Part 1 : Border Molding and Secondary Impression Mandible

Summary

In prosthodontics, the meticulous process of creating a precise mandibular impression is vital for denture support, retention, and stability. This involves using custom trays and border molding techniques to capture the natural contours of a patient’s mouth accurately. The video guides dental practitioners through each step of applying impression compounds and taking zinc oxide eugenol impressions, emphasizing the importance of correctly judging the depth and extension of tray borders. Such precision ensures that dentures fit comfortably and function effectively, providing a secure foundation for improved aesthetics and oral health.

Highlights

• Impression making captures denture bearing surfaces for support and stability. ✔️
• Custom trays control soft tissues for undisturbed impressions. 📐
• Border molding uses impression compounds for perfect tray borders. ✏️
• Zinc oxide eugenol ensures final impressions are precise. 💯

Key Takeaways

• Custom trays are essential for precise mandibular impressions! 🦷
• Mastering border molding is key to great denture fit! 🤓
• Using impression compounds correctly ensures accurate results! 🎨
• Zinc oxide eugenol is the go-to for final impressions! 🧪

Overview

Understanding the intricate process of border molding and creating secondary impressions in the mandible is crucial for dental professionals aiming to provide the best support and stability for dentures. This video delves into each step, with clear instructions on how to use a custom tray to achieve the most accurate impressions possible.

From starting with custom trays to ensuring a precise fit with impression compounds, the technique of border molding is like a science and an art. Dental practitioners will find valuable insights into adjusting tray extensions and recording the exact resiliency of the mouth's limiting structures, ensuring no detail is overlooked.

Ultimately, capturing detailed impressions using materials like zinc oxide eugenol facilitates the creation of dentures that not only enhance a patient's oral function but also positively impact their appearance and comfort. Proper execution of these methods is indispensable in the field of prosthodontics.

Chapters

• 00:00 - 00:30: Objectives of Impression Making The chapter 'Objectives of Impression Making' discusses the goals involved in creating impressions for dentures. These objectives include capturing all potential denture-bearing surfaces and tissues to ensure the denture provides support, retention, and stability during function. It highlights that the denture base also serves as a foundation for enhancing the appearance of the lips. Furthermore, it emphasizes that the denture should extend peripherally to accurately record the resiliency of surrounding limiting structures. This involves creating the appropriate length and width to accommodate these structures.
• 00:30 - 01:30: Using a Custom Tray for Final Impressions The chapter discusses the use of a custom tray for making a final impression in edentulous patients. Custom trays are highlighted for their adjustable borders, which can control movable soft tissues around the impression without disturbing them. Additionally, space is provided inside the tray to ensure that the shape of tissues covering the denture-bearing area is recorded with minimal or selective displacement.
• 01:30 - 02:30: Checking and Adjusting the Custom Tray The chapter focuses on the detailed procedure for checking and adjusting the custom tray in the primary denture bearing areas. It emphasizes the importance of ensuring the tray adequately covers crucial areas such as the buccal shelf and retromolar pad, while also providing necessary clearance for the labial, buccal, and lingual frenum. Proper spacing of 1.5 to 2 millimeters between the tray and the sulcus is also highlighted. The chapter provides specific instructions for seating and adjusting the tray to ensure optimal denture fit.
• 02:30 - 03:30: Marking and Adjusting Overextended Borders The chapter focuses on methods to check and adjust overextended borders in a dental context. It describes techniques for examining labial and buckle extensions by retracting the lips and cheeks to observe the activation of the buckle and labial frenum. For checking lingual extensions, it suggests using a mirror in the distrolingual area and asking the patient to elevate and protrude their tongue. If the dental tray is displaced during this process, it indicates that the lingual borders are overextended, necessitating adjustments.
• 03:30 - 04:00: Preparation for Border Molding The chapter focuses on the preparation for border molding in dental procedures. It highlights the importance of ensuring that the borders of dental trays are not overextended. Specifically, it discusses the need to adjust the borders to be one millimeter shorter and illustrates marking the labial and buccal frenum using an indelible pencil.
• 04:00 - 06:00: Border Molding with Impression Compound This chapter discusses the technique of border molding in dental impressions using impression compound. It highlights the use of an indelible marker to delineate desired borders and guide the reduction process for accurate impression making.
• 13:00 - 17:30: Final Impression Procedure with Zinc Oxide Eugenol The chapter titled 'Final Impression Procedure with Zinc Oxide Eugenol' discusses the technique of mounting an acrylic bird using a chair side straight handpiece. It emphasizes the use of this tool to remove excessive extensions and provide relief, particularly in the labial area and a broken free.

