Continuing Education

Immediate Complete
Denture Impressions
Case Report and Modern Clinical Technique
Authored by Joseph J. Massad, DDS and David R. Cagna, DMD, MS

Upon successful completion of this CE activity 1 CE credit hour may be awarded

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courses is not a substitute for sound clinical judgment and accepted standards of care. Participants are urged
to contact their state dental boards for continuing education requirements.

Recommendations for Fluoride Varnish Use in Caries Management
Immediate Complete
Denture Impressions
Case Report and Modern
Clinical Technique
LEARNING OBJECTIVES:
After reading this article, the individual will learn:
• historic techniques for taking impressions for
immediate complete dentures, and
• a new technique for taking accurate impressions for
immediate complete dentures.
ABOUT THE AUTHOR
Dr. Massad is director of removable
prosthodontics at the The Scottsdale
Center for Dentistry in Scottsdale, Ariz.
He is an associate faculty member of
Tufts University School of Dental
Medicine in Boston, and is an adjunct
associate faculty member of the Department of
Prosthodontics at the University of Texas Health Science
Center Dental School in San Antonio, Tex. He can be
reached at (918) 749-5600 or joe@joemassad.com.
Disclosure: Dr. Massad is the developer and holds the
patent for the Strong-Massad Dentate & Implant Trays.
Dr. Cagna is a professor and director
of the Department of Restorative
Dentistry, Advanced Prosthodontic
Program, at the University of
Tennessee Health Science Center
College of Dentistry in Memphis, Tenn.
He may be contacted via e-mail at the address
dcagna@ utmem.edu.
Disclosure: Dr. Cagna is a stockholder in Global Dental
Impression Trays, which is the company that manufactures
the impression trays used in this article.
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Continuing Education
INTRODUCTION
For patients confronted with the extraction of their
remaining natural teeth and the need for complete pros-
thodontic rehabilitation, the transition is generally
psychologically challenging for the pa-tient and demanding
of the clinician. This dramatic treatment is often
necessitated by generalized caries, extensive periodontal
disease, or a malocclusion that is not amenable to
treatment. Of considerable significance to many patients
facing this course of treatment is their desire to specifically
improve the appearance of their anterior teeth, contributing
to an attractive smile. In order to optimize immediate
denture therapy, thoughtful consideration must be given to
the treatment planning, definitive impression making, and
denture tooth set-up phases of therapy.
The primary advantage of an immediate denture is the
absence of an edentulous period where prosthetic tooth
replacement is not available. Specifically, advantages of
immediate complete dentures include the maintenance or
improvement of: 1. dental aesthetics, 2. perioral and facial
tissue support, 3. masticatory function, and 4. phonetic ability.
If the patient’s natural anterior teeth remain but are scheduled
for extraction, the selection and arrangement of anterior
denture teeth, from an aesthetic perspective, may be easier.
From the patient’s viewpoint, immediate complete
dentures provide the psycho-social advantage of continuous
tooth display to allow personal and public interactions.
Though abrupt, the transition from the dentulous state to
edentulism may be made less difficult by incorporating
immediate complete dentures in the treatment plan.
Major disadvantages of immediate denture therapy
relate to the technical difficulties associated with denture
fabrication. Because immediate complete dentures are
constructed prior to extraction of the remaining teeth, 4
significant challenges arise: 1. the making of anatomically
and physiologically accurate definitive impressions in the
presence of remaining teeth and associated soft and hard
tissue undercuts is often difficult and occasionally
impossible, 2. if the residual teeth are mobile, recording
accurate interocclusal jaw registrations may be difficult, 3.
creating edentulous contours on dentate master casts
utilizing clinically valid and reliable estimation techniques is
often associated with unavoidable errors, and 4. the

