Journal club
PRESENTED BY:
DR. BRAJENDRA SINGH TOMAR
PRESENTED BY:
DR. G. S. CHANDU
Title
The Use of Injectable Polyvinylsiloxane
as Medium for Border-Molding Denture
Impressions
Author
(G. Roger Troendle and Karen B. Troendle)
J Prosthod 1992, I: 121-123
CONTENTS
Terminologies
Introduction
Border moulding
Materials
Article
Discussion
References
TERMINOLOGIES
Border seal: the contact of the denture border with
the underlying or adjacent tissues to prevent the
passage of air or other substances.
Border tissue movements: the action of the muscles
and other tissues adjacent to the borders of a denture.
Border molding :Border molding is the shaping of
an impression material by the manipulation or action
of tissues adjacent to the borders of an impression
tray.
INTRODUCTION
Master impression is the one of most important step in
the fabrication of a complete denture. It should record
the denture bearing area to reproduce finer details and
muscular peripheral tissues in function. It involves 3
steps1.border moulding/ peripheral tracing
2.tray preparation after border moulding
3.making wash impression
BORDER MOULDING
Border moulding is the process by which the shape of
the border of the tray is made to conform accurately
to the contours of the buccal and labial vestibules
(Bouchers).
The shaping of the border areas of an
impression tray by functional or manual
manipulation of the tissue adjacent to the
borders to duplicate the contour and size of the
vestibule(GPT-99).
Determining the extension of a prosthesis by
using tissue function or manual manipulation
of the tissues to shape the border areas of an
impression material(GPT-99).
OBJECTIVE
To determine the contours, height and width of the
borders of the completed denture
REFINING THE CUSTOM TRAY
For border moulding to be carried out successfully,
space must be created for border moulding material.
Therefore, flanges of the custom tray should be
reduced until they are 2mm short of the reflections.
Custom tray should be 2-3 mm thick, with a stepped
handle to facilitate easy removal. The step should be
of sufficient height to avoid distortion of upper and
lower lip.
Border moulding can be performed either in
Sections/recording one part of the border at a
time.
Simultaneous recording of all of the border.
REQUIREMENTS OF MATERIAL FOR
SIMULTANEOUS MOULDING
Should have sufficient strength to remain in position
on the borders during loading.
Allow some preshaping of borders without adhering
to fingers.
Should have proper setting time.
Should retain adequate flow while the tray is seated in
mouth.
Should not cause displacement of vestibular tissues.
BORDER MOULDING WITH
POLYETHER
An adhesive for polyether is placed on the borders
covering both inside and outside of the border.
Polyether material is mixed and introduced into
plastic syringes slightly less catalyst is used.
Material is syringed around the borders and
preshaped with fingers moistened in cold water.
Loaded tray is placed in mouth carefully.
If insufficient material, then excess material
from adjacent site is transferred with finger.
Border movements are carried out. This is
accomplished in ant. region by elevating lip
and extending outward, downward and inward
for maxillary and by lifting lip outward,
upward and inward for mandibular border
moulding.
In buccal frenum region cheek is elevated and
then pulled outward ,downward and inward
and then moved backward and forward to
simulate frenum movement in maxilla whereas
cheek is lifted outward ,upward and inward
and then moved backward and forward to
simulate frenum movement in mandible .
Anterior lingual flange is moulded by asking
pt to protrude the tongue and then to push
tongue against ant palate.
Tongue protrusion also activates mylohyoid
muscle which raises floor of the mouth. this
determines slope of lingual flange in molar
region.
Distal end of lingual flange is moulded by
again asking pt to protrude the tongue.
This records activated superior constrictor
muscle, which supports retromylohyoid
curtain.
Then pt is asked to open wide and move
mandible side to side.
When material is set, tray is removed carefully
and examined.
BORDER MOULDING WITH GREEN
STICK COMPOUND
Soften one end of a stick of green impression
compound slowly over alcohol torch.
Place the compound along the border of the
dried tray in segments.
Temper the compound by placing it briefly in a
140 degree F water bath. Reflect the cheek
with a mouth mirror and position the tray and
seat it in the patient's mouth and border
movements are performed.
When set, remove the tray, repeat the
procedure. The compound should be rounded
with no voids, be symmetrical in shape, and
should not be glossy. If voids are present or
the compound is glossy, add more compound,
flame, temper, and repeat the procedure.
Next, add compound to the border of the tray
from the previously molded area.
Evaluate the retention and stability of the border
molded maxillary tray. The fully seated tray should
resist dislodging forces applied to the handle in a
downward direction in the anterior and premolar
area.
If the tray comes away easily by a direct pull, it has
poor retention and may be underextended. Check the
stability by applying a horizontal force with your
fingers to the handle of the tray.
Evaluate the stability of the border molded
mandibular tray. With the tongue at rest, the tray
should resist dislodging forces applied to the handle
in a horizontal direction in the anterior and premolar
areas.
If the border molded final impression tray does not
exhibit stability and retention at this time, the
complete denture will not be stable or retentive.
Corrections should be made before proceeding to the
next step.
MATERIALS
The different material that can be used are:
a. Green stick compound .
b. Polyether impression technique.
c. Autopolymersing acrylic resins.
d. Polyvinyl siloxane
The Use of Injectable Polyvinylsiloxane
as Medium for Border-Molding Denture
Impressions
The technique described here does not vary in
concept from the classical technique. The only
difference between this technique and the
classic technique is the material used to
border-mold and wash the final impression.
TECHNIQUE
Make a custom tray on a cast made from an
irreversible hydrocolloid impression.
Evaluate the custom tray in the patient's mouth
to ensure that it is short of the estimated
periphery of the final prosthesis.
With a no. 8 round bur in a straight hand piece,
perforate the complete periphery of' the tray.
Place adhesive on the labial flange of the tray.Place
the tray in the mouth, and inject Kerr Stat
B.R. (Kerr Manufacturing Company, Romulus,
MI) arid mold the material to the peripheral
musculature.
If needed, excess material can be trimmed with
a sharp 25 surgical blade after the material
sets.
The maxillary tray is molded in four segments,
1.the labial flange
2.right buccal flange
3.left buccal flange and
4.posterior palatal flange.
The remainder of the tray is painted with
adhesive.
Then medium-viscosity polyvinylsiloxane
impression material is injected in the tray,
placed in the patient's mouth, and bordermolded.
ADVANTAGES
More acceptable to both dentist and patients.
Easy manipulation.
Less time consuming.
DISADVANTAGE
Cost of the material.
Area of impression should be absolutely dry
for better flow of material.
DISCUSSION
This technique was presented for border-molding a
custom tray with a quick-set, high-viscosity
polyvinylsiloxane material (Stat B.R.; Kerr) and
making a wash with a medium-viscosity
polyvinylsiloxane impression material (Express; 3M
Dental Products, St Paul, MN).
The technique was described for a maxillary
overdenture, but is useful for complete dentures, both
upper and lower.
The principle of activating the musculature at the
periphery of the denture is the same as when using
the classical technique with thermoplastic compound.
However, the technique using the polyvinylsiloxane
material is more acceptable to the patient and dentist
REFERENCES
Essentials of complete denture prosthodontics
,2nd edition, sheldon winkler.
Syllabus of complete dentures, C.M.Heartwell.
Bouchers Prosthodontic treatment for
edentulous patients,11th edition.
Complete Dentures: A Clinical Manual for the
General Dental Practitioner, Hugh Devlin
THANK YOU