Part 1 : Border Molding and Secondary Impression Mandible Transcription

• 00:00 - 00:30 the objectives of impression making are to capture all potential denture bearing surfaces and tissues to provide support retention and stability of the denture under function the denture base also acts as a foundation for improved appearance of the lips the denture should extend peripherally to record the resiliency of the surrounding limiting structures which include creating appropriate length and width of the
• 00:30 - 01:00 final denture borders a custom tray is used to make the final impression for an edentulous patient individual or custom trays have Porter's that can be adjusted so they control the movable soft tissues around the impression and do not disturb them at the same time space cap he provided inside the tray so that the shape of the tissues covering the denture bearing area may be recorded with minimal or selective displacement
• 01:00 - 01:30 in the primary denture bearing areas begin by checking the extensions of the custom tray make sure that the tray covers the buccal shelf area and the retromolar pad provide clearance for the labial buccal and lingual frenum and make sure that there is 1.5 to 2 millimeters between the tray and the full depth of the sulcus when the rib is moved away horizontally once the tray is fully seated move the
• 01:30 - 02:00 lower lip away from the vestibule to check the labial and the buckle extensions retraction of the lip and cheeks would activate the buckle and the labial frenum and make it easier to visualize the extensions to check the lingual extensions use a mirror in the destroy lingual area and ask the patient to elevate and protrude their tongue if the tray is displaced then the lingual borders are overextended and you need to
• 02:00 - 02:30 adjust them you can see here that the borders of the three are slightly overextended so I need to make the borders one millimeter shorter and also to mark the labial and the buccal frenum so use an indelible pencil to mark the labial and typical
• 02:30 - 03:00 frenum and to draw the over extensions so they could guide you when you do the adjustments using a straight on piece you so here I'm using an indelible marker to mark the desired borders on the tree as this web guide me when I do the reduction you
• 03:00 - 03:30 mount an acrylic bird on a chair side straight hands piece use the word to remove all over the extensions and to provide relief for the label and a broken free
• 03:30 - 04:00 now you can see that the borders are adequate and we're ready to start the border holding procedure impression compound is the material of choice for border molding its advantage is that it can be placed incrementally you can observe the surface trim it back add
• 04:00 - 04:30 more material and then we adapt the periphery each addition and section of the three border can be seamlessly adapted to the previous compound impression compound is a mixture of waxes and thermoplastic resin plus fillers that increase the viscosity at high temperatures and provide rigidity at room temperature the material is softened by heat over a flame move the
• 04:30 - 05:00 material over the flame and don't allow it to ignite or boiled once the material has softened you will realize that it becomes a bit glossy now it's time to apply the material on the borders of the tray use the stick as a pen and apply it on the borders of the tray and as we are doing the segment by segment window the labial segment first pre-heat the material over the flame and
• 05:00 - 05:30 tamper it with hot water before putting it in the patient's mouth you may use some Vaseline on your fingertips to shape the borders once you're happy with the appearance of the material you may now transfer to the patient's mouth and start order molding
• 05:30 - 06:00 now place the tray in the patient's mouth to border mold the labial frenum seat the tray and then retract the lip and horizontally to view the labial frenum and then move it in an upward direction this would border mould the labial frenum in most cases its prominent and you can also instruct the patient to squeeze their lips together
• 06:00 - 06:30 once removed from the patient's mouth dry the tray and inspected under good light you will see what we call here loss of gloss meaning that impression compound once it contacts the tissues it will lose its glossy characteristics and the material will become done if it becomes dull this way it means that
• 06:30 - 07:00 you've done the border moulding correctly and the material has recorded the wound depth and width of the sulcus inspect the inside of the tree make sure that no material or no impression compound material extends beyond the height of the tree border inside the tree as we be using zinc oxide eugenol later to make the impression on the fitting surface so heat the Rock Ron Carver and remove all excess material
• 07:00 - 07:30 from the inside of the tree so once you had happy with the first segment it's now time to do the second segment which is the right buccal vestibule so dry the tray heat the distal end of the last segment that you