Immediate Complete Denture Impressions: Case Report and Modern Clinical Technique
inability to accomplish a full wax try-in of the proposed
denture tooth arrangement makes the aesthetic outcome
unpredictable. It is due to these technical difficulties that
immediate complete dentures are often considered
“interim” prostheses requiring replacement upon healing of
the edentulous ridges.
Optimal retention, support, and stability for removable
prosthodontic restorations are important factors in
treatment success and patient comfort. When considering
im-mediate complete dentures, certain clinical conditions
often prohibit achieving ideal retention, support, and
stability in the planned prostheses. As mentioned, the
presence of residual natural teeth and associated
unfavorable osseous and soft tissue contours require that
the clinician: 1. modify existing techniques to generate
physiologically and anatomically accurate impressions and
master casts, 2. evaluate existing den-tate or partially
edentulous clinical conditions and predict expected eden-
tulous ridge contours following tooth extractions, 3. develop
these edentulous contours on the master casts, and finally
4. construct the immediate complete dentures.
Although techniques have been developed to fabricate
immediate complete dentures, significant obstacles are
frequently encountered. The development of diastemata
secondary to advanced periodontal disease may
complicate impression procedures. Varying degrees of
periodontal involvement of the residual dentition will result
in an irregular contour of the edentulous alveolar ridges.
Irregular osseous contours that protrude into the vestibular
sulcus interfere with an accurate impression in this area,
ultimately affecting the development of a peripheral seal in
the final prostheses.
The accurate, physiologic replication of vestibular
anatomy (including frenum attachments, the postpalatal
zone, and the retromylohyoid space) is important to the
development of peripheral denture seal and denture
retention. When physiologic vestibular anatomy is
represented accurately in the immediate denture flange
contours, the denture may function effectively as suction is
achieved. Under such conditions and in the presence of
appropriate volume of saliva, optimal consistency of the
saliva, accurate fit, and a favorable occlusal scheme,
satisfactory denture retention is possible.
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Continuing Education
It is not uncommon to encounter problems with denture
retention on the day of immediate denture insertion. As
mentioned, this problem can often be traced back to
inaccurate adaptation of the denture flanges to the
physiologic limits of the vestibular sulci. Horizontal and/or
vertical overextension of vestibular anatomy during
impression making, as is common when using
inappropriately contoured stock impression trays and
irreversible hydrocolloid im-pression materials, does not
allow physiologically accurate impressions. The result will
be overextension of the immediate denture flange.
Ultimately, extensive adjustments are necessary on the day
of denture placement and during the post-operative
adjustment period.
Although challenging in many ways, anatomic and
functionally accurate impressions are critical to successful
immediate denture therapy. A predictable immediate denture
impression technique adaptable to a wide variety of dentate
and partially edentulous conditions is available. The following
case report discusses historical immediate denture im-
pression techniques, and concerns in regard to the utility of the
resultant casts. Also presented are step-by-step procedures
for making immediate denture impressions using a new
impression tray design and modern impression materials.
CASE REPORT
A 44-year-old white female presented on referral from her
general dentist for evaluation and treatment of a severely
compromised dentition. The patient was a professional
makeup artist and expressed concern regarding the
aesthetics of her smile and the appearance of her teeth during
close, personal, daily interactions with her clients. The
patient also reported that she smokes cigarettes (one half
pack per day). This habit began 15 years ago.
Intraoral examination revealed multiple missing teeth,
substantial accumulation of dental plaque and calculus,
many teeth with 6 to 9 mm probing depths, generalized
bleeding on probing, generalized moderate to severe
mobility, and severe fremitus involving most teeth (Figures 1
and 2). Following scaling and root planing, many of the
teeth previously demonstrating moderate mobility now
displayed severe mobility.

