Biological principles of

complete denture
impression

Definition
A complete denture impression
is a negative registration of the
entire denture bearing,
stabilizing and border seal areas
of
present in theTypes
edentulous
mouth
complete
denture
impression

Primary
impressio
n

Final
impressio
n

Objectives
1) RETENTION
2) STABILITY
3) SUPPORT
4) ESTHETICS
5) PRESERVATION OF REMAINING
STRUCTURES

STABILITY
It is the ability of the denture to
withstand horizontal forces.

Factors Affecting Stability

Vertical height of the residual ridge.
Quality of soft tissue covering the
ridge.
Occlusal plane

Quality of the impression.

Teeth arrangement.
Contour of the polished surfaces.
4

SUPPORT
It is the resistance to vertical forces of
mastication & to occlusal or other forces
applied in a direction toward the basal
seat .

To make the best support, it is necessary

to enhance the available support by
utilizing maximum coverage of all usable
ridge bearing areas

Secondary
supporting area:area of edentulous
ridge that are
greater than at
right angle to
occlusal forces ;
also the area of
dentulous ridge
that are at right
angle to occlusal
forces but tend to
.resorb under load
Maxillary :- anterior
ridge ,rugae & all
ridge slopes
Mandibular:- anterior
ridge & all ridge
slopes

Primary support area:area of edentulous ridge

that are at right angle to
occlusal forces & usually do
not resorb easily

a)posterior ridge

maxillary
b)

flat areas of the palate

Mandibular:a)buccal shelf area
b)Posterior ridge
c)pear shaped pad

mandibular

ESTHETICS
Thicker denture flanges are preferred in
long-term edentulous patients to give
required labial fullness.
Impression should perfectly reproduce the
width and height of the entire sulcus for the
proper fabrication of the flanges.

PRESERVATION OF REMAINING
STRUCTURES
De Van (1952) stated that, the
preservation of that which remains is of
utmost importance and not the meticulous
replacement of that which has been lost.
Impressions should record the details of
the basal seat and peripheral structures in
an appropriate form to prevent injury to
the oral tissues.
8

MUCOUS
MEMBRANE
The bones of the upper and lower
edentulous jaws are covered with soft
tissue, and the oral cavity is lined with
soft tissue known as mucous membrane
on which the denture bases rest
Mucous membrane serves as a cushion
between the bases and the supporting
bone.

The mucous membrane is

composed of two layers
Mucosa

Submucosa

It is formed by
stratified
squamous
epithelium and a
subjacent layer of
connective tissue
known as the
lamina propria.

It is formed by
connective tissue
and may contain
glandular , fat , or
muscle cells
Its function is to
transmit the blood
and nerve supply
to mucosa

BIOLOGIC
CONSIDERATIONS FOR
MAXILLARY IMPRESSIONS

In order to obtain a successful impression

the anatomy of the supporting and
limiting structures must be understood
well
Anatomical
landmarks
of the
maxilla

Limiting
structures

Supporting
Structures

1ry stress
bearing
areas

2ry stress
bearing
areas

Relief
areas

Limiting structures
During impression taking a great care
must be given to limiting structures
Labial frenum
Labial vestibule
Buccal frenum
Buccal vestibule
Hamular notch

Posterior palatal seal area

Maxillary
tuberosity

Supporting Structures
They are areas which can bear stresses
more than other areas in the oral cavity
and they are divided into :PRIMARY STRESS
BEARING AREAS
Hard palate

residual alveolar
ridge.

SECONDARY
STRESS BEARING
AREAS
Rugae
Maxillary
tuberosity
Alveolar tubercle.

Relief areas
These are areas which either resorb under
constant load or are covered by thin mucosa
whichcan be easily traumatized
Hence should be relieved
They are :

Incisive papilla
Cuspid eminence
Mid- palatine raphe
Fovea palatina

Support for maxillary denture

N.B : The bone of the two maxillae and the palatine bone
make up most of the support of maxillary denture
When the natural teeth are removed The
shape and size of the alveolar ridges
change.
The alveoli become more holes in the
jawbone and begin to fill up with new
bone, but at the same time the bone
around the margins of the tooth sockets
begin to resorb.
The rate of resorbing is rapid at first, but it
continues at a slower rate throughout life.

