Impression Technique For Flabby Tissues Short Notes

If flabby tissues cannot be treated by any surgical procedures due to certain clinical situations other methods such as tissue conditioning should be tried before going in for impression procedures. The patient’s existing denture can be relined with tissue-conditioning material to promote tissue healing.

Flabby tissues Hypermobile ridge tissue

• This condition results from resorption of the alveolar bone under an ill-fitting denture from constant unbalanced occlusal forces in a localized area.
• If the movable tissue is localized and does not interfere with the stability of the denture, then
  a nonpressure, mucositis impression technique can be done. If the tissue is excessive and pendulous and interferes with the stability of the denture then, surgical removal is recommended.

Flabby tissues  Impression technique

Flabby Tissues Preliminary Impression

With alginate impressions that should be poured immediately. Thirty minutes is the maximum time that should elapse between making the impression and pouring it.

Flabby tissues  Impression plaster/anti-expansion solution

Flabby tissues  Composition:

1. Impression plaster is based on calcined calcium sulfate hemihydrate
2. Alizarin red–coloring agent–0.04%
3. The impression plaster is mixed with an anti-expansion solution containing
4. Potassium sulfate–4% (reduces expansion to 0.05% and acts as an accelerator also)
5. Borax–0. 4% (Retarder)
6. This setting reaction is associated with an expansion of 0.3–0.6%
7. The plaster is mixed with water or an anti-expansion solution in a ratio of 100 gram to 50–60 ml
8. Setting the time 3 min.

Flabby tissues  Special Plasters

• Special plasters are obtainable for impressions that contain potassium sulfate and borax in the solid form and so have only to be mixed with water.
• Another type contains starch which makes a very smooth mix with the added advantage that it is slightly sticky and so will adhere to the tray and is easy to remove from the cast by boiling, water which causes the starch granules to swell and so disintegrate the whole impression.

Flabby tissues  Impression for flabby ridges

Flabby tissues  Mixing Plaster for Impressions

About 20 mL of anti-expansion solution in a dry bowl, quickly sift the plaster and allow it to stand for 30 s without disturbance. After half a minute when the entire plaster is moistened throughout, stir two or three times with a spatula for a homogeneous mass.

Flabby tissues  Individual Trays

• Cold-cure acrylic tray with a handle measuring 2 cm from the sulcus is made. The lower tray should have a finger stand in the first molar region on both sides.
• Check and trim the trays for plaster impressions. After the impression is made the green stick compound should be seen through the plaster impression. This can ensure that the impression plaster has determined the height of the sulcus appropriate to the width already decided by the buccal trim.

Flabby tissues  Puddling of Plaster

Instead of using firm direct pressure, the hand is wriggled and puddled into the mass with a gentle vibratory movement so that the plaster flows around the tissue surface. This method is referred to as puddling.

Flabby Tissues Failures With Plaster Impressions

1. Using a tray of the wrong design.
2. Failure to reduce the depth of the flanges of the tray.
3. Insufficient plaster in the tray.
4. Too much plaster in the tray.
5. Seating the tray after the plaster begins to set.
6. Incorrect centering of the tray.
7. Direct pressure and not puddling the tray into position.

The patient is often pre-medicated with atropine to reduce salivary flow so that the surface of the impression, made in low-viscosity impression paste, is in very close and intimate contact with the mucosa.

In order to maintain the ecstatic theme, the denture base is finished without encroaching on muscle tissue and so the periphery is much shallower and thinner than with other techniques.

Flabby tissues  Displaceable maxillary ridge

An anterior ridge that is displaceable, in the upper with the incisive papilla lying towards the front of the flabby ridge and the bunched pairs of palatal rugae on the crest of the ridge.

Flabby tissues  Impression techniques

Flabby tissues  Mucocompression without Displacement

• This is a two-stage technique designed to compress the flabby tissue so that the compression throughout the whole of the maxillary denture-bearing area is as uniform as possible. Preliminary impression: Made with alginate and a cast is poured. A special tray is made with chemically activated resin.
• The borders are refined and border molding with green stick compound is done.

Flabby tissues  Final impression: With Zinc oxide eugenol impression paste. After the paste sets, the tray is trimmed corresponding to the flabby portion. This appears as a window in the tray.

Flabby tissues  The second stage: Impression plaster is painted onto the flabby portion with a brush. The tray is removed after the plaster sets and poured into dental stone after applying separating media at the region of the plaster impression.