Impression Making

Prof. Dr. Abdel-Basit Mahmoud 19

CHAPTER II

IMPRESSION MAKING IN COMPLETELY
EDENTULOUS CASES
(Techniques, Procedures and Materials Used)

The impression procedure is simply a means of recording the detail of the basal
seat area so that a stone replica can be poured.

Objectives of Impression Making:
The impression should cover the maximum possible area without interfering with
normal muscle movements.
Complete denture impression should provide:-
1- Preservation of the remaining residual alveolar ridge: - The impression
technique and impression material have an effect on the accuracy of denture
base, which has an effect on the continued health of both the soft and hard
tissues of the jaws.
2- Support: - maximum coverage distributes applied forces over as wide an area
as possible.
3- Stability close adaptation to the undistorted mucosa is most important for
stability of the denture.
4- Esthetic: - border thickness should be varied with the needs of each patient in
accordance with the extent of the residual ridge loss.
5- Retention: - it should be readily seen that if the other objectives are achieved,
retention will be adequate.
To provide these attributes specific objectives must be achieved by the final
impression.
1. To attain maximum area coverage within anatomico-physiological limits.
2. To develop a border seal.
3. To reproduce the foundation and border tissues accurately.
4. To equalize forces on the denture foundation area.






Impression Making
Prof. Dr. Abdel-Basit Mahmoud 20
Requirements for an impression:
To achieve a successful impression, the following conditions should be done:
The tissues of the mouth must be health.
Proper space for the selected impression material should be provided
within the impression tray.
The border must be in harmony with the anatomical and physiological
limitations of the oral structures.
The impression should include all of the supporting and limiting tissues.
The tray and the impression material should be made of dimensionally
stable materials.
The external shape of the impression must be similar to the external form
of the complete denture.

Preparation of the Mouth
The oral tissues should be healthy before impressions are made. Any distortion
or inflammation of the denture foundation tissues must be eliminated before
the impressions are made as the following:-
The patients must leave their old dentures out of the mouth for at least 24
hours before the impressions are made.
Use of tissue conditioners if the patient cannot leave the dentures out the
mouth.
The anatomical landmarks in the maxilla










Impression Making
Prof. Dr. Abdel-Basit Mahmoud 21
Buccal anatomical relations of the upper denture



Anatomical landmarks in the mandible






















Impression Making
Prof. Dr. Abdel-Basit Mahmoud 22
Anatomical relations of the lower denture.









Impression Making
Prof. Dr. Abdel-Basit Mahmoud 23
The Preliminary Impression
I. The patient's position:
The dental chair is set in the upright position; this being important during the
impression making since the fears existing among patients is that of being
choked by the material in use.
The chair should be adjusted so that the head and neck are in line with the
trunk. If the head is allowed to bend backwards from the neck the supra and
infrahyoid muscles will be tense and difficulty in swallowing will result, also
should a fragment of impression material break away from the main impression
it can more easily fall into the throat and possibly cause obstruction in the
airway.

During impression making the operator usually stands behind and to the right
of the patient for a maxillary impression (Fig. 2: 1). For the mandibular
impression the operator stands in front of the patient (Fig. 2: 2).













Fig. 2; 1: operator behind and to right Fig. 2; 2: operator in front of patient
of patient for upper impression for lower impression.

A suitable covering in the form of apron or large towel should be provided to
protect the patient's clothing and also, ready at hand, a warm, flavored mouth
wash.






Impression Making
Prof. Dr. Abdel-Basit Mahmoud 24
II. Selection of the stock tray:
The objective is to make an over-extended impression of the edentulous
foundation area.
suitable upper and lower sterilized stock trays are chosen (Fig. 2: 3 & 4) and
tested in the mouth for their approximation to the oral structures (a space of
about 4-6 mm should be present between the borders of the tray and the tissues
to accommodate the impression material whether compound or alginate).







