. The ultimate goal of designing prosthesis lies in diagnosis and treatment planning, the impression recording procedure is the first step in the clinical aspect of the execution of the plan. The principle challenge in an immediate denture is recording the impression in static and functional form. Commonly, Kennedy Class I, Class II cases with poor periodontal prognosis are planned for the immediate denture.[1],[2],[3] The concepts of recording the edentulous posterior region with functional impression and dentulous anterior region by the static technique give increase to the unique dual impression technique.[4],[5]

Aim and objectives

Dual impression technique takes into consideration the combined aim of recording the remaining hard and soft tissue in the impression procedure. The distal extension edentulous region has to be recorded with the remaining teeth to attain a homogeneous impression of the entire maxillary arch.


  Case Report Top


A 52-year-old male patient reported to the Department of Prosthodontics Crown and Bridge Hazaribagh College of Dental Sciences Hospital, with chief complaint of difficulty in mastication. Clinical evaluation revealed loss of all teeth in maxillary left side except lateral incisor. The right side remaining teeth were the central and lateral incisor, canine and first premolar. All remaining teeth were mobile. Radiographic examination revealed severe loss of bone structure around all teeth. A combined evaluation suggested poor periodontal prognosis of the remaining natural teeth [Figure 1].
Figure 1: Preoperative intraoral view showing periodontally compromised teeth

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Treatment plan

The patient was advised to go for total extraction and a maxillary complete denture. The concept of immediate denture was explained to the patient. The patient was comfortable with the treatment plan as his job profile did not allow him to be edentulous for long span.

Procedure

Impression

A two-step final impression technique was planned for the fabrication of the denture. A primary impression of the maxillary arch was made using alginate [Figure 2] and subsequently, a primary cast was made. The cast was poured in dental stone. An impression of the mandibular arch was made. The remaining teeth in the cast were blocked out and a primary impression tray was made which covered the teeth anteriorly and posterior extended toward rugae area. 1mm perforations were made for the retention of impression material. The posterior part of the tray had a large hole to accommodate the handle of the second tray [Figure 3]. The second tray was made to cover the edentulous portion of the cast up to the posterior palatal seal area and was left short by 1 mm for border molding. This tray is nonperforated [Figure 4].
Figure 2: Preliminary impresion

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Figure 3: First tray to take impression of teeth

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Figure 4: Second tray to take impression of edentulous portion

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In the first step, the posterior edentulous arch border molding is done and a wash impression of the area is recorded using light body elastomeric impression paste for both steps. The alginate loaded tray made for dentulous area is placed along with the edentulous tray in the mouth [Figure 5]a and [Figure 5]b and both trays are removed simultaneously after the respected impression materials have set. The trays were removed together and dental stone poured and cast made [Figure 6]. The resulting cast was of dual impression where dentulous area was recorded under anatomical method and edentulous under functional method [Figure 7].
Figure 5: (a) Impression made of dentulous segment. (b) Impression made of edentulous segment

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Figure 6: Dual impression

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Figure 7: Master cast

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Jaw relation

Articulation and mounting were done in the conventional method of preparing occlusal rims and recording the jaw relation. Postarticulation the teeth arrangement is determined [Figure 8].
Figure 8: Jaw relation

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Teeth arrangement and try-in

Posterior teethes are placed and try-in is performed. After satisfying the steps of try-in, we proceeded to replace the remaining teeth. Alternate teeth on the cast are trimmed to preserve the jaw relation and replicate the anatomical features of teeth to be extracted. This method gives us a scope to exactly place the artificial teeth as it was in the natural setup. The denture is then waxed finished, flaked, and conventionally cured [Figure 9]a,[Figure 9]b,[Figure 9]c.
Figure 9: Teeth arrangement. (a) Alternate trimming of teeth on the cast. (b) Replacing the trimmed teeth. (c) Completed teeth arrangement

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Extraction

On the day of extraction, the maxillary denture is ready. The remaining natural teeth are extracted under local anesthesia, wound closure done by suturing and hemostatic attained [Figure 10]. Postextraction the maxillary denture is placed in the mouth and checked for retention, occlusion [Figure 11] and [Figure 12]. The patient is instructed to not remove the denture for 24 h. Next day, the denture is removed and again placed in the mouth. The patient is instructed to take good oral hygiene care. After 1 week, the sutures are removed. Periodic check up is done to evaluate bone resorption and loss of retention based on the final healing status the decision to either reline the denture or rebase the denture is taken.
Figure 10: Extraction of teeth at insertion appointment

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Figure 11: Denture insertion showing occlusion

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Figure 12: Denture insertion satisfied patient

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  Discussion Top


Immediate denture is defined as any removable dental prosthesis fabricated for placement immediately following extraction of natural tooth/teeth (GPT-8). Immediate denture is seen to be a very successful and acceptable means of providing and restoring the functional habits in a patient without waiting and.[1],[2],[6],[7] It shows better acceptability to prosthesis compared to conventional denture wearer who wait approximately 6–8 weeks postextraction. Follow-up with relining or rebasing has given good long-term results. There are few impression techniques proposed for the accurate recording of immediate denture situations.[5],[6],[7],[8],[9],[10],[11],[12]

The process of dual impression satisfies the requirements of retention, stability, and support in the complete denture. It involves the concept of a functional impression in the form of border molding and recording the limiting structure as well as recording tissue in the anatomical state. Thus, the resulting impression is satisfactory to enable the function of denture as per our goals.[6],[7],[12]


  Summary Top


If planned and executed systematically, dual impassion technique in immediate denture gives a good result for future denture related the solution to the prosthodontics as well as the patient. It is a novel method to fulfill the requirements of complete denture without the patient having to be edentulous for a prolonged time.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Winkler S. Essentials of Complete Denture Prosthodontics. 2nd ed. USA: A.I.T.B.S. Publishers & Distributors; 2004. p. 361-74.  Back to cited text no. 1
    
2.
Zarb GA, Bolender CL. Prosthodontics Treatment of Edentulous Patients. 12th ed. St. Louis MO: Mosby; 2004. p. 123-59.  Back to cited text no. 2
    
3.
Cupero HM. Impression technique for complete maxillary immediate denture. J Prosthet Dent 1978;39:108-9.  Back to cited text no. 3
    
4.
Campagna SJ. An impression technique for immediate dentures. J Prosthet Dent 1968;20:196-203.  Back to cited text no. 4
    
5.
Goldstein GR. An alternative immediate complete denture impression technique. J Prosthet Dent 1992;67:892-3.  Back to cited text no. 5
    
6.
Seals RR Jr., Kuebker WA, Stewart KL. Immediate complete dentures. Dent Clin North Am 1996;40:151-67.  Back to cited text no. 6
    
7.
Bolouri A. Double-custom tray procedure for immediate dentures. J Prosthet Dent 1977;37:344-8.  Back to cited text no. 7
    
8.
Freese AS. Simplified impressions for immediate complete dentures. J Am Dent Assoc 1957;54:240-2.  Back to cited text no. 8
    
9.
Terrell WH. Immediate restorations by complete dentures. J Prosthet Dent 1951;1:495-507.  Back to cited text no. 9
    
10.
Rayson JH, Wesley RC. An intermediate denture technique. J Prosthet Dent 1970;23:456-63.  Back to cited text no. 10
    
11.
Appleby RC, Kirchoff WF. Immediate maxillary dentures impression. J Prosthet Dent 1955;5:443-51.  Back to cited text no. 11
    
12.
Blank HM. Impression materials for maxillary immediate dentures. J Prosthet Dent 1961;11:414-9.  Back to cited text no. 12
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10], [Figure 11], [Figure 12]



 

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