In a prior post, I discussed the Massad technique for complete denture impressions. I do not claim to be an expert on his technique! If you would like to learn more about Joseph Massad DDS, check out his site here. I’ve adapted his technique to suite my needs for all PVS denture impressions.
Please read my prior post to save time and learn from my mistakes for edentulous impressions. But what about a partial denture or an immediate denture? There will be teeth to contend with for our impression! The technique is essentially the same as for edentulous patients but with some minor changes.
Here’s the custom tray, ready to go.
Now take your rest stop impression with heavy body PVS.
Certainly you’ll want to place a drop of material in all edentulous areas and one in the center palate. But the key is to place a very small amount in the areas with teeth as well. Failure to do so may result in an uneven impression. But whatever you do, do not place too much impression material around the teeth. Remember, this is heavy body material! Not only might it lock into undercuts, it may be difficult to re-seat the tray into the correct position!
So just place heavy body at the occlusal and incisal aspects to capture just a hint of the teeth. Next, re-seat the tray intra-orally to confirm that you can do so easily.
Now we can border mold. Remember to let the heavy body sit for about 30 seconds before placing the tray intra-orally to border mold.
If this impression is for a removable partial denture: it is not essential to border mold in areas with teeth. It can’t hurt to capture great anatomy in these spots, but there’s no need to retake the impression if you miss it. However any edentulous areas will certainly need great detail.
If this impression is for an immediate denture: it is essential to border mold all soft tissue landmarks. Some people will say that it is not necessary because all immediate dentures get a hard reline in a few months after insertion. That’s true, but I guarantee you and the patient will have an easier time after insertion if you take the time to transfer every bit of anatomy you can to your immediate denture.
If there are any spots where the tray shows through the impression material, grind with an acrylic bur and simply proceed to the next step.
Speaking of which, the next and final step is to use a wash of medium or light impression material.
Before you do this, block out all open embrasure spaces with wax. I cannot stress the importance of this enough! If the patient has “black triangles,” that is to say, a history of periodontal disease that has left open gingival embrasures between teeth, the impression material can lock into these areas.
If it’s just one or two open embrasures, it may not be a big deal. But several open embrasures will guarantee locking in the tray. That’s not a good day.
Anyway, take your wash and you’re good to go.