Fig. 2; 3: Rim lock stock trays Fig. 2; 4: Perforated upper &lower stock trays

Modification of stock tray
It may be necessary to bend the tray slightly with pliers to provide
adequate space.
Cut and trim the flange to accommodate the frena and prevent pressure
on bony structures such as the zygomatic process of the maxilla.
Addition of a little warmed wax or composition (of a higher softening
point than that to be used for the impression) to correct Shortness in the
flanges (Fig. 2: 5).

Fig. 2; 5: Utility wax added to adjust insufficient length of upper and lower rim lock trays.



Impression Making
Prof. Dr. Abdel-Basit Mahmoud 25
III. Selection of impression material
Composition, sometimes called impression compound, has been used for
making the preliminary impression. Nowadays irreversible hydrocolloids are the most
commonly used preliminary impression material.
Procedure of impression making using compound:

The composition is heated in a water bath at 55 to 60C.
Since the material has a low thermal conductivity, it
must be immersed in the water bath for sufficient time to
ensure complete softening.
The composition is, then, removed from the water bath and kneaded. It is rolled
into a ball for the maxillary impression and into a cigar-shape for the
mandibular impression.
The molded compound is placed in the tray and finger
molded to conform to the contour of the tray with bulk
evenly distributed.
The tray is inserted by a rotating motion, oriented into
position and centered over the ridge while, the labial
flange is brought upwards making certain that the lip is freed.
The patient is asked to do functional movements. The patient is instructed to
close. In doing so, the coronoid process of the mandible is retruded and tension
on the cheek (buccinators muscle are released) permitting access to the buccal
space (buccal pouch).
The tray is held in place for one minute or two, removed and chilled thoroughly
in cold water.
The same procedure is carried out for the lower. In general, composition is not
considered as an accurate impression material.
Impression compound is used as a primary impression for the following reasons:
1. Addition and correction can be done.
2. Ease of manipulation.
3. Well tolerated by the patients.
4. Cheap and can be reused.
5. Accuracy is not essential for primary impressions.


Impression Making
Prof. Dr. Abdel-Basit Mahmoud 26
Procedure of impression making using alginate:

o The clearance between the tray and the tissues should be approximately 4-5
mm.
o The tray for alginate should be perforated. Rim lock trays may also be used.
Attachment of the alginate to the tray is essential because if it pulls away a
distorted impression will result which may easily pass unnoticed since the detail
of the surface will remain unchanged.
o Alginate produces excellent surface detail. It is elastic and can be withdrawn
over undercuts. It cannot be added to if faulty.

the following points should be observed with alginate impression:
1- The container of powder should be shaken before use to get an even distribution of
constituents.

2- The powder and water should be measured, as directed by the manufacturer. The
water is poured into the bowl first then the powder is added.

3- Room temperature water is usually used, slower or faster setting time can be
achieved, if required, by using cooler or warmer water, respectively.

4- There should be vigorous mixing-by spreading the material against the side of the
bowl, for the spatulated time, usually one minute.

5- During setting of the material it is important that the impression should not be
moved. The reaction is faster at higher temperature, and so the material in contact
with the tissues sets first. Any pressure on the gel due to movement of the tray will
set up stresses within the material, which will distort the alginate after its removal
from the mouth.

6- An alginate impression, when sets, develops a very effective peripheral seal so
before trying to remove it from the mouth this seal should be freed by running the
finger round the periphery.

7- An alginate impression should be displaced sharply from the tissues; this sudden
displacement ensures the best elastic behavior. A gentle, long continued, pull will
frequently cause the alginate to tear or pull away from the tray.

Impression Making
Prof. Dr. Abdel-Basit Mahmoud 27
8- On removal from the mouth, the impression should be washed with cold water to
remove saliva (Fig. 2: 8), covered with a damp napkin to prevent syneresis, and the
impression poured as soon as possible, preferably not more than 15 minutes after
making the impression (Fig. 2: 10 & 11).

The reasons for this are that:
a- Even in the humidor imbibitions may take place.
b- The stresses induced in the material are released slowly, and the sooner it is poured,
the less the stresses will have been released and so the less it will have warped.








Fig. 2; 9: Completed upper & lower preliminary alginate impressions.












