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Dry Mouth impressions
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<blockquote data-quote="denturist-student" data-source="post: 241000" data-attributes="member: 5492"><p>When I make the impression whether it is a reline , silicone or even tissue conditioner, I am finding that it has suction when we make the impression however when we take it out and reinsert all suction is absent. Pretty certain it is due to the dry environment and viscosity of the impression materials. Not getting very good flow. When I do carve out the palate to achieve adequate flow, I can do the impression and have suction naturally while the impression is placed but when it is taken out and then even when I do a functional impression nothing seems to stay in place...Old dentures will have some suction and stay in place and have a higher post dam. I wanted to try a luckman dam but have not acheived adequate suction even on any impression to continue to processing...Once I placed a tempo tc and wanted to get some functonal impressions. Patient could eat apples and cookies at first but then when I went back two days later, they were loose...this is turning out quite frustrating both for me and the patient. Patient cannot tolerate long involved procedures. After two attempts to reline family is getting impatient. I have even proposed to try and replicate old denturebases but I am not certain that will work either....attaching photo of old denture base which patient says stays in place. Problem I have is that old denture seems to stay in place but new denture has no suction at all...has suction when impression material is not dislodged ie leave in place but then taking it out and reinsert has no suction all and falls out. Not really certain what is keeping old denture in place....tissues are very loose and lack any tone at all...My thinking is to just keep trying various viscosities until something works. May even try a dual viscosity impression using regular on borders and extra light intaglio. but I am certain that the dry mouth is a factor because most materials are slightly hydrophilic and are water resorptive...might try a non hydrophylic material but not sure which one would work. Currently using Elite light body wash with heavy border molding. That works well and stays in place post impression however post processing produces no suction at all.</p><p></p><p>Tried Biotene rinse but that made things worse too slippery...and it stings patients mucosa....</p><p></p><p>Wondering if a dilluted hyrdrocast might work. I have yet to try hydrocast but want to suspend until I find something that will work. Patient is not enjoying this at all because it hurts to handle her oral tissues. I have tried Tempo tc and Elite silicon pvs light body both as reline impressions....COEcomfort tc tried a third time but cannot maintain any suction post impression. Elite pvs works and stays in place but not post processing. palatal curtain is downward sloping. ridges slightly tapering.</p><p></p><p>I recall Turbyfill uses a reline jig to place the hydrocast and I have also done this....but standard protocol is not like this...obviously this patient cannot be treated using standard protocols...Unlikely the patient will pay for Turbyfill protocol. Nor will she endure what it takes to complete the Turbyfill protocol.</p><p>Thing is we sometimes are limited by insurance companies to standard protocols. Patient doesn't see difference in results. To them a denture is a denture is a denture...Luckilly now up here at least insurance companies will pay part of a higher level of protocol.</p></blockquote><p></p>
[QUOTE="denturist-student, post: 241000, member: 5492"] When I make the impression whether it is a reline , silicone or even tissue conditioner, I am finding that it has suction when we make the impression however when we take it out and reinsert all suction is absent. Pretty certain it is due to the dry environment and viscosity of the impression materials. Not getting very good flow. When I do carve out the palate to achieve adequate flow, I can do the impression and have suction naturally while the impression is placed but when it is taken out and then even when I do a functional impression nothing seems to stay in place...Old dentures will have some suction and stay in place and have a higher post dam. I wanted to try a luckman dam but have not acheived adequate suction even on any impression to continue to processing...Once I placed a tempo tc and wanted to get some functonal impressions. Patient could eat apples and cookies at first but then when I went back two days later, they were loose...this is turning out quite frustrating both for me and the patient. Patient cannot tolerate long involved procedures. After two attempts to reline family is getting impatient. I have even proposed to try and replicate old denturebases but I am not certain that will work either....attaching photo of old denture base which patient says stays in place. Problem I have is that old denture seems to stay in place but new denture has no suction at all...has suction when impression material is not dislodged ie leave in place but then taking it out and reinsert has no suction all and falls out. Not really certain what is keeping old denture in place....tissues are very loose and lack any tone at all...My thinking is to just keep trying various viscosities until something works. May even try a dual viscosity impression using regular on borders and extra light intaglio. but I am certain that the dry mouth is a factor because most materials are slightly hydrophilic and are water resorptive...might try a non hydrophylic material but not sure which one would work. Currently using Elite light body wash with heavy border molding. That works well and stays in place post impression however post processing produces no suction at all. Tried Biotene rinse but that made things worse too slippery...and it stings patients mucosa.... Wondering if a dilluted hyrdrocast might work. I have yet to try hydrocast but want to suspend until I find something that will work. Patient is not enjoying this at all because it hurts to handle her oral tissues. I have tried Tempo tc and Elite silicon pvs light body both as reline impressions....COEcomfort tc tried a third time but cannot maintain any suction post impression. Elite pvs works and stays in place but not post processing. palatal curtain is downward sloping. ridges slightly tapering. I recall Turbyfill uses a reline jig to place the hydrocast and I have also done this....but standard protocol is not like this...obviously this patient cannot be treated using standard protocols...Unlikely the patient will pay for Turbyfill protocol. Nor will she endure what it takes to complete the Turbyfill protocol. Thing is we sometimes are limited by insurance companies to standard protocols. Patient doesn't see difference in results. To them a denture is a denture is a denture...Luckilly now up here at least insurance companies will pay part of a higher level of protocol. [/QUOTE]
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