PMC4020562_01
edentulous maxillary arch with arrows showing areas of flabby tissue.
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fig1
The anterior canine-canine region in maxilla along with the maxillary tuberosity and the mandibular canine-canine region was flabby (Figures 1 and 2).
edentulous mandibular arch with arrows showing areas of flabby tissue.
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fig2
The anterior canine-canine region in maxilla along with the maxillary tuberosity and the mandibular canine-canine region was flabby (Figures 1 and 2).
Additional wax placed to create relief over areas of flabby tissues.
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fig3
The mandibular cast was first adapted with a layer of wax to provide extra relief in the flabby region (Figure 3) followed by addition of one more layer of wax covering the ridge except the buccal shelf area (Figure 4).
Relief wax placed over the mandibular arch.
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fig4
The mandibular cast was first adapted with a layer of wax to provide extra relief in the flabby region (Figure 3) followed by addition of one more layer of wax covering the ridge except the buccal shelf area (Figure 4).
Relief wax placed over the maxillary arch.
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fig5
On the maxillary cast, an "I" shaped spacer was applied along the mid palatine raphe using modelling wax with additional relief given in the flabby area from canine-canine region (Figure 5).
Clear acrylic custom "open" tray.
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fig6
A maxillary custom tray was fabricated using clear autopolymerising acrylic resin (RR self-cure acrylic resin, Dentsply, India) covering the tissues except the area that was flabby (Figure 6).
Maxillary custom tray with "supporting" tray covering areas of flabby tissue with the handle placed at the center of the palatal area.
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fig7
The handle was placed in the palatal portion of the maxillary tray to ensure visualization of the underlying tissues through the clear acrylic tray and also to facilitate uniform distribution of pressure during impression making (Figure 7).
Mandibular custom tray fabricated with clear acrylic resin.
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fig8
A mandibular custom tray was fabricated with autopolymerising clear acrylic (Figure 8).
Buccal shelf area recorded with impression compound.
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fig9
The Buccal shelf area was recorded by using mucocompressive impression material like impression compound Type 1 (Y Dents, Mumbai, India) (Figure 9).
Custom tray with complete mandibular border moulding.
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fig10
The remaining borders of impression were recorded by selective pressure technique using green stick compound (Pinnacle tracing stick, DPI, Mumbai, India) (Figure 10).
Mandibular custom tray with wax spacer removed. Multiple relief holes are placed in areas of flabby tissue.
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fig11
A final impression with monophase (medium body) (Aquasil LV Monophase, Dentsply Caulk) addition silicone was made (Figure 11).
Completed mandibular impression with monophase polyvinylsiloxane material.
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fig12
A monophase impression material was preferred as it has the desirable thixotropic property thereby ensuring adequate flow under pressure (Figure 12).
Maxillary custom tray with wax spacer removed.
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fig13
The maxillary borders were recorded by selective pressure impression technique using green stick compound (Figure 13).
Maxillary custom tray with multiple relief holes.
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fig14
The relief wax was removed and multiple holes were drilled in the "supporting tray (Figure 14)." Placement of multiple relief holes was done to ensure prevention of pressure build-up in the flabby area thereby leading to inadvertent tissue compression.
Completed secondary impression with monophase polyvinylsiloxane material.
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fig15
Similar to the lower impression a monophase impression of addition silicone was made (Figure 15).