Immediate Complete Denture Impressions: Case Report and Modern Clinical Technique
Figure 1. The patient’s
clinical appearance
prior to immediate
denture therapy.
Figure 2. The patient’s
radiographic condition
prior to immediate
denture therapy.
The patient’s remaining teeth were not salvageable.
Treatment options, duration, and prognosis, as well as cost,
were reviewed with the patient. The patient elected full
mouth extractions and placement of immediate maxillary
and mandibular complete dentures.
IMMEDIATE DENTURE
IMPRESSION TECHNIQUES
A number of different impression techniques have been
described for use in the fabrication of immediate complete
dentures. These techniques include:
1. An irreversible hydrocolloid im-pression made in a
stock impression tray.1-5
2. An elastomeric impression made in a border molded
custom impression tray.6-20
3. A combination or double impression21-25 involving (a) a
primary impression made in a border molded custom
tray using an elastomeric impression material to
capture only edentulous regions and associated
vestibular areas, and (b) a secondary impression made
in a stock impression tray using irreversible
hydrocolloid to capture the remaining teeth and
associated vestibular areas. The secondary impression
is made with the primary impression in place in the
patient’s mouth.
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Continuing Education
4. A sectional impression20,26-35 involving (a) a posterior
section im-pression made in a border molded custom tray
using an elastomeric impression material to capture
edentulous posterior regions, associated vestibular areas,
and the lingual aspects of the residual dentition, and
(b) an anterior section impression, or facial matrix, made
by placing a bulk of impression material in the labial
vestibular space associated with the residual dentition
and allowing it to set. Alternatively, the impression
material may be carried to the mouth in a second
sectional tray that is indexed to the primary tray. In
either case, the anterior section impression will capture
the facial anatomy of the teeth, the vestibular anatomy,
and indices on the primary impression/tray. Upon
removal of the anterior and posterior sections
separately, the 2 sections are reassembled outside the
mouth (using the indices) and prepared for casting.
5. The “Campagna” combination impression36-39 involving
(a) a primary impression made in a border molded
custom tray using an elastomeric impression material to
capture the posterior edentulous regions and ALL
vestibular areas, and (b) a secondary impression, or
over-impression, made in a stock impression tray using
irreversible hydrocolloid to capture only the residual
dentition and pick-up the primary dentition.
Because of the residual teeth, associated osseous
undercuts, and the use of hydrocolloid impression materials,
these impression techniques fail to register anatomically and
physiologically accurate vestibular anatomy. With the
development of a new impression tray system (Strong-
Massad Dentate & Implant Trays, Global Dental Impression
Trays) and the use of vinyl polysiloxane many of the
shortcomings associated with classic immediate denture
impressions may be successfully avoided. The impression
technique illustrated here employs vinyl polysiloxane (VPS)
impression material to accomplish single ap-pointment
definitive immediate denture impressions.
THE MAXILARY IMPRESSION
Tray Selection
The first step is to determine the dimensions of the
dental arch and select a stock impression tray of appropriate
 Continuing Education

Immediate Complete Denture Impressions: Case Report and Modern Clinical Technique

size (Figure 3). The im-pression trays illustrated here are

constructed from a clear polystyrene-based polymer and Figure 3. An
impression tray
(Strong-Massad
permit see-through visibility to assist when selecting and

Dentate & Implant

fitting the tray (Figure 4). Retention slots perforate the trays
Trays, Global Dental
to maximize mechanical retention of the material. PVS
adhesive should NOT be used in the trays. Rather, it is Impression Trays) is
preferred that the im-pression material is wiped clean from selected to fit the
the tray in areas where the tray impinges on border and maxillary arch.
peripheral tissues. The elimination of im-pression material
from tray borders indicates the need to selectively adjust the
tray prior to making the definitive impression.
Figure 4. The clear
Tray Adaptation polystyrene impression
Customized tray adaptations can be made to tray permits see-
through visibility for
selecting and fitting the
accommodate existing anatomic contours. The trays

tray to the dental arch.

illustrated here are thermoplastic. To effect subtle alteration
of flange trajectory, pass the tray quickly through a
laboratory flame until the resin begins to soften. Once
softened, carefully manipulate the tray flange into the
desired shape. Cool the tray in water. Border extensions of

Figure 5. Impression
the tray may also be reduced by grinding with a
tray stops are formed
conventional acrylic resin bur.
in the tray using high
Tray Stops viscosity VPS
The impression procedure described here requires impression material.
repetitive placement of the impression tray in the patient’s
mouth. In order to achieve consistently accurate tray
placements, tray stops are used. Using high viscosity VPS,
dispense quarter-size mounds in the molar, incisor, and Figure 6. High
mid-palate areas of the tray (Figure 5). Seat the tray in the viscosity VPS
pa-tient’s mouth and center the tray over the residual teeth impression material
is applied to the
impression tray borders
and ridge. Upon polymerization, remove the tray and
prior to border molding.
inspect the stops to assure even thickness and that the
teeth and ridge crest are centered within the tray. Trim the
VPS with a sharp knife to eliminate all but the occlusal Border Molding
surface and incisal edge impressions and minimize any For maxillary impressions, it is recommended that a
areas of soft tissue contact (Figure 5). Tray stops permit: 1. high or medium viscosity VPS material be used for border
adequate and even space between the tray and residual molding. Dispense a rope of VPS material along the
tissues for impression material, 2. adequate and even peripheral tray borders, including the postpalatal seal area
space between the tray and vestibular reflections for (Figure 6). Place the tray in the patient’s mouth and seat the
impression material, and 3. consistently repeatable tray onto the maxilla using the tray stops as guides. Use the
positioning during tray placement. following tissue manipulations to define peripheral borders:

