Third stage Prosthodontics HMU/ College of Dentistry

Prosthodontics

Individual impression tray (Special or custom tray)

Impressions of the Partially Edentulous Arch

Impression materials used in the various phases of partial denture fabrication

may be classified as rigid, thermoplastic, or elastic substances. Rigid impression
materials are those that set to a rigid consistency. Thermoplastic impression materials
are those that become plastic at higher temperatures and resume their original form
when cooled. Elastic impression materials are those that remain in an elastic or
flexible state after they have set and have been removed from the mouth.

Rigid: Impression plaster

Metallic oxide (ZOE) paste
Thermoplast: Modeling compound
Impression waxes
Elastic: Reversible Hydrocolloid
Irreversible Hydrocolloid
Rubber base (Marcaptan, Silicon, Polyether)

An impression of the partially edentulous arch must record accurately the

anatomic form of the teeth and surrounding tissues. Materials that could be
permanently deformed by removal from tooth or tissue undercuts should not be used.
Although rigid impression materials may be capable of recording tooth and
tissue details accurately, they cannot be removed from the mouth without fracture and
reassembly. Thermoplastic materials cannot record minute details accurately because
they undergo permanent distortion during withdrawal from tooth and tissue undercuts.
Elastic materials are the only ones that can be withdrawn from tooth and tissue
undercuts without permanent deformation and therefore are used generally for making
impressions for removable partial dentures, immediate dentures, crowns, and fixed
partial dentures when tooth and tissue undercuts and surface detail must be recorded
with accuracy.
The introduction of hydrocolloids as impression materials was a giant step
forward in dentistry. For the first time, impressions could be made of undercut areas
with a material that was elastic enough to be withdrawn from those undercuts without
permanent distortion. It permitted the making of a one-piece impression, which did
not require the use of a separating medium, and was and still is an acceptably accurate
material when handled properly.
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Individual impression tray (Special or custom tray)

A rigid stock tray can be used for recording an impression of the anatomic form of a
dental arch for making a diagnostic cast, a working cast for restorations, or a master
cast. There are times, however, when a stock tray is not suitable for making the final
anatomic impression of the dental arch. Most tooth supported removable partial
dentures may be made on a master cast from such an impression. Some maxillary
distal extension removable partial dentures with broad palatal coverage, particularly
those for a Kennedy Class I arch, may also be made on an anatomic cast, but usually
these necessitate the use of an individually made tray.
Custom tray (Special tray) is an individualized impression tray made from a cast
recovered from a preliminary impression. It is used in making a final impression. The
diagnostic cast is often adequate for the preparation of the individual tray. However, if
extensive surgery or extractions were performed after the diagnostic cast was made, a
new impression in a rigid stock tray and a new cast must be made. There are several
techniques for making individual impression trays.

Materials used for construction of special tray

• Light-cure resins
• Auto polymerizing acrylic resin
• Vacuum-form poly vinyl
• Thermoplastic materials
• Double thickness shellac base plate

Requirements of special tray

▪ It should be well adapted to the primary cast
▪ It should be dimensionally stable on the cast and in the mouth
▪ The tissue surface should be free of voids or projection
▪ It should be at least 2mm thick in the palatal area and lingual flange for
adequate rigidity
▪ It should be rigid even in thin section
▪ It should not bind to the cast
▪ It should be easy to remove
▪ It should not react with the impression material

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▪ It should have contrasting colour to make its margins appear prominent when
placed in the patient mouth.
▪ It should have 2 mm relief near the sulcus so that green stick compound can be
used to do border moulding

Conditioning the primary cast before special tray fabrication

1. The cast should be soaked in slurry water
2. The primary impression has usually over extended border, hence the special
tray should be 2-4mm short of the sulcus
3. Sever undercut should be blocked out, failure to block out the undercuts lead to
breakage of the cast.
4. The relief area should be marked in the cast
5. The border of the special tray should be marked using a pencil

A technique for making an individual maxillary tray with light-polymerized resin

is as follows:

This format could be used for both autopolymerizing acrylic-resin and visible
light-cured (VLC) acrylic-resin. The VLC custom tray materials are premixed sheet
materials that, when polymerized, provide a highly stable, distortion-free custom
impression tray that is ready to use in minutes. These materials are provided by the
manufacturers in sheet forms of various sizes, thicknesses, and colors.