Fig. 2; 10: The alginate impression pouring Fig. 2; 11: Upper plaster cast obtained from
with plaster of Paris. Alginate impression.







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Prof. Dr. Abdel-Basit Mahmoud 28
The Final Impression
(The secondary or working impression)

The primary impressions are poured into plaster. Special trays are then
constructed on the plaster models to make the final impressions.

Theories of Final Impressions:
I. Minimal pressure impression technique (mucostatic impressions or open
mouth impression):

It is a technique in which the soft tissues are in no way compressed or distorted
and therefore the impression material must flow readily; and impose no pressure
on the mucosa.
Plaster of Paris is the only true mucostatic impression material (Fig. 2: 12) though
the hydrocolloids often give equally good clinical results.
Trays constructed for this technique require a spacer with stops and one or two
holes to allow escape of the material.







Fig. 2; 12: Plaster upper final impression.
Advantages:
1. The operator can see and insure proper border molding and muscle movements are
more easily accomplished.
2. There is less distortion to the mucosa.
3. It is the technique of choice for flabby and thin wiry ridges.

Disadvantages:
1. The mucosal topography is not static over a 24-hour period.
2. It neglects the principle of distributing masticatory forces over the largest possible
basal seat area.
Impression Making
Prof. Dr. Abdel-Basit Mahmoud 29
II. Muco-functional or compression impressions (Closed mouth impression
technique):

It is a technique in which the soft tissues are under biting force while the
impression material sets.
The impression material most commonly used for this technique is zinc oxide
and eugenol paste (Fig. 2: 13).
Trays require occlusion blocks set at the required vertical dimension.








Fig. 2; 13: ZOE upper Final Impression.

Advantages:
1. The patient can exert his own masticatory force on the impression material.
2. It permits adequate trimming of the lingual borders of the lower impression.

Disadvantages:
1. Dentures constructed from such an impression do not fit well at rest, as the
compressed tissues tend to rebound.
2. An overextended denture may result due to improper border molding.
3. It interferes with blood supply and this may accelerate ridge resorption.









Impression Making
Prof. Dr. Abdel-Basit Mahmoud 30
III Selective Pressure Impressions Techniques:
This technique combines pressures over areas and little pressure on others. The
tray is constructed with relief over areas of no pressure and closely adapted over other
areas (stress bearing areas).
1. The plaster wash impression is an example of the selective pressure impression
technique:
A preliminary compound impression is made.
The compound is then scrapped and relieved over hard and sensitive areas or
over flabby areas ,
A plaster wash impression is made over the preliminary compound impression.
Plaster records the relieved areas with minimal pressure and the other areas are
recorded under a considerable amount of pressure.

2. The composite method:
This technique is used if the flabby tissue is in the anterior part of the mouth.
A metal or acrylic tray is made covering the normal area only. The impression
of this area is then made using zinc oxide paste or composition under biting
force.
Whilst the impression is still in the mouth, plaster is painted around the flabby
tissues, and built up in thickness sufficient to allow its withdrawal with the rest
of the composite impression (Fig. 2: 16).







Fig. 2; 16: Selective pressure impression technique (Composite method)

Procedures for recording the final impression:
1. Checking and adjusting the special tray.
2. Border molding the special tray.
3. Final impression making.
4. Checking the impression.
5. Beading, boxing and pouring the impression.
Impression Making
Prof. Dr. Abdel-Basit Mahmoud 31

I. Checking and adjusting the special tray:
The tray should be well adapted to the cast, following the outline but 2mm shorter
than the vestibule (Fig. 2 17).
The border should be smoothened with V-shaped notches around the frena.
The tray is then checked visually and digitally for extension and adaptation in the
patient's mouth. Any adjustments should be made.










Fig. 2; 16: The tray well adapted to the cast & 2mm shorter than the vestibule.

II. Border molding the special tray:
The objective of border molding is to determine the contours and width of the
borders of the completed denture and to register this width and contour on the
final impression. This procedure fulfills impression-making objectives of
maximum area coverage and border seal.