Limiting structures
Labial frenum : is a fold of mucous
membrane at the median line.
No muscle attachment.

Limiting structures
Labial Vestibule: It is the space
between the lips and the alveolar
The
major muscle in this area is
process
There
are oris
3 objectives related to
orbicularis
labial vestibule:
1. The impression must supply sufficient
support to the upper lip to restore the
relaxed contour.
2. The labial flange of the impression must
have sufficient height to reach the
reflecting mucous membrane of the

Limiting structures
Buccal Frenum: The buccal frenum is
sometimes a single fold of mucous
membrane, sometimes double, and in
some
mouths,
broad and
fan shaped.
Associated
muscles
are:
Buccinator
Orbicularis oris
Levator anguli oris

Limiting structures
Buccal Vestibule: The buccal vestibule
extends from the buccal frenum to the
notch. by the buccinator and the
hamular
It is influenced
modiolus.
And distally by the coronoid process.

Limiting structures
Hamular Notch: The hamular notch is a
displaceable area about 2mm wide ,
between the tuberosity of the maxilla and
the hamulus of the pterygoid plate.

Limiting structures
Posterior palatal seal area : This is an area at
or distal to the junction of hard and soft palate
where movement occurs when patient says ah.
This generally is not a line and should be described
rather as an area.
Posterior vibrating line : It is 4-1 2mm or on an
average is 8.2 mm dorsally to the hard and soft
palate junction.
The denture should end 1 or 2mm posterior to the
vibratory line .

Limiting structures
Maxillary Tuberosity: It is the
distal aspects of the posterior
ridges.

BIOLOGIC
CONSIDERATIONS FOR
Mandibular IMPRESSIONS

There are some differences between

consideration for maxillary and
mandibular impression like:
The basal seat of mandible is different in
size and form from the maxillary
counterpart.
The submucosa in some parts of mandibular
basal seat contains anatomic structures
different from those in the upper jaw.
The nature of the supporting bone on the
crest of residual ridge usually differs
between the two jaws.
The presence of the tongue complicates the

Anatomical
landmarks
of the
mandible

Supporting
Structures

Buccal
shelf area

Limiting
structures

Relief
areas

Residual
alveolar
ridge
Crest of
the
residual
alveolar
ridge

Genial
tubercles

Mental
foramen

Torus
mandibul
aris.

Limiting structures
Labial frenum
Labial vestibule
Buccal frenum
Buccal vestibule
Lingual frenum
Alveololingual sulcus
Retromolar pads
Pterygomandibular raphe.

Supporting structures:
Buccal shelf area
Residual alveolar ridge

Relief areas:
Crest of the residual alveolar ridge
Mental foramen
Genial tubercles
Torus mandibularis.

Role of saliva during

impression making
Amount & consistency of saliva affect impression
making procedure
Excessive saliva particaulry by submandibular
&sublingual S.G represent a problem in impression
making and excessive salivation of mucous
membranwe from palatal glands may distort the
posterior two thirds of the palate
To counteract this problem
1. The palate should be massaged to evacuate the
gland
2. The mouth should be irrigated with an astringent
mouth wash before inserting the impression
materila

Role of saliva during

impression making
In case of xerostomia
1- careful gentle approach as the moucisa is easily
traumatized
2-coating lips with petrolium jelly to help retraction
of oral mucosa
3-wetting operator fingers to prevent sticking to soft
tissue
4- using mirror for inserting the tray as it is less
bulky than the fingers

Nausea during impression

making

It may be due to:

1- sensitivity of the dorsum of
the tounge to foreign body.such
conditions may reduce retching
and rarely actual vomitting .its
more during selection of tray
rather than impression making
2- psychological factor related to
fear from impression which can

