LYMANANDBOUCAER
6. Garver DG, Fenster RK. Vital root retention in humans: a final report. J PROSTHJXT DENT 1980;43:368-73. ‘7. Kerr DA, Ash MM Jr, Millard DH. Oral diagnosis. St Louis: CV Mosby Co, 1983. 8. Swenson HM, Hudson JR. Roentgentographic examination of edentulous patients. J PROSTHETDENT 1967;18:304- 7. 9. Swenson HM. Roentgenographic examination of the edentulous mouth. J Am Dent Assoc 1944;31:475-8. 10. Michaeli Y, Hermel J, Gixenfeld E, Michman J. Pathologic radiographic findings in clinically symptom free edentulous subjects J PROSTHET DENT 1977;37:494-8. 11. Bareclay JK, Donaldson KI. Panoramic radiography of the edentulous jaws-a survey of 100 patients. N Z Dent J 1970;66:53-68. 12. Bremer VA, Grant AA. A radiographic survey of edentulous mouths. Aust Dent J 1971;16:17-21. 13. Spyropoulos ND, Pateakas AJ, Angelopoulos AP. Findings from radiographs of the jaws of edentulous patients. J Oral Surg 1981;52:455-9. 14. Scandrett FR, Tebo HG, Miller JT, Quigley MS. Radiographic examination of the edentulous patient. J Oral Surg 1973;35:166-74. 15. McCall UO, Wald SS. Clinical dental radiology. Philadelphia: WB Saunders Co, 1957. 16. Williams WW. Roentgenology’s place in denture prosthesis. J Am Dent Assoc 1953;46:688-9. 17. Ennis LM, Berry HM. Necessity for routine roentgenographic examination of the edentulous patient. J Oral Surg 1949;7:3-19. 18. Smylski PT. Panoramic radiography in the practice of oral surgery. J Can Dent Assoc 1967;33:192-9. 19. Barr JH, Stephens RG. Dental radiology. Philadelphia: WB Saunders Co, 1980. 20. American Dental Association. Guide to dental health. Special edition. J Am Dent Assoc 1985. 21. Council on Dental Materials and Devices. Recommendations in radiographic practices-March 1978. J Am Dent Assoc 1978;96:485-6.
tice and improved accessof the patient population to good dental treatment. Later studies that appear to contradict this trend should be analyzed with respect to the population studied. Later studies have also shown a change in the nature of the pathosis reported. Early studies reported large numbers of root fragments, cysts, and other residues of incomplete dental surgery. Later studies, while still reporting some residual tooth fragments, have also reported on morphologic changes and nonspecific radiographic changes. The clinical significance of this type of information must be weighed against the exposure of the patient to radiation.
SUMMARY
’
The use of radiographs for diagnosis of edentulous patients must be evaluated in the light of patient history and clinical examination. The routine making of radiographs of patients wearing complete dentures who need new dentures should be discouraged. REFERENCES 1. Logan WHG. Should ah pulpless teeth be removed? J Nat1 Dent Assoc 1921;8:126-31. 2. Eusterman MF. Roentgenographic findings in two hundred and ninety partially edentulous or edentulous mouths. Dent Cosmos 1921;63: 901-3. 3. Jones JD, Seals RR, Schelb E. Panoramic radiographic examination of edentuIous patients. J PROSTHETDENT 198%53:535-g. 4. Perrelet LA, Bernhard M, Spirgi M. Panoramic radiography in the examination of edentulous patients. J PROSTHETDENT 1977;37:494-8. 5. Johnson DL, Kelly JF, Fliton RJ, Cornel MT. Histologic evaluation of vital root retention. J Oral Surg 1974;32:829-33.
Reprint requests to: DR. SANFORDLYMAN SCHOOLOF DENTAL MEDICINE SUNY AT STONYBROOK STONYBROOK,NY 11794-8706
Modification of immediate denture technique using vinyl polysiloxane
sectional
impression
L. Kirk Gardner, D.D.S.,* Gregory R. Parr, D.D.S.,** and Arthur 0. Rahn, D.D.S.*** Medical Collegeof Georgia,School of Dentistry, Augusta, Ga. The labial sectional impression technique in the maxillary immediate denture can be done in many different materials with varied results. The use of vinyl polysiloxane putty for this impression technique is demonstrated and shows the superior results both in the ease of use and the detail of the impression surface. (J PROSTHET D~~~1990;64:182-4.)