4
 Continuing Education

Immediate Complete Denture Impressions: Case Report and Modern Clinical Technique
• To define the labial notch, grasp the filtrum close to the
vermilion border and pull downward (Figure 7).
Figure 7. The
• To form the labial vestibular borders, ask the patient to maxillary impression
purse the lips using a sucking action (Figure 7). tray is placed in the
patient’s mouth and
border molding
• To define the buccal notches and buccal vestibular
borders, grasp the cheek with the forefinger and thumb at procedures are
the corner of the mouth and pull downward and forward accomplished.
(Figure 7). Repeat this process on the opposite side.
• To define the coronomaxillary vestibular border and
hamular frenum area, ask the patient to open the mouth
wide (Figure 8). This will cause the coronoid processes
Figure 8. Additional
border molding is
to translate through the coronomaxillary spaces,

accomplished for
bringing associated muscles to their terminal positions.
the maxillary
If the mandibular opening is restricted, instruct the
patient to move the mandible from side to side. impression tray.
• To functionally form the posterior border of the tray,

Figure 9. Border
instruct the patient in Valsalva’s maneuver.40-42

adaptation of the
Manually occlude the patient’s nostrils and ask the
maxillary impression
patient to attempt to forcibly exhale through the nose
only (Figure 8). This causes the soft palate to move tray is carefully
downward, forming the VPS along the postpalatal seal inspected. All areas of
aspect of the impression tray. VPS tissues contact
are reduced by one to
Following polymerization of the VPS, remove the 2 mm using a bur or
impression tray and inspect all peripheral borders to assure scalpel blade. The tray is then loaded with low viscosity VPS
that appropriate anatomic and functional detail is present. impression material in preparation for the final impression.
If the resin tray is apparent through the border molding
material, adjust the tray by grinding. Finally, in preparation for
the definitive impression, relieve one to 2 mm from all borders Figure 10. Extra-low
using a scalpel blade and/or rotary instrument (Figure 9). viscosity VPS
impression material is
injected around
residual teeth and the
Definitive Impression

Dispense low-viscosity VPS impression materials into
the maxillary impression tray (Figure 9). Inject extra-low-
viscosity VPS material around all residual teeth using
manual syringes (Figure 10). Extra-low-viscosity VPS
material possesses relatively low tear strength43, permitting
easier recovery of the polymerized impression from the
patient’s mouth without damaging periodontally involved
teeth. The relatively low stiffness of low viscosity VPS also
facilitates recovery of the definitive master cast from the
impression without damage.
impression tray is
seated on the maxilla.
Following injection of low viscosity VPS around all
teeth, place and center the impression tray on the maxilla
(Figure 10) using the tray stops as guides. Repeat all
border molding manipulations. Upon polymerization of the
VPS, remove and inspect the impression for appropriate
anatomic, functional, and surface details (Figure 11). Once
satisfied with the quality of the definitive impression, bead,

5
 Continuing Education

Immediate Complete Denture Impressions: Case Report and Modern Clinical Technique
box, and cast the impression44 using a suitable vacuum
mixed dental stone (Figure 11).
Figure 11. The
definitive maxillary
impression is carefully
THE MANDIBULAR IMPRESSION
inspected. A master
cast is then poured
Examine the dimensions of the mandibular dental arch and

using an appropriate
select a stock impression tray of appropriate size (Figure 12).
dental stone.
Tray Adaptation
Customized tray adaptations may be made to Figure 12. An
accommodate existing anatomic contours. As with the impression tray
maxillary impression procedure previously described, (Strong-Massad
Dentate & Implant
Trays, Global Dental
subtle thermoplastic tray reshaping and selective removal