1. Outline the extent of the tray on the cast with a pencil (figure 1, a). The tray
must include all teeth and tissue that will be involved in the removable partial
denture.

2. Adapt one layer of baseplate wax over the tissue surfaces and teeth of the cast
to serve as a spacer for impression material (figure 1, b). The wax spacer
should be trimmed 2 to 3 mm short of the outline drawn on the diagnostic cast.
Wax covering the posterior palatal seal area should be removed so that intimate
contact of the tray and tissue in this region may serve as an aid in correctly
orienting the tray when making the impression.
Expose portions of the incisal edges of the central incisors to serve as anterior
stops when placing the tray in the mouth. Other cast undercuts should be
blocked out with wax or modelling compound,
NOTE: Adapt an additional layer of baseplate wax over the teeth if the
impression is to be made in irreversible hydrocolloid (alginate).
This step is not necessary if the choice of impression material is a rubber-base
or silicone type of material.

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3. Usually 4 stops are placed 2 anterior & 2 posteriors. The stops should be about
2 * 4 mm thick. They are placed on the teeth other than abutments & on the
edentulous ridge distally. The part of the special tray that extends into the cut
out of the spacer is called stopper (figure 1, c and d).

Why to have stoppers?

• Provide intimate contact between the tray and tissue
• Orienting the tray when making the impression.
• For achieving even thickness of the impression material.
• To stabilize the tray during impression making

A B
C D

Firure 1.

4. Paint the exposed surfaces of the cast that may be contacted by the light-
polymerized resin tray material with a model release agent (MRA) or
separating medium to facilitate separation of the polymerized tray from the
cast (figure 2, a).
5. Remove the VLC tray material from the lightproof pouch and carefully cut the
desired length with a knife or scalpel. Adapt the VLC material to the cast and
trim it with a knife. Be sure not to thin the material over the teeth or the
posterior border area (figure 2, b).
6. Attach a handle by molding excess VLC material into the desired shape and
blend it into the tray material in the cast (figure 2, c). Alternatively, some
manufacturers make prefabricated metal custom tray handles that may be
easily adapted.
7. Place the cast with the adapted tray in the light polymerizing unit and process
according to the manufacturer's directions, usually a maximum of 1 minute
(figure 2, d).

A B D

Figure 2.

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8. Remove the cast from the unit and gently remove the tray from the cast. Peel
the softened wax out of the tray while the wax is still warm.
9. When the polymerizing cycle is completed, remove the tray from the unit and
clean it with a brush and water.
10. Perfect the borders of the tray with rotary instruments (vulcanite burs, acrylic
resin trimmers, etc.) and slightly polish the external surface of the tray.
11. Place perforations (No. 8 bur size) in the VLC resin tray at 5-mm intervals,
with the exception of the alveolar groove areas, if using an irreversible
hydrocolloid impression material.
12. The finished tray must be clean and tried in the mouth so that any necessary
corrections to the tray can be accomplished before the impression is made.

Mandibular special tray

The technique for making an individual mandibular VLC resin tray follows the
same procedures. The wax spacer does not cover the buccal shelf regions on the
mandibular cast, because these areas provide the primary support for the mandibular
removable partial denture and serve as posterior stops in orienting the tray in the
patient's mouth.

Master casts made from impressions in special trays are generally more
accurate than those made in rigid stock trays. The use of individual trays should be
considered a necessary step in making the majority of removable partial dentures
when a secondary impression technique is not to be used.
Final impressions for maxillary tooth-supported removable partial dentures
often may be made in carefully selected and re-contoured stock trays. However, an
individual tray is preferred in those situations in the mandibular arch when the floor of
the mouth closely approximates the lingual gingiva of remaining anterior teeth.
Modification of the borders of an individual tray to fulfil the requirements of an
adequate tray is much easier than is the modification of a metal stock tray.

Summary of the steps for construction of special tray

Outline of the special tray on the cast block-out of the undercuts

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Wax spacer on the cast cut it 2mm shorter than outline 2 layer of wax on remaining teeth

Stopper place and adapt the acrylic to proper shape

Curing in curing unit trimming the excess perforations

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