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1、,印模和模型,本课首先回顾了无牙颌的特点和难点，固位力的主要来源，如何获得固位力，然后重点介绍了初印模和工作印模的制作过程和制作要求，逐步深入，全面介绍，为相关医务工作者提供了系统的讲解,课前导读,课程内容,工作印模的临床标准,相关知识的回顾,初印模的灌制,个别托盘的制作,工作印模的制作,思考,相关知识回顾 无牙颌的特点和修复难点,固位！,相关知识回顾 固位力的主要来源,相关知识回顾 固位力的主要来源,大气压力形成条件 形成负压状态和保持负压状态影响因素 密贴程度 基托的面积 边缘封闭程度,相关知识回顾 固位力的主要来源,基托组织面与唾液间附着力粘膜表面与唾液间 吸附力唾液分子间 粘着力影响因
2、素:、基托与粘膜表面接触的紧密程度 接触越紧密唾液膜越薄吸附力越大、基托与粘膜表面接触的面积 接触面积越大吸附力越大固位力越大唾液的质与量,全口义齿怎样获得这些力？,义齿基托与粘膜极其密合 义齿基托的面积尽量大 义齿的边缘保持封闭状态,本节课要解决的问题,制取一副规范的印模,全口义齿的印模,定义 无牙上、下颌牙槽嵴和周围软硬组织的阴模 用途 复制无牙颌的阳性模型 临床意义 制作全口义齿的基础 获得固位力的关键,工作印模的要求,适当扩大覆盖面积面积 精确再现粘膜表面的细微结构密合 印模边缘与功能状态下的边缘封闭区软组织紧密贴合良好的边缘形状,无牙颌的解剖标志及其印模,印模的分类（自学内容）,根据
3、取模次数分 一次法 二次法 多次法 根据取模时患者口腔状态分 张口式 闭口式 根据印模料对粘膜的压力分 粘膜静止式 粘膜活动式,二次印模法制取无牙颌工作印模,初印模公用托盘 初模型 个别托盘 工作印模个别托盘 工作模型,思考,初印模的制取方法和要求是什么？,如何制作个别托盘？,初印模的制取,Insert tray Seat posterior portion Rotate the anterior portion into position Border mold the impression,Completed impression,Maxillary Alginate Impression
4、,初印模,初模型的灌制,初模不粗,初印模小结,材料 藻酸盐 方法 医者的体位 肌功能修整 要求 适度伸展 系带清晰 压力均匀 目的 制作个别托盘,Scribe a red line at the depth of the vestibuleScribe a blue line 2mm above the red line. The blue line determines the tray extension,Block out undercut areas. The usual areas are:FrenumBuccal surface of the tuberosityRugaeFlab
5、by portions of the alveolar ridges,个别托盘的制作,Mark the vestibular region as previously described with red and blue pencil. Block out the undercuts. The usual areas are:Mylohyoid ridgeFrenumLingual side of the mandible opposite the retromylohyoid space,下颌个别托盘,When the wax blockout is complete soak the c
6、ast in water for 5 minutes. Then coat the surface of the cast with a tin foil substitute,涂分离剂,制作个别托盘Making the Tray,The tray material is adapted to the cast and the excess is trimmed away with a knife,Mix approximately cup of tray resin for each tray and apply a thin layer of vaseline to your finger
7、s,Making the Tray Tray Resin,Wait for the material to get to a doughy consistency before you apply it to the template. Press material with a glass slab to obtain the proper thickness,Making the Tray Tray Resin,Adapt the resin material to the cast as shown. Trim excess with a knife,Making the Tray,Pl
8、ace additional resin to create handlesTrim excess material with a bladeAllow the resin to polymerizeRemove the tray from the castTrim the tray with an acrylic bur to the desired extensions and contoursRemove any wax adhering to the tissue surface of the tray,Making the Tray,Tray periphery should be
9、2 -3 mm thick. The edges should be rounded. The rest of the tray should be about 1-2 mm in thickness,Tray handle - 10mm high,Completed Maxillary Tray Check List,个别托盘的要求,颊侧及下颌舌侧边缘比功能边缘短2mm，唇、颊、舌系带处留出足够的空间 上颌后缘超过颤动线2mm，下颌包括磨牙后垫及下颌舌骨嵴边缘厚度2mm,手柄与牙槽嵴垂直,制取工作印模,思考,如何制作工作印模？,工作印模的要求有哪些要求？,选择性压力印模技术是材料与可动的松软
10、的前庭沟组织密切接触的情况下，最大面积的覆盖组织表面，采用流动动性强的轻体硅橡胶材料使组织表面受到最小的压力的印模技术,选择性压力印模技术,Check extension along the buccal vestibule,Check the labial flange extensionCheck frenum clearance,个别托盘Custom Tray,Mix approximately cup of tray resin for each tray and apply a thin layer of vaseline to your fingers,Making the Tra
11、y Tray Resin,Tray periphery should be 2 -3 mm thick. The edges should be rounded. The rest of the tray should be about 1-2 mm in thickness,Tray handle - 10mm high,Completed Maxillary Tray Check List,Armamentarium,Dental compoundKingsley scraperSlow speed handpieceAcrylic bur#7 wax spatulaIndelible m
12、arking sticksRed handled knifeCustom impression traysHanau torchWater Bath,Border Molding,Heat the modeling compound over a flame,边缘整塑Border Molding,干燥托盘,在边缘滴加融化的材料,边缘整塑Border Molding,Insert the tray with compound being careful to retract the cheek with a mouth mirror or your index finger Area “A” i
13、s molded by instructing the patient to move the mandible laterally and anteriorly, pucker and smile,边缘整塑Border Molding,Posterior palatal seal area,These tissues must be compressed in order to obtain and maintain peripheral seal,修整后腭封闭区的材料,边缘整塑-回切,托盘易于就位 缓解切牙乳头和腭皱襞的压力 避免气泡形成,在前腭部开孔,涂布托盘粘结剂,Finish mix
14、ing the polysulfide material with the flat edge of the blade. This technique will minimize the number of air bubbles incorporated into the material,Apply a thin layer of impression material to the tray with a cement spatula,Key factors for a successful impression,患者自主肌功能修整：吮医生的手指,腭后封闭区,下颌边缘整塑的次序,按摩颊
15、部,Border molding the buccal flange-Area “A”,完成整塑的部分边缘,高宽回切 0.5 mm为印模材料留出空间,边缘整塑- 回切,涂粘结剂,Mix polysulfide as previously directed and apply a thin layer of impression material to the tray,Do not overload the tray,Mandibular Impression,让病人轻抬舌,使托盘就位.边缘修整直到材料固化,下颌印模,冲洗,消毒,检查印模是否完整， 用锐利的剪刀去处多余的材料,下颌印模,What factors make for a good impression?,Smooth well defined peripheriesMaximum extensionEven pressure distribution (there should be no areas where the underlying tray or compound shows through)There should be intimate tissue contact,规范的无牙颌印模和模型,工作印模的临床标准,思考,全口义齿工作印模的边缘有哪些要求？,全口义齿工作印模边缘的要求,
