1) Make impressions w/ alginate trays, stock trays with wax

2) Make sure captures all of these landmarks:

Max tuberosity

RMHyloid space

RM pads

Buccal shelf

3) Make custom trays 2-3mm short of vestibules and clearance for vestibules

Block out hard and soft tissue undercuts

For POLYSULFIDE: use 1 layer of wax on teeth

FOR ALGINATE: 2 layers of wax 3-4mm

4) Tray Resin: Apply vaseline prior to placing PMMA/resin. Place handle on it

• Instruct pt to remove existing RPD for 24 hts prior to apt

• Remove all calculus from teeth

1) Place rope wax to block out undercuts

2)IF using alginate: Perforate the custom tray for retention

3) Border mold if necessary (use pink wax normally, use green wax if needing longer span of border molding) using torch and water bath

4) Use polysulfide or alginate to make master impression (if using polysulfide use the diamond-ish shaped long spatula, and wait for it to set 8-10 minutes)

Alginate: misaligned teeth, great teeth mobility

Alginate requires more vigorous border movements

5) Mark the PPS in mouth and transfer to final impression

Anterior line: junction of hard and soft palate

Posterior: from hamular notch to hamular notch

6) Box, pour, and bead to make the master cast

7) Carve PPS prior to record base fabrication

1) IF insufficient teeth: need to make record base on master cast w/ wax rims

• Can add wire retainers

• Extend the record base to the proximal and lingual surfaces of the tooth to obtain retention

2) Apply separating medium

3) Mix tray acrylic and wait fm runny stage until doughy

4) Roll acrylic for right shape

5) Adapt acrylic to cast, wait for setting

6) Make wax rims, making them slightly higher than needed

1) Evaluate and determine VDO

• IORS= 2-3mm

2) Adjust wax rims to correct VDO and mark structures if needed

• Lip Support: symmetrically supported and outer edge on the wet-dry line, have them count from 50-59

• Incisal edge display: 1-2mm incisal to upper lip

• Interpupillary Plane=occlusal plane , use the Fox plane to assess parallelism

• Camper's plane (Ala to EAC)=occlusal plane

• Canines: Ala of nose, lip commissures at rest

• Mark high smile line

• Mark RVD without the wax rims in, then subtract 2-4mm

  • • Lick lips and swallow

    • Repeat emm-emm and relax

    • Closest speaking space: s, sh, ch

    • Sibilants

    • Facial contours

    • Tactile sense

3) Mark the position and direction of facial midline, should correlate to the Incisive Papilla

either on the cast or wax rim

4) Mark the upper lip line on the cast or wax rim

5) Face bow record

• Mark the orbitale (inferior rim) with indelible marker

• Patient keeps fork in position while adjusting facebow and tightening bolts

6) Guide patient into CR (make notches first)

Have the entire mandible retruded

Position condyle in uppermost anterior position

7) Take protrusive record

8) Mark and transfer the posterior palatal seal, in case this was forgotten during master impression appointment.

9) Select teeth shade and mould

10) Evaluate if they need preprosthetic surgery (tori prominent)

IF they need it, make surgical stent, altering the cast w/ desired shape