Denture Initial visit – Final Impression – With Nothing
At the initial denture visit we can take final impressions of both arches. This visit lasts 30 minutes. Follow “Seating a Patient” SOP
Method 1 for final denture impression
1. Accu-Dent to pour up in house System 1 – Follow their laminated sheet
Use Massad tray to create custom tray – If have custom tray skip to step 5
1. Place Regisil fast set PVS stops in tray and impression (one in front two in back=tripod)
2. Remove and trim excess
3. Place rigid PVS and border mold
4. Remove and trim excess
5. Light body PVS
*gaggers ” = smell the flowers” – (slow deep breath) – lift legs – acupuncture
Border mold for upper denture
1. Mark vibrating line with ink before impression
2. Cough
3. Valsalva maneuver
4. Open wide as can and close to half repeat
5. Pucker and blow kiss
6. Big smile with squinty eyes
7. O face, forcing upper lip down, stretch nose
8. Pull upper lip down and out and back
Border mold lower denture
1. 2 fingers on tongue and have resist my light pressure (once flex=done)
2. Pucker and blow kiss
3. Pull lower lip out and up and back
Take a centric tray impression at approximate VDO using Bite caliper
1. Place tape on nose and chin for measuring VDO (vertical dimension occlusion)
2. Use support wings for edentulous areas
Set maxillary teeth height
Find esthetic A point = edge of future central incisor = 3-4mm showing at rest
1. Measure distance from ridge (papillameter at rest and smile)
2. Ask for labial surface of wax rim or anterior teeth to be set 10-12mm from most posterior point of incisive papilla AlHelal 2018 JPD. I like 8-10mm from middle of incisive papilla to labial surface of central from page 649 of Hickley. Ortman’s first couple paragraphs have some good information on this as well.
A short list of where to set the maxillary denture teeth in the horizontal.
- Line connecting canines is +/- 1mm the center of the papilla in 92% cases.
- 8-10mm from center papilla to facial and seldom less than 8mm
- 12.4 mm from distal point of papilla to most facial line of 8 and 9
Set mandibular teeth height
Find esthetic B point = 0-1mm show at rest (papillameter?)
Facial meter used to measure Interala distance
Pour up impressions with Type IV stone
If they have an existing denture the following are the extra steps.
- Check the horizontal lip support with the existing denture.
- Check denture covers vibrating line
- Use alma gauge to measure incisal edge length and facial profile of wax rim
For more information you can check out our denture page as well.