Materials used for border molding:
1. Green stick compound, red impression compound are
materials used for border molding. One end of the stick
is heated over a flame without burning. The heated
compound is added to the tray in the area to be molded
and built to a height of 3 or 4mm. The compound on
the tray is then tempered in a water bath at 140F. The tray is then
quickly inserted in the patient's mouth to proceed with molding.
2. Polyether impression materials is prefer because they are well suited
for this purpose and meet all of the requirements listed previously.
3. Heavy body vinylpolysiloxane : VPS does not have the viscosity or
rigidity of modeling compound and therefore cannot be used to correct
borders that are under extended.

Impression Making
Prof. Dr. Abdel-Basit Mahmoud 32
Technique of border molding
1- A properly extended custom tray is needed that is 2 to 4 mm short of full
extension to accommodate space for border-molding materials.
2- This may be carried out either in sections, recording one part of the border at a
time, or recording the entire border simultaneously.
3- Tray wax spacer remains in place during border molding
procedures. Do not remove the wax spacer until final
impression is made.
4- Do not drill the palatal relief hole(s) in the maxillary tray until the
borders have been molded and peripheral seal demonstrated.
Assessing Peripheral Role:
- Proper thickness: average denture border usually is between 2 to 4 mm.
- The height of the border molding material above the tray should be no
more than 2-3 mm because that was the amount of space created between
the soft tissue and the impression tray prior to border molding.
- Should smoothly flow from one area to the next without visible lines of
demarcation.
- No evidence of overextension: the material is then rechecked intraorally
to ensure complete fill of the border

Maxillary Border Molding:

1. The buccal space and the zygomatic process area:
a. Apply the green stick compound in the Hamular notch
area and on the buccal space and the zygomatic arch
area.
b. Insert the tray and the cheek may be drawn in the
direction of the buccinators fibers.
c. The patient is asked to move his jaw to the opposite side.
This motion will enable the coronoid process to displace the material, which
would interfere with the jaw movement.


Impression Making
Prof. Dr. Abdel-Basit Mahmoud 33
2. The buccal frenum area:
a. Green stick compound is added to the borders of the denture from the
previously molded area to a point anterior to the buccal frenum. The
compound is flamed to insure fusion with the previously molded area.

b. The tray is inserted, seated and the patient is asked to close. The cheek is
grasped in the area of the corner of the mouth and the vestibular tissues are
drawn down and back and forth to provide adequate clearance during
functional movements.

3. The anterior arch area and labial frenum:
a. Green stick compound is applied to the borders of the denture from the
previously molded area to the same area on the opposite side of the arch
(cross the midline).

b. The tray is inserted and seated. The vestibule is massaged in the direction of
the fibers of the orbicularis oris.
c. Avoid pulling the lip down except in the corners of the mouth. In these areas
excess material squeezed laterally by the molding action in the vestibule
may create an overextension in the buccal frenum area.

4. The posterior border:
a. The green stick compound is added over the posterior section of the tray as
diagrammed in Fig. 2: 18.
b. Heat is applied carefully to avoid distortion of the tray itself (if shellac is
used).
c. The tray is inserted and seated firmly.
d. When the material has set torquing the tray may test the peripheral seal. A
positive resistance to dislodgement must be demonstrated before proceeding.

The addition of the border molding material over the posterior border :
Completes the peripheral seal by displacement of the tissue along the
posterior border to permit evaluation of the overall border seal.
Insures intimate fit of the tray in the posterior palatal seal area.
Possibly aids in preventing excessive posterior flow of final impression
material.


Impression Making
Prof. Dr. Abdel-Basit Mahmoud 34







Fig. 2; 17: The stick compound Fig. 2; 18: Completed upper tracing
adapted with fingers.

Mandibular Border Molding:

1- The retromolar, disto-buccal and buccal shelf area:
a. Compound is placed along the border of the tray
from the most lingual extent of the retromolar pad to
an area approaching the buccal frenum.
b. The tray is inserted & seated and the patient is asked
to close against the downward force of the dentist's
finger on the tray in the premolar area. This motion
permits the tissues displaced by closing action to mold the disto-buccal
portion of the tray (masseter notch).
c. Along the external oblique ridge the border is molded by massaging the cheek
to displace the compound, which has extended beyond the external oblique
ridge.