Impression Trays) is
of tray material using an acrylic bur may be accomplished
selected to fit the
until an acceptable fit is achieved.
mandibular dental arch.
Tray Stops The clear polystyrene
Because the impression tray will be reseated in the impression tray permits see-through visibility for selecting and
patient’s mouth a number of times during the impression fitting the tray to the dental arch.
making, and accurate tray placement is essential, a system
of tray stops must be developed early in the impression
procedure. Using high-viscosity VPS, dispense a ribbon of
material along the occlusal wall of the impression tray Figure 13. A
continuous impression
tray stop is formed in
(Figure 13). Seat the tray in the patient’s mouth and center

the tray using high

the tray over the residual teeth and ridge (Figure 13). Upon
viscosity VPS
polymerization, remove the tray and inspect the stops to
assure even thickness and that the teeth and ridge crest impression material.
are centered within the tray. Trim the VPS with a sharp knife
to eliminate all but the occlusal surface and incisal edge Figure 14. The
impressions (Figure 14). impression tray stop is
trimmed with a scalpel
blade or bur. Medium
viscosity VPS
Border Molding
impression material is
For mandibular immediate denture impressions, it is
recommended that a medium viscosity VPS material be used applied to the tray
for border molding. Dispense a rope of medium viscosity borders in preparation
VPS material along the peripheral tray borders (Figure 14). for border molding.
Place the tray in the patient’s mouth and seat the tray onto
the mandible using the tray stops as guides. Use the • To form the labial notch, grasp the lower lip at the
following tissue manipulations to define peripheral borders: vermilion border and pull outward and upward.

• To functionally form the lingual and retromylohyoid
flange borders, have the patient place the tip of the
tongue forward out of the mouth and then move the
tongue side to side (Figure 15). Next, have the patient
retract the tip of the tongue to touch the posterior palate.
• To functionally form the labial and buccal borders,
stabilize the tray with the index and middle fingers on
the finger rest and the thumb beneath the chin. Ask the
patient to purse the lips using a sucking action and then
smile widely (Figure 15).

6
 Continuing Education

Immediate Complete Denture Impressions: Case Report and Modern Clinical Technique
• To form the buccal notches, grasp the cheek with the
forefinger and thumb at the corner of the mouth and
Figure 15. The
mandibular
pull upward and forward. Repeat this process on the

impression tray is
opposite side.

Following polymerization of the VPS, remove the placed in the patient’s

mouth and border
molding is
impression tray and inspect all peripheral borders to

accomplished.
assure that appropriate anatomic and functional detail is
represented. If the resin tray is apparent through the border
Figure 16. Border
molding material, adjust the tray by grinding. Finally, relieve
all borders approximately one to 2 mm using a scalpel adaptation of the
blade and/or rotary instrument in preparation for the mandibular impression
definitive impression (Figure 16). tray is carefully
inspected. All areas of
VPS tissues contact
are reduced by one to
Definitive Impression
2 mm using a bur or
Dispense low-viscosity VPS im-pression materials into
the mandibular impression tray (Figure 16). Inject extra- scalpel blade. The tray
low-viscosity VPS material around all residual teeth using is then loaded with low viscosity VPS impression material in
manual syringes (Figure 17). As noted previously, extra- preparation for the final impression.
low-viscosity VPS material possesses relatively low tear
strength43 permitting easier recovery of the polymerized
impression from the patient’s mouth without damaging
periodontally involved teeth. The relatively low stiffness of Figure 17. Extra-low
low-viscosity VPS also facilitates recovery of the definitive viscosity VPS
impression material
is injected around
master cast from the impression without damage.

residual mandibular
Following injection of low-viscosity VPS around all
teeth, place and center the impression tray on the mandible teeth.
(Figure 18) using the tray stops as guides. Repeat all
border molding manipulations (Figure 18). Upon

Figure 18. The

polymerization of the VPS, remove and inspect the

impression tray is
impression for appropriate anatomic, functional, and
seated on the mandible
surface details (Figure 19). Once satisfied with the quality
of the definitive impression, bead, box and cast the and the patient is
impression44 using a suitable vacuum mixed dental stone instructed to
(Figure 19). accomplish all border
molding movements.