M
ost immediate denture impression techniques use a primary custom posterior impression tray that, once
*AssociateProfessor,Department of Prosthedontics. **Professor, Department of Proethodontics. ***Professor and Chairman, Department of Prosthodontics. 1011117909
182
border molded and impressed, is removed, trimmed of any flash, and placed back in the mouth for making the anterior segment of the impression.1-3 The anterior part of the impression of the remaining teeth and vestibule can be completed with several different techniques. 1. Plaster can be used for the anterior section. Once set, the plaster is sectioned for removal and reassembled on the primary tray outside of the mouth.le4 AUGUST1990
VOLUME 64 NUMBER2
MODIFICATION
OF IMPRESSION
TECEINIQUE
Fig.
1. Primary impression trimmed and ready for reinsertion.
Fig.
2. Primary impression with labial sectional impression (separated).
Fig.
3. Primary impression with labial sectional impression (joined).
2. Modeling plastic or wax placed on the border of a sec-
ondary tray may be used in the same way for the anterior sectional impression.3 3. The Campagna technique uses an open tray in the region of the remaining teeth with a small extension into the labial vestibule. Once border-molded and impressed, a stock tray with irreversible hydrocolloid is used to capture the remaining teeth. The two trays are removed as one.6 THE JOURNAL
OF PROSTHETIC
DENTISTRY
This article describes a technique that uses vinyl pol ysiloxane for the labial sectional impression.
IMPRESSION
TECHNIQUE
1. Border mold the primary (posterior) impression t;ray with the material of choice. 2. Remove the posterior impression tray from the mouth and trim any excess material in the postpalatal seal region around the teeth and on the palatal surfaces of the 183
GARDNER,
anterior teeth approximately halfway into the interproximal spaces (Fig. 1). 3. Mix an appropriate amount of vinyl polysiloxane putty at a ratio of 50% catalyst and 50% base with ungloved hands. (Remove all glove powder from the hands or the putty will not catalyze properly.) 4. Place a small portion of the mixed putty in the labial vestibular space in the region of the anterior teeth. The putty is molded in contact with the surface of the tray, the labial surface of the teeth, and the labial vestibule. Manipulate the lip outward, downward, and inward and lightly pat the lip to decrease the bulk and provide a well-molded labial border (7 minutes working time). 5. Remove the total impression as a one-piece unit unless severe undercuts are present. If separation is necessary, remove each segment individually and accurately reassemble the impression outside the mouth by using sticky wax (Fig. 2). Box and pour the impression in the conventional manner (Fig. 3). The advantages of this technique are as follows. 1. The labial vestibule can be recorded in a relaxed physiologic state. 2. The two-part impression usually can be removed in one piece.
184
PARR,
AND
RAHN
3. The vinyl polysiloxane index accurately records the labial vestibular space. 4. The vinyl polysiloxane is compatible with any impression material used. 5. The procedure is not messy and is faster than other similar techniques. 6. The impression can be made easily by one person instead of requiring assistance. REFERENCES 1. Lutes MR, Ellinger CW, Terry JM. An impression procedure for construction of maxillary immediate dentures. J PROSTHET DENT 1967; l&202-10. 2. Lambrecbt JR. Immediate dentures construction: the impression phase. J PROSTHET DENT 1966$9:237-45. 3. Hartwell CM Jr, Rahn AO. Syllabus of complete dentures. 4th ed. Philadelphia: Lea & Febiger, 1986;458-60. 4. Ellinger CW, Rayson JH, Terry JM. Rahn AO. Synopsis of complete dentures. Philadelphia: Lea &Febiger, 19X$282-5. 5. Campagna SJ. An impression technique for immediate dentures. J PR~EXHET DENT 1968;20:196-203.