2. The buccal frenum area:
a. The border molding material is added to the tray, which is inserted and
seated.
b. The cheek is grasped in the corner of the mouth and drawn upward and
inward, back and forth to permit full freedom of movement area.

3. The anterior labial arch:
The green stick compound is added and the patient is asked to suck or
draw his lip upwards and/or the dentist gently massages the lip in an
upward direction.



Impression Making
Prof. Dr. Abdel-Basit Mahmoud 35
4. The sublingual flange(to sublingual crescent area):
a. The border molding material is placed on one border of the tray.
b. The tray is inserted and seated into position.
c. The patient is asked to extend his tongue so that the tip of the tongue is placed
just outside the corner of the mouth on the side opposite that which is being
molded.
d. The procedure is then repeated on the opposite side.

5. The sublingual crescent area:
a. A piece of green stick compound is softened in a water bath, attached to the
tray, and molded with a finger into a shelf extended out area over the
crescent area
b. The material is softened to a (lowing consistency, tempered, inserted and
seated into position (Fig 2: 19).
c. The patient is asked to close and relax. The tongue should assume its normal
rest position with the tip approximating the position of the lingual surfaces
of lower anterior teeth.








Fig. 2; 19-a: Stick compound traced along b: The completed lower traced tray.
the lower tray, tempered, and inserted
into the patient's mouth.









Impression Making
Prof. Dr. Abdel-Basit Mahmoud 36
III- The final impression:
For routine edentulous final impression making, the materials used are zinc
oxide and eugenol paste and rubber base materials.

Materials used for final impression making:

1-Plaster of Pairs
Plaster of Paris had been used in the past for routine edentulous final impression
making because of its high fluidity and accuracy.
Some of its disadvantages limited its use to excessive flabby tissue cases only (
If there are undercuts present, the plaster impression
will fracture on removal from the mouth.
Impression plasters may be unpleasant for the patient
because they produce dry sensation in the mouth.
Before pouring a model in plaster or dental stone, the
plaster impression must be treated with a separating medium.
The possibility of scratching the model during removal of the impression
is present.

2-The Zinc Oxide-Eugenol Paste ( ZOE )
Indications:
a- As a final wash material (functionally trimmed impression)
b- Relining of dentures. c- In cases having pronounced nausea.
d- Muco-functional impression (Closed mouth technique).
Contra-indications:
1- When more than a slight undercut exists. 2- Excessive salivation.
Disadvantages:
The set material is not elastic, so will not record undercuts.
This material will not produce a satisfactory impression of the periphery unless
supported by a very accurately adapted tray.
Advantages
There are probably little or no dimensional changes associated with the setting
process.
These impression materials are sufficiently fluid to record the fine detail in the
mouth.
Impression Making
Prof. Dr. Abdel-Basit Mahmoud 37
Technique
The acrylic special trays used for this material require no clearance and are
adapted directly on to the preliminary model.
The pastes are mostly supplied in two tubes, one containing basically zinc oxide
and the other basically eugenol (Fig. 2: 21).
For the lower impression about 6 cm and for the upper 10 cm of each are
squeezed on to the mixing block, thoroughly spatulated and evenly distributed
over the fitting surface of the carefully dried tray (Fig. 2: 22).
Before starting to mix the paste the patient's lips and neighboring skin should be
lightly covered with face cream or Vaseline to prevent the paste adhering to
these dry surfaces should it touches them during the insertion of the tray. Many
operators also treat their fingers in the same way.
Should some zinc oxide paste accidentally touch a patient's or operator's dry
skin, a napkin moistened with chloroform or Dettol solution can remove it.








Fig. 2; 22- a: Mixing of ZOE impression paste b: Loading the tray with ZOE mix.