CONCLUSION
The provision of prosthodontic restorations immediately
following extraction of all remaining nonrestorable teeth is
an important treatment option. Many patients in need of this
therapy are eager to receive aesthetic replacement of their
missing teeth, but express concern about edentulism. As
new denture wearers, these patients will require time to
accommodate to their situation. It is also expected that
the post-extraction denture adjustment and maintenance
phase of therapy will be challenging. Therefore, it is
imperative that techniques be continuously developed to
optimize the accuracy of immediate dentures in an effort to
facilitate the difficult transition to edentulism.
As we improve conventional approaches to common

7
 Continuing Education

Immediate Complete Denture Impressions: Case Report and Modern Clinical Technique
prosthodontic problems, the incorporation of new materials
and techniques must also be considered. The immediate
denture impression procedures presented here combine
standard concepts of im-pression tray relief and physiologic Figure 19. The
definitive mandibular
impression is carefully
border molding with modern concepts of improved

inspected. A master
impression tray design and vinyl polysiloxane materials to
cast is then poured
facilitate better clinical outcomes for patients. It is important
to carefully evaluate impression border details, the using an appropriate
replication of critical anatomy in the master cast, and the dental stone.
development of anatomic and physiologic accuracy in the

Figure 20. A carefully

definitive denture borders (Figure 20). Attention to detail
when capturing the physiologic and anatomic developed maxillary
characteristics of the denture foundation and peripheral impression displays
sulci during impression making will facilitate retention, vestibular details that
support, and stability of the definitive prostheses. are carried through the
master cast, to the
contours of the
Following impression making and cast construction,

definitive immediate
care must also be given to: 1. accurate mounting of
casts in a semiadjustable articulator, 2. extraction of the maxillary complete
residual dentition from the casts, 3. recontouring of denture.
extraction sites to simulate expected soft and hard tissue
changes, and 4. setting of denture teeth for acceptable
denture function and aesthetics.

