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Increase Case Success With Your Denture Impressions! 8 Keys to Getting a Good Impression for Dentures

Increase Case Success With Your Denture Impressions! 8 Keys to Getting a Good Impression for Dentures

A high-quality impression is fundamental to patient care and practice success. Whether for a denture revision or submission, accuracy ensures effective treatment while simultaneously avoiding time-wasting delays. To achieve both, you need to take your time, commit to a repeatable process, and keep a steady hand; the rest of the process will then follow smoothly.

Increase Case Success With Your Denture Impressions! 8 Keys to Getting a Good Impression for Dentures

1. Maintain Clear Margins

Among the most common problems with impressions are short and/or obstructed margins. To avoid either problem, you must first choose the best fitting tray. From there, keep blood and saliva out of the margins to ensure you have an accurate impression.

For patients who are bleeding, consider using mechanical retraction with cords, retraction paste, hemostasis agents, or any appropriate combination therein. The goal is to keep margins dry and visible.

2. Try the Tray First

Before taking the impressions, you’ll want to try the tray in the mouth first. This allows you to see how it fits and make adjustments if necessary. Be sure to stand in front of the patient for the best view and ensure the patient’s lip fits over the tray’s anterior edge.

Also wiggle the tray around while it’s in the mouth; if it moves, you have room for the PVS material. If it does not wiggle, the material will likely leak out and make for an incomplete impression. If this is the case, the tray is likely too tight or small. Remember an ill-fitting tray will cause impressions with voids and more compact tissue markings.

3. Watch for Gagging

If a patient begins gagging or moving, the impression will likely become distorted. One helpful measure is to have an assistant nearby who can chat with and divert the patient; this helps take his or her mind off gagging urges and physical discomfort.
Also, remind the patient to wiggle toes and breathe deeply through the nose. Providing updates as to the time remaining in the treatment is additionally helpful. For patients who don’t respond to the above suggestions, these ideas often provide relief:
  • Raise feet off the chair
  • Tilt the head forward
  • Place salt under the tongue
  • Use nitrous oxide

4. Follow Material Instructions

While it can be tempting to start rushing through dental impressions, especially after you’ve performed several in one day, it’s important you follow the material instructions every single time. Keep in mind that materials handle differently in various temperatures. Reading and following the manufacturer’s directions can ensure perfect timing in every situation. 

Even after you’ve memorized the instructions, stay consistent in your practices. Physical timers can keep track of mixing and set times so you’re always on track. Developing and sticking to a routine will similarly allow you to take accurate impressions with every patient and reduce your chair-side time.

5. Pay Attention to Tray Seating

This step represents the potential for any number of errors. If you notice that ledges are a common issue with your impressions, try to seat the tray more slowly. Position the tray first and move forward with a slow, steady seating motion. Likewise, drags can occur when the tray is placed and seated all at once. They may also be the result of teeth rebounding off the tray. Again, seat the tray slowly after it’s positioned within the mouth and avoid contact with teeth.

Problems like slanted teeth and rocking crowns are caused by tray movement after it’s seated. Apply passive pressure to the tray to keep it immobile throughout the recommended set time.

6. Know Your Expiration Dates

A distorted impression can be the result of improper mixing or expired materials. Here is still another reason to read the usage instructions provided with the material; doing so allows you to monitor expiration dates and avoid the need for repeat impressions. 
This will save your office time and money, as expired materials can usually be exchanged with the manufacturer’s rep for those that are current.

7. Watch How You Remove the Impression

When removing the impression, it’s important to take your time and follow precise steps. For instance, removing an upper arch impression requires that you pull straight down; for the lower arch, you need to conversely pull straight up. Controlled movements are essential so you don’t get a “wiggly” tooth that requires a do-over.

If the tray feels too tight upon removal, gently rock it from side to side. This should help loosen it so you can freely take it out of the patient’s mouth. If the impression gets locked, have your patient close his or her lips and blow. These tricks of the trade can help you safely remove the tray in a way that preserves its integrity.

8. Avoid Common Issues

One of the most common problems that occurs with dentures impressions is the material not being fully set before it’s removed. You can solve this with three simple steps:

  • Set a timer, as mentioned earlier, so you know exactly how long the material must be left untouched
  • Discard the initial 1-inch of material that comes from every new mix
  • Wait one extra minute beyond the instructed set time before removing trays

Watch the Distal Teeth

Distortion of the most distal teeth is another frequent concern, and with good reason. It’s hard to see into the deepest corners of a patient’s mouth, which means posterior teeth often get shortchanged. This can be overcome by ensuring the tray you use extends beyond the last tooth without touching the gums.

It’s equally important to ensure the impression material you use is well-combined so it can reach the distal teeth. It should have a uniform color and be free of streaking. If you’re hand-mixing, knead the material quickly and within the manufacturer’s recommended working time.

Complications that arise during the dentures impression process can be perplexing and frustrating. Those that most frequently occur, such as short margins and patient discomfort, are often easy to correct. Others, such as avoiding wiggly and distorted teeth, simply require a change in technique. For more information on the best practices for good impressions, contact Team Prudental Laboratories & Milling Center today.

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