Removal of the impression is sometimes a little difficult owing to the excellent
peripheral seal obtained, but it can be facilitated by introducing a few drops of
water from syringe around the periphery of the set impression.
Some patients may complain of burning sensation when the impression is in the
mouth, this is due to the slight irritation caused by the oil of cloves or eugenol.
The treatment by mouthwashes is all that is required.







Impression Making
Prof. Dr. Abdel-Basit Mahmoud 38
3- Rubber base impressions (Elastomers)
These are elastic impression materials, which are classified into three chemical
types: Polysulphide, silicone and polyether.

They are used in making secondary impressions for complete dentures.
Functionally trimmed borders are better achieved before impression making.
The rubber base impressions will not adhere to the tray and the use of an
adhesive or perforation of the tray is required.
The impression material is usually supplied in two collapsible tubes and
occasionally as a base paste and a catalyst liquid.
A uniform mixing is essential. These materials are also supplied in a range of
viscosities and after setting they are elastic in behavior.

In general, elastomers can record fine details, and are tolerated well by the
patients. They should be displaced sharply from the tissues to ensure elastic
behavior.
These materials are in general compatible with model and die materials and
consequently, no separating medium is required.
the shelf life of these materials is not ideal they should be kept in a refrigerator.

Nausea during impression making:

A disturbing factor experienced by some patients is the sensitivity of the
dorsum of the tongue to foreign bodies, such conditions may produce retching
and in rare instances actual vomiting.
Cause:
This is a normal reaction to gentle intermittent stimulation of this area
and many patients are more affected during the selection of a standard
tray than during the actual making of the impression with its firmer
contact over a more restricted area and its avoidance of the dorsum of the
tongue.

Unfortunately with the more difficult cases there is always a
psychological factor present as well, probably connected with a fear of
choking,

Impression Making
Prof. Dr. Abdel-Basit Mahmoud 39
one or more of the following methods can assure a successful operation:

1- A firm sympathetic manner of self-confidence on the operator's part.

2- Assure the patient that no difficulty will be experienced if instructions are followed
and that the discomfort will be minimized as much as possible, being in any case
only for a short time.

3- The patient should blow the nose to clear any nasal obstruction and then
encouraged in deep, nasal breathing.

4- Explain to the patient that, as soon as the impression is seated, the head may be
brought well forward over the lap and that a bowl will be provided to hold under
the chin to catch any saliva that may run out of the mouth. This will reduce the
fear of being choked and will also help by keeping the patient's hands occupied.

5- Carry out the impression technique using as little material as possible. Avoid
touching the dorsum of the tongue with the back of the tray and seat the
impression as quickly as possible.

6- Desensitize the surface of the mucous membrane with:
a. Phenol mouth washes of one part phenol to eighty parts of cold water.
b. Sucking a tablet made for this purpose.
c. The application of a surface type of local anesthetic either in the form of
cream or spray.

7- gradual desensitization: As sensitive patients will experience the same difficulty at
each succeeding visit and as the wearing of the finished denture will be difficult, it is
advisable to construct a fitting base plate in acrylic on the first impression and give
it to the patient with instructions to practice wearing it for increasingly longer periods
each day until it can be worn for at least an hour without discomfort.

8- Patients dislike plaster of Paris more than any other material, even when it is
flavored, the alginates are tolerated slightly better; composition is usually tolerated
well, probably owing to its putty-like consistency and its heat, zinc oxide-eugenol
paste seems to be disliked least of all but this may be largely due to its only being
used in a tray which already fits, though its flavor of cloves undoubtly helps in some
cases.

Impression Making
Prof. Dr. Abdel-Basit Mahmoud 40
IV. Checking the accuracy of the impression
The impression should accurately reproduce the tissue details (Fig. 2: 24).
Large voids and wrinkled areas caused by movement of the tray during setting of the
material necessitate repeating the impression.
If the tray shows through the impression material in a small area, scrapping could
relieve that area. If this area is large, the impression is preferably repeated.