Reprintrequeststo: DR. L. KIRY GARDNER SCH%L OF DENTISTRY P MEDICAL COLLEGE OF GEORGIA AUGUSTA, GA 30912-1250
AUGUST
1990
VOLUME
64
NUMBER
2
6. Garver DG, Fenster RK. Vital root retention in humans: a final report. J PROSTHJXT DENT 1980;43:368-73. ‘7. Kerr DA, Ash MM Jr, Millard DH. Oral diagnosis. St Louis: CV Mosby Co, 1983. 8. Swenson HM, Hudson JR. Roentgentographic examination of edentulous patients. J PROSTHETDENT 1967;18:304- 7. 9. Swenson HM. Roentgenographic examination of the edentulous mouth. J Am Dent Assoc 1944;31:475-8. 10. Michaeli Y, Hermel J, Gixenfeld E, Michman J. Pathologic radiographic findings in clinically symptom free edentulous subjects J PROSTHET DENT 1977;37:494-8. 11. Bareclay JK, Donaldson KI. Panoramic radiography of the edentulous jaws-a survey of 100 patients. N Z Dent J 1970;66:53-68. 12. Bremer VA, Grant AA. A radiographic survey of edentulous mouths. Aust Dent J 1971;16:17-21. 13. Spyropoulos ND, Pateakas AJ, Angelopoulos AP. Findings from radiographs of the jaws of edentulous patients. J Oral Surg 1981;52:455-9. 14. Scandrett FR, Tebo HG, Miller JT, Quigley MS. Radiographic examination of the edentulous patient. J Oral Surg 1973;35:166-74. 15. McCall UO, Wald SS. Clinical dental radiology. Philadelphia: WB Saunders Co, 1957. 16. Williams WW. Roentgenology’s place in denture prosthesis. J Am Dent Assoc 1953;46:688-9. 17. Ennis LM, Berry HM. Necessity for routine roentgenographic examination of the edentulous patient. J Oral Surg 1949;7:3-19. 18. Smylski PT. Panoramic radiography in the practice of oral surgery. J Can Dent Assoc 1967;33:192-9. 19. Barr JH, Stephens RG. Dental radiology. Philadelphia: WB Saunders Co, 1980. 20. American Dental Association. Guide to dental health. Special edition. J Am Dent Assoc 1985. 21. Council on Dental Materials and Devices. Recommendations in radiographic practices-March 1978. J Am Dent Assoc 1978;96:485-6.
tice and improved accessof the patient population to good dental treatment. Later studies that appear to contradict this trend should be analyzed with respect to the population studied. Later studies have also shown a change in the nature of the pathosis reported. Early studies reported large numbers of root fragments, cysts, and other residues of incomplete dental surgery. Later studies, while still reporting some residual tooth fragments, have also reported on morphologic changes and nonspecific radiographic changes. The clinical significance of this type of information must be weighed against the exposure of the patient to radiation.
SUMMARY
’
The use of radiographs for diagnosis of edentulous patients must be evaluated in the light of patient history and clinical examination. The routine making of radiographs of patients wearing complete dentures who need new dentures should be discouraged. REFERENCES 1. Logan WHG. Should ah pulpless teeth be removed? J Nat1 Dent Assoc 1921;8:126-31. 2. Eusterman MF. Roentgenographic findings in two hundred and ninety partially edentulous or edentulous mouths. Dent Cosmos 1921;63: 901-3. 3. Jones JD, Seals RR, Schelb E. Panoramic radiographic examination of edentuIous patients. J PROSTHETDENT 198%53:535-g. 4. Perrelet LA, Bernhard M, Spirgi M. Panoramic radiography in the examination of edentulous patients. J PROSTHETDENT 1977;37:494-8. 5. Johnson DL, Kelly JF, Fliton RJ, Cornel MT. Histologic evaluation of vital root retention. J Oral Surg 1974;32:829-33.
Reprint requests to: DR. SANFORDLYMAN SCHOOLOF DENTAL MEDICINE SUNY AT STONYBROOK STONYBROOK,NY 11794-8706
Modification of immediate denture technique using vinyl polysiloxane
sectional
impression
L. Kirk Gardner, D.D.S.,* Gregory R. Parr, D.D.S.,** and Arthur 0. Rahn, D.D.S.*** Medical Collegeof Georgia,School of Dentistry, Augusta, Ga. The labial sectional impression technique in the maxillary immediate denture can be done in many different materials with varied results. The use of vinyl polysiloxane putty for this impression technique is demonstrated and shows the superior results both in the ease of use and the detail of the impression surface. (J PROSTHET D~~~1990;64:182-4.)