8

Immediate Complete Denture Impressions: Case Report and Modern Clinical Technique
REFERENCES
1. Terrell WH. Immediate restorations by complete dentures.
J Prosthet Dent. 1951;1:495-507.
2. Standard SG. Preparation of casts for immediate dentures.
J Prosthet Dent. 1958;8:26-30.
3. Nagle RJ, Sears VH, Silverman SI. Denture Prosthetics -
Complete Dentures. 2nd ed. St Louis, MO: Mosby; 1962.
4. Boucher CO. Swenson’s Complete Dentures. 5th ed. St Louis,
MO: Mosby; 1964.
5. Rayson JH, Wesley RC. An intermediate denture technique.
J Prosthet Dent. 1970;23:456-463.
6. Swenson MG. Improving immediate dentures in general
practice. J Am Dent Assoc. 1953;47:550-556.
7. Appleby RC, Kirchoff WF. Immediate maxillary denture
impression. J Prosthet Dent. 1955;5:443-451.
8. Freese AS. Simplified impressions for immediate complete
dentures. J Am Dent Assoc. 1957;54:240-242.
9. Gehl DH, Dresen OM. Complete Denture Prosthesis. 4th ed.
Philadelphia, PA: WB Saunders; 1958.
10. Leathers LL. Overcoming obstacles and objections to
immediate dentures. J Prosthet Dent. 1960;10:5-13.
11. Klein IE. Immediate denture prosthesis. J Prosthet Dent.
1960;10:14-24.
12. Blank HH. Impression materials for maxillary immediate
dentures. J Prosthet Dent. 1961;11:414-419.
13. Passamonti G. Immediate denture prosthesis. Dent Clin
North Am. 1964;8:781-800.
14. Rapuano JA, Vinton PW. A single tray, dual material technique
for immediate dentures. N Y State Dent J. 1970;36:73-76.
15. Bates JF, Stafford GD. Immediate complete dentures. 4.
Techniques in construction. Brit Dent J. 1971;131:449-454.
16. Sharry JJ. Complete Denture Prosthodontics. 3rd ed.
New York: McGraw-Hill; 1974.
17. Passamonti G. Atlas of Complete Dentures. Chicago, IL:
Quintessence Publishing; 1979.
18. Anderson JN, Storer R. Immediate and Replacement Dentures.
3rd ed. Oxford, England: Blackwell Scientific Publications; 1981.
19. Nimmo A, Winkler S. Conventional immediate complete
dentures. In: Winkler S, ed. Essentials of Complete Denture
Prosthodontics. 2nd ed. Littleton, MA: PSG Publishing;
1988:361-374.
20. Arbree NS. Immediate dentures. In: Zarb GA, Bolender CL,
Carlsson GE, eds. Boucher’s Prosthodontic Treatment for
Edentulous Patients. 11th ed. St Louis, MO: Mosby-Year Book;
1997:415-422.
21. Pound E. An all-inclusive immediate denture technic.
J Am Dent Assoc. July 1963:16-22.
22. Cupero HM. Impression technique for complete maxillary
immediate denture. J Prosthet Dent. 1978;39:108-109.
23. Morrow RM, Feldmann EE. Clinical appointment V - impression
procedures. In: Morrow RM, ed. Handbook of Immediate
Overdentures. St Louis, MO: Mosby; 1978:73-106.
9
Continuing Education
24. Heartwell CM. Conventional immediate complete dentures. In:
Winkler S, ed. Essentials of Complete Denture Prosthodontics.
Philadelphia, PA: WB Saunders; 1979:517-537.
25. Rahn AO, Heartwell CM. Textbook of Complete Dentures. 5th
ed. Philadelphia, PA: Lea & Febiger; 1993.
26. Schlosser RO. Complete Denture Prosthesis. Philadelphia, PA:
WB Saunders; 1939.
27. Geller JW. Prosthetic dentistry. J Prosthet Dent. 1960;10:33-36.
28. Kelly EK. The immediate denture. In: Prosthodontic Syllabus -
United States Army Institute of Dental Research. Washington,
DC: Walter Reed Medical Center; 1965:200-208.
29. Lutes MR, Ellinger CW, Terry JM. An impression procedure for
construction of maxillary immediate dentures. J Prosthet Dent.
1967;18:202-210.
30. Lambrecht JR. Immediate denture construction: the impression
phase. J Prosthet Dent. 1968;19:237-245.
31. Javid N, Tanaka H, Porter M. Split-tray impression technique
for immediate upper dentures. J Prosthet Dent. 1974;32:348-
351.
32. Ettinger CW, Rayson JH, Terry JM, Rahn AO. Synopsis of
Complete Dentures. Philadelphia, PA: Lea & Febiger; 1975.
33. Firtell DN, Elahi JM, Harman LL. Impression technique for an
immediate or transitional denture. Quintessence Int Dent Dig.
1980;11:33-36.
34. Lucia VO, Swanson KH. Treatment of the Edentulous Patient.
Chicago, IL: Quintessence Publishing; 1986.
35. Gardner LK, Parr GR, Rahn AO. Modification of immediate
denture sectional impression technique using vinyl
polysiloxane. J Prosthet Dent. 1990;64:182-184.
36. Mitchel KF. Muscle-trim and tissue control in immediate
dentures. Dental Digest. 1942;48: 318-320.
37. Campagna SJ. An impression technique for immediate
dentures. J Prosthet Dent. 1968;20: 196-203.
38. Bolouri A. Double-custom tray procedure for immediate
dentures. J Prosthet Dent. 1977;37: 344-348.
39. Wyatt CCL. Immediate dentures. In: MacEntee MI, ed. The
Complete Denture: A Clinical Pathway. Chicago, IL:
Quintessence Publishing; 1999:99-107.
40. Laney WR, Gonzalez JB. The maxillary denture: its palatal
relief and posterior palatal seal. J Am Dent Assoc.
1967;75:1182-1187.
41. Naylor WP, Rempala JD. The posterior palatal seal: its forms
and functions. (I) Diagnosis. Quintessence Dent Technol.
1986;10:417-422.
42. Lavelle WL, Zach GA. The posterior limit of extension for a
complete maxillary denture. J Acad Gen Dent. 1973;21:31.
43. Johnson GH. Impression materials. In: Craig RG, Powers JM,
eds. Restorative Dental Materials. 11th ed. St Louis, MO:
Mosby; 2002:330-389.
44. Rudd KD, Morrow RM, Feldmann EE. Final impression, boxing
and pouring. In: Morrow RM, Rudd KD, Rhoads JE, eds.
Dental Laboratory Procedures. Volume One: Complete
Dentures. 2nd ed. St Louis, MO: Mosby; 1986:57-79.
 Continuing Education