Nausea during impression

To control nausea making
1-firm sympathetic manner &self confidence of
dentitst
2-tell the pt that there will be no difficulties if
instrctions are followed
3- blowing from nose to clear nasal obstruction
4-use littlematerial as possible to avoid touching
dorsum of the tounge
5- desensitization of the surface of mucos membrane
by pheno
6-use sodium bicarbonate mouth wash to remove
ropy secretion
7- costruct fitting base plate from the first
impression and ask the patient to practise wearing it
for increasing longer periods each day

Classification of
impression according to
Amount of pressure used

1. Pressure technique

2. Minimal pressure technique

3. Selective pressure technique

Pressure theory or mucocompressive

theory:
assumed that tissues recorded under functional
pressure provided better support and retention for the
denture.

Primary impression compound

Special tray using shellac base plate.
Second Impression using compound
Bite rims with uniform occlusal surfaces
are then made.
Areas to be relieved softened
the impression is inserted in mouth and
held under biting pressure for one or two
minutes.
Borders are molded by asking the
patient
to
perform
functional

Demerits of the
theory

1. Excess pressure could lead to increase alveolar

bone resorption.
2. Excess pressure was applied to the peripheral
tissues and the palate.
3. Dentures which fit well during mastication tend to
rebound when the tissue resume their normal
resting state.
4. Pressure on sharp bony ridges results in pain.
5. The oral soft tissues are resilient and thus tend to
return to their anatomical position once the forces
are relieved. Dentures made by this technique
tend to get displaced due to the tissue rebound at
rest. During function, the constant pressure
exerted onto the soft tissues limit the blood
circulation leading to residual ridge resorption.

Applied aspects:
border tissues are recorded in their
functional positions and denture cannot be
dislodged during functional movements of
jaws.
The pressure applied is more and directed
towards the palate and peripheral tissues.
So the retention will be for short time and
will be lost as soon as the bone undergoes
resorption.
Usually this technique is used for
preliminary impression making as it gives
a positive peripheral seal and tissues are
recorded in function. Amount of pressure

Minimal pressure or mucostatic

theory
made with the oral mucous membrane and the jaws
in a normal, relaxed condition. Border molding is
not done here.
The main advantage of this technique is its high
regard for tissue health & preservation.
1946 Page gave the concept of mucostatic based
on Pascals law.
results in a denture closely adapted to the mucosa
the denture-bearing area but has poor
of
Technique
peripheral
A compoundseal.
impression

A special tray is adapted over a wax spacer.

an impression is made with a free flowing material with

little pressure.

Escape holes are made for relief.

Demerit
s
The short denture borders are readily accessible to
the tongue which might provoke irritation.
lack of border molding ineffective peripheral seal.
The short flanges
may reduce support for the face.
flange would mean less lateral stability.
prevent the wider distribution of masticatory stresses.

Applied aspect:
preservation of tissue health.
In practice with short flanges the oral musculature is
non supported and stresses are not widely distributed.
Food can slip beneath the denture and tongue can
readily access the denture borders.
This technique is useful in impressions of flabby and
sharp or thin ridges.

ctive pressure theory

combines both pressure and minimal pressure technique.
tissue preservation is combined with mechanical factor of
achieving retention, through minimum pressure which is within
physiologic limits of tissue tolerance.
The technique makes it possible to confine the forces acting on
the denture to the stress-bearing areas. through the design of
the special tray in which the non stress-bearing areas are
relieved and the stress-bearing areas are allowed to come in
contact with the tray.

the impression is made to extend over as much denturebearing area as possible without interfering with the limiting
structures at function and rest.

Demerits
Some feel that It is impossible to record areas with varying
pressure.
Some areas still recorded under functional load, the dentures
still faces the potential danger of rebounding and loosing
retention.

Applied aspect:
Inspite of some of its apparent drawbacks all the impression
techniques based on the selective pressure technique are still
popular.
Final impressions using this technique are made where relief
areas are provided and pressure is distributed on the stress
bearing areas.