• 07:30 - 08:00 just did and then heat the greenstick just like we described previously applied and then apply the material on the borders of the tray temperate with hot water and then use Vaseline on your fingertips to adjust the borders of the anticipated vestibule
• 08:00 - 08:30 seep the tray into the patient's mouth hold the patient's cheeks between your index finger and your thumb and start moving the cheeks and outward as an upward direction this is the warder mode the vocal freedom and the bakken vestibule
• 08:30 - 09:00 notice how the buckle frenum is nicely moulded into the three borders and how the material has lost its gloss meaning that it contacted the tissues everywhere so as you can see here the others and
• 09:00 - 09:30 excess material inside the tray so use again use a sharp cover to remove the material from the inside now repeat the procedure for the left side using the same steps so first apply the material on the Border's heated above the flame and then temperate in
• 09:30 - 10:00 hot water notice here that the buckle frenum was
• 10:00 - 10:30 not molded really accurately so you can reheat this segment apply more material and then please eat it in the patient's mouth to fully record the buccal frenum now notice the difference and see how
• 10:30 - 11:00 the buccal frenum is molded correctly now that we've bought the molded right and left buckle segments it's time to do the anterior lingual segment again apply the material heat it over the flame and then temper it with hot water ask the patient to follow the instructions to border mold the anterior
• 11:00 - 11:30 lingual segment elevate the tongue protrude move to the right and then to the left and then swallow inspect the tray boulders remove excess material and then it's time now to do the destroyed inguinal area we're going
• 11:30 - 12:00 to do right and left separately one more time apply heat temper in this segment we'll be bordered molding that the stolen goal area under a true molar pad area seat the tray in
• 12:00 - 12:30 the patient's mouth ask the patient to elevate their tongue protruded move it to the right and left and then to swallow ask them to swallow for a second time as forceful swallowing would further elevate the floor of the mouth and you'll be able to record the retro mylohyoid fossa repeat the procedure twice to make sure that the material has
• 12:30 - 13:00 reached the full depth of the sulcus so when you look at the borders you should be looking at a slight curve in the distal lingual area meaning that you've recorded the retro mylohyoid fossa properly and you should be looking at seamless transition between the different segments so make sure that you
• 13:00 - 13:30 heat the distal end of the previous segment before making a new addition and now repeat the same procedures for the left the strolling goal area and the retromolar pad area
• 13:30 - 14:00 again ask the patient to protrude the tongue move it to the right and left and then swallow twice the border mall d'etre should have seamless transition between the segments and should record the full depth and width of the sulcus zinc oxide eugenol is the material of choice for the final impression procedure it is supplied as a form of two pastes zinc oxide the white
• 14:00 - 14:30 paste and during all the red paste equal lengths of the material are dispensed into a mixing pad the manufacturer further controls the ratio of the two pastes by using different size openings of each tube the material is mixed using a spatula on
• 14:30 - 15:00 a mixing pad use the side of the spatula to connect the material and spreaded over the mixing part in a figure 8 motion until a homogeneous mix is achieved initial set of the material is three to five minutes and full setting is achieved in ten minutes
• 15:00 - 15:30 start loading the trake from the distal end gradually this is to avoid incorporating air bubbles and to ensure that you have a homogeneous smooth impression surface
• 15:30 - 16:00 apply Vaseline on the patient's face this is to prevent the material from adhering to the face so it becomes easier to clean afterwards the nurse is going to hand you over the impression tray and then you're going to see the tray into the patient's mouth as we have described previously when a seat the
• 16:00 - 16:30 tray and then repeat the board and molding movements in the order we've mentioned earlier so first you'll start with the labial suncast retract the lip horizontally and then upward and inward border mold the right and left buccal vestibules and then ask the patient to move their to protrude the tongue move it to the right and left to the back and
• 16:30 - 17:00 then swallow and then swallow one more time this is to activate the lingual area repeat the sequence two or three times until the material starts reaching the initial set remove the impression material five minutes after it reached the initial setting inspect the impression and make sure
• 17:00 - 17:30 that you've captured all anatomic details disinfect impression in two percent glutaraldehyde solution for five minutes REMS it and dry it well and then send it to the route for the construction of record blocks