Fig. 2; 24: Accurate upper & lower ZOE final impressions.
V. Pouring the Final Impressions

The impression should be poured as soon as possible to avoid distortion of the
impression. Beading and boxing are of utmost importance to preserve the borders of
the impression and to produce the landmark areas (Fig. 2: 25).







Fig. 2; 25: Beading & boxing of both upper and lower ZOE impressions.







Fig. 2; 25: Poured the boxed impression until the stone has set & removing the boxing wax.
Impression Making
Prof. Dr. Abdel-Basit Mahmoud 41














Fig. 2; 26: Upper & lower stone master casts already for making the recording blokes.





REASONS FOR REMAKING IMPRESSIONS
1- Incorrect tray position in the mouth:
A thick buccal border on one side with a thin buccal border on the opposite
side. This indicates that the tray was out of position in the direction of the
thick border (poorly centralized).
A thin labial border with the tray showing on the inside surface of the labial
flange. This indicates that the tray was placed too far posteriorly and not
centered correctly over the anterior ridge.
A thick lingual border on one side with a thin lingual border on the opposite
side. This indicates that the lower tray was out of position in the direction of
the thin border.
A thin anterior lingual border with the tray showing on the inside surface of
the lingual flange. This suggests that the lower tray was too far forward in
Impression Making
Prof. Dr. Abdel-Basit Mahmoud 42
relation to the residual ridge. It will be accompanied by a thick labial border.
In a similar manner, a thick labial border in the upper arch with the tray
showing through over the anterior slope of the palate. This indicates that the
tray was too far forward in relation to the residual ridge.
Pressure spots on the lingual surface of the maxillary labial flange usually
indicate that the tray was not fully seated. Pressure spots on the anterior part
of the mandibular lingual flange indicate that the mandibular tray is too far
forward in the mouth, in many instances as a result of action of the tongue,
If the tray is correctly positioned in the mouth, errors in the impression indicate that the tray needs
to be modified before another impression is made. The tray should not be modified unless it was
positioned correctly when the impression was made.
2- A The tray showing through the impression material
Tray showing through the impression material over the fitting surface of the
tray and the borders showing through the final impression material. This
indicates that the tray has been seated on the residual ridge with too much
pressure.
Tray showing through the impression material over the border with the correct
thickness of material over the fitting surface of the tray, suggests that the tray is
overextended in that area.
If the tray shows through the impression material in a small area, scrapping could relieve that
area. If this area is large, the impression is preferably repeated.
3- Movement of the tray while the final impression material was setting it result in wrinkled
areas necessitate repeating the impression
4- Pulling the impression material away from any area of the tray.
5- Contact between cusps of teeth and the impression tray.
6- Incorrect border molding procedures.
7- Incorrect border foundation as a result of incorrect border length of the tray. A sharp border
usually indicates that the impression is underextended in that area.
Impression Making
Prof. Dr. Abdel-Basit Mahmoud 43
8- Incorrect consistency of the final impression material when the tray was positioned in the
mouth (granular impression with poor tissue details).
9- A material unsupported by the borders of the tray:
Excess thickness of impression material over the fitting surface of the tray and
material unsupported by the borders of the tray. This indicates that the tray was
not seated down sufficiently on the residual ridge.
The correct thickness of material over the fitting surface of the tray, but material
extending beyond the border of the tray so that it is unsupported by the tray,
suggests that the tray is under extended in that area.
10- Voids or discrepancies those are too large to be corrected accurately on the cast. Some voids
may be corrected by adding new impression material to the impression and reinserting
however any impression with a void this large generally should be remade in its entirety.
Small voids may be correctable on the master cast since they will result in positive bubbles
that can be removed with a cleoid/discoid instrument.
11- Using either too much or too little impression material.
12- Sticking the impression material to the teeth.
13- Layered impression.
14- Trapping lip, cheek, tongue or floor of the mouth.
15- Tearing of an area of impression.
16- Poor detail in the impression because of a poor mixing technique or because the material
had begun to set before the impression was fully seated


Impression Making
Prof. Dr. Abdel-Basit Mahmoud 44
Problems and solutions of alginate impression