Immediate Complete Denture Impressions: Case Report and Modern Clinical Technique
POST EXAMINATION INFORMATION 3. Which of the following is/are necessary for
complete denture retention?
To receive continuing education credit for participation in a. Peripheral denture seal.
this educational activity you must complete the program b. Appropriate volume and consistency of saliva.
post examination and receive a score of 70% or better. c. Accurate denture fit.
Traditional Completion Option: d. ALL of the above.
You may fax or mail your answers with payment to Dentistry Today
4. Which is a concern when using irreversible
(see Traditional Completion Information on following page). All
information requested must be provided in order to process the
hydrocolloid (alginate) impression material for
program for credit. Be sure to complete your “Payment”, “Personal definitive immediate denture impressions?
Certification Information”, “Answers” and “Evaluation” forms, Your a. Poor soft tissue detail.
exam will be graded within 72 hours of receipt.. Upon successful b. Hyper-allergenic patient response.
completion of the post-exam (70% or higher), a “letter of c. Over extension of peripheral impression borders.
completion” will be mailed to the address provided. d. Patient acceptance of the material’s taste.

Online Completion Option: 5. Which is an alternative immediate denture

Use this page to review the questions and mark your answers. impression technique described in the literature?
Return to dentalCEtoday.com and signin. If you have not a. Irreversible hydrocolloid impression material in a
previously purchased the program select it from the “Online custom impression tray.
Courses” listing and complete the online purchase process. Once b. Irreversible hydrocolloid impression material in a stock
purchased the program will be added to your User History page impression tray.
where a Take Exam link will be provided directly across from the c. Elastomeric impression material in a non-border-
program title. Select the Take Exam link, complete all the program molded stock impression tray.
questions and Submit your answers. An immediate grade report d. Zinc oxide impression material in a stock impression tray.
will be provided. Upon receiving a passing grade complete the
online evaluation form. Upon submitting the form your Letter Of 6. In the impression technique described, which VPS
Completion will be provided immediately for printing. material is preferred for border molding the
impression tray?
General Program Information:
a. Extra-low viscosity material.
Online users may login to dentalCEtoday.com anytime in the
b. Low viscosity material.
future to access previously purchased programs and view or print
“letters of completion” and results. c. Medium viscosity material.
d. High viscosity material.
POST EXAMINATION QUESTIONS 7. In the impression technique described, what
1. Advantages of immediate complete dentures advantage(s) is/are suggested for using extra low
include all of the following EXCEPT: viscosity VPS material?
a. maintenance or improvement of aesthetics. a. Low tear strength permits easier recovery of the
polymerized impression without damaging periodontally
b. maintenance or improvement of masticatory function. weakened teeth.
c. maintenance or improvement of phonetics. b. The bright orange color is easily discernible when
d. eliminates post-delivery adjustments. inspecting the final impression.
c. Low stiffness facilitates recovery of the definitive master
2. Disadvantages of immediate complete dentures cast from the impression without damage.
include all of the following EXCEPT: d. Both a and c are correct.
a. With residual teeth and soft/hard tissue undercuts,
anatomically/ physiologically accurate definitive 8. The purpose of Valsalva’s maneuver during border
impressions are difficult. molding is:
b. Arranging denture teeth in the lab is substantially more a. Functionally forms lingual flange extensions into the
difficult compared to conventional complete dentures. retromylohyoid space.
c. If residual teeth are mobile, accurate interocclusal b. Causes exaggerated physiologic movement of the
jaw registrations may be difficult. mandibular buccal frena.
d. Creating edentulous contours on dentate master casts c. Permits reduced thickness of the maxillary labial flange
using valid estimation techniques may involve during impression making for aesthetics.
unavoidable errors.
d. Helps form a physiologically accurate posterior border
in the maxillary final impression.
10
 Continuing Education

Immediate Complete Denture Impressions: Case Report and Modern Clinical Technique

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