M
ost immediate denture impression techniques use a primary custom posterior impression tray that, once
*AssociateProfessor,Department of Prosthedontics. **Professor, Department of Proethodontics. ***Professor and Chairman, Department of Prosthodontics. 1011117909
182
border molded and impressed, is removed, trimmed of any flash, and placed back in the mouth for making the anterior segment of the impression.1-3 The anterior part of the impression of the remaining teeth and vestibule can be completed with several different techniques. 1. Plaster can be used for the anterior section. Once set, the plaster is sectioned for removal and reassembled on the primary tray outside of the mouth.le4 AUGUST1990
VOLUME 64 NUMBER2
MODIFICATION
OF IMPRESSION
TECEINIQUE
Fig.
1. Primary impression trimmed and ready for reinsertion.
Fig.
2. Primary impression with labial sectional impression (separated).
Fig.
3. Primary impression with labial sectional impression (joined).
2. Modeling plastic or wax placed on the border of a sec-
ondary tray may be used in the same way for the anterior sectional impression.3 3. The Campagna technique uses an open tray in the region of the remaining teeth with a small extension into the labial vestibule. Once border-molded and impressed, a stock tray with irreversible hydrocolloid is used to capture the remaining teeth. The two trays are removed as one.6 THE JOURNAL
OF PROSTHETIC
DENTISTRY
This article describes a technique that uses vinyl pol ysiloxane for the labial sectional impression.
IMPRESSION
TECHNIQUE
1. Border mold the primary (posterior) impression t;ray with the material of choice. 2. Remove the posterior impression tray from the mouth and trim any excess material in the postpalatal seal region around the teeth and on the palatal surfaces of the 183
GARDNER,
anterior teeth approximately halfway into the interproximal spaces (Fig. 1). 3. Mix an appropriate amount of vinyl polysiloxane putty at a ratio of 50% catalyst and 50% base with ungloved hands. (Remove all glove powder from the hands or the putty will not catalyze properly.) 4. Place a small portion of the mixed putty in the labial vestibular space in the region of the anterior teeth. The putty is molded in contact with the surface of the tray, the labial surface of the teeth, and the labial vestibule. Manipulate the lip outward, downward, and inward and lightly pat the lip to decrease the bulk and provide a well-molded labial border (7 minutes working time). 5. Remove the total impression as a one-piece unit unless severe undercuts are present. If separation is necessary, remove each segment individually and accurately reassemble the impression outside the mouth by using sticky wax (Fig. 2). Box and pour the impression in the conventional manner (Fig. 3). The advantages of this technique are as follows. 1. The labial vestibule can be recorded in a relaxed physiologic state. 2. The two-part impression usually can be removed in one piece.
184
PARR,
AND
RAHN
3. The vinyl polysiloxane index accurately records the labial vestibular space. 4. The vinyl polysiloxane is compatible with any impression material used. 5. The procedure is not messy and is faster than other similar techniques. 6. The impression can be made easily by one person instead of requiring assistance. REFERENCES 1. Lutes MR, Ellinger CW, Terry JM. An impression procedure for construction of maxillary immediate dentures. J PROSTHET DENT 1967; l&202-10. 2. Lambrecbt JR. Immediate dentures construction: the impression phase. J PROSTHET DENT 1966$9:237-45. 3. Hartwell CM Jr, Rahn AO. Syllabus of complete dentures. 4th ed. Philadelphia: Lea & Febiger, 1986;458-60. 4. Ellinger CW, Rayson JH, Terry JM. Rahn AO. Synopsis of complete dentures. Philadelphia: Lea &Febiger, 19X$282-5. 5. Campagna SJ. An impression technique for immediate dentures. J PR~EXHET DENT 1968;20:196-203.
Reprintrequeststo: DR. L. KIRY GARDNER SCH%L OF DENTISTRY P MEDICAL COLLEGE OF GEORGIA AUGUSTA, GA 30912-1250
AUGUST
1990
VOLUME
64
NUMBER
2
