Denture Initial visit – Final Impression

Denture Initial visit – Final Impression – With Nothing

At the initial 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

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 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.
  • 8mm from center papilla to facial
  • 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

 

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