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1、 印模和模型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索相关知识回顾 无牙颌的特点和修复难点固位！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基托组织面与唾液间 附着力附着力 粘膜表面与唾液间粘膜表面与唾液间 吸附力吸附
2、力 唾液分子间唾液分子间 粘着力粘着力影响因素影响因素: 、基托与粘膜表面接触的紧密程度、基托与粘膜表面接触的紧密程度接触越紧密接触越紧密唾液膜越薄唾液膜越薄吸附力越大吸附力越大 、基托与粘膜表面接触的面积、基托与粘膜表面接触的面积接触面积越大接触面积越大吸附力越大吸附力越大固位力越大固位力越大 唾液的质与量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制取一副规范的印模 全口义齿的印模1.定义定义2.无牙上、下颌牙槽嵴和周无牙上、下颌牙槽嵴和周围软硬组织的阴模围软硬组织的阴模3.用途用途 4.复制无牙
3、颌的阳性模型复制无牙颌的阳性模型5.临床意义临床意义6.制作全口义齿的基础制作全口义齿的基础7.获得固位力的关键获得固位力的关键工作印模的要求1.适当扩大覆盖面积面积2.精确再现粘膜表面的细微结构密合3.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）1.根据取模次数分2.一次法3.二次法4.多次法5.根据取模时患者口腔状态分6.张口式7.闭口式8.根据印模料对粘膜的压力分9.粘膜静止式10.粘膜活动式二次印模法制取无牙颌工作印模1.初印模公用托盘2.初模型 个别托盘3.工作印模个别托盘4.工作模型思索初印模的制取方法和要求是什么？如何制
4、作个别托盘？初印模的制取Insert traySeat posterior portionRotate the anterior portion into positionBorder mold the impressionCompleted impressionMaxillary Alginate Impression初印模初模型的灌制初模不粗初印模小结1.资料2.藻酸盐3.方法4.医者的体位5.肌功能修整6.要求7.适度伸展8.系带清晰9.压力均匀10.目的11.制作个别托盘Scribe a red line at the depth of the vestibuleScribe a bl
5、ue line 2mm above the red line. The blue line determines the tray extensionBlock out undercut areas. The usual areas are: Frenum Buccal surface of the tuberosity Rugae Flabby 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
6、the undercuts. The usual areas are: Mylohyoid ridge Frenum Lingual side of the mandible opposite the retromylohyoid space下颌个别托盘When the wax blockout is complete soak the cast 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 materi
7、al is adapted to the cast and the excess is trimmed away with a knifeMix approximately cup of tray resin for each tray and apply a thin layer of vaseline to your fingersMaking the Tray Tray ResinWait for the material to get to a doughy consistency before you apply it to the template. Press material
8、with a glass slab to obtain the proper thicknessMaking the Tray Tray ResinAdapt the resin material to the cast as shown. Trim excess with a knifeMaking the Tray Place additional resin to create handles Trim excess material with a blade Allow the resin to polymerize Remove the tray from the cast Trim
9、 the tray with an acrylic bur to the desired extensions and contours Remove any wax adhering to the tissue surface of the trayMaking the TrayTray periphery should be 2 -3 mm thick. The edges should be rounded. The rest of the tray should be about 1-2 mm in thicknessTray handle - 10mm highCompleted M
10、axillary 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索如何制作工作印模？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 vestibuleCheck the labial flange extensi
11、onCheck frenum clearance个别托盘Custom TrayMix approximately cup of tray resin for each tray and apply a thin layer of vaseline to your fingersMaking the Tray Tray ResinTray periphery should be 2 -3 mm thick. The edges should be rounded. The rest of the tray should be about 1-2 mm in thicknessTray handl
12、e - 10mm highCompleted Maxillary Tray Check List ArmamentariumDental compound Kingsley scraper Slow speed handpiece Acrylic bur #7 wax spatula Indelible marking sticks Red handled knife Custom impression trays Hanau torch Water BathBorder MoldingHeat the modeling compound over a flame边缘整塑Border Mold
13、ing干燥托盘,在边缘滴加融化的材料边缘整塑Border MoldingInsert the tray with compound being careful to retract the cheek with a mouth mirror or your index fingerArea “A” is molded by instructing the patient to move the mandible laterally and anteriorly, pucker and smile边缘整塑Border MoldingPosterior palatal seal areaThese
14、 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1. 托盘易于就位2.缓解切牙乳头和腭皱襞的压力3.避免气泡形成在前腭部开孔涂布托盘粘结剂Finish mixing the polysulfide material with the flat edge of the blade. This technique will minimize the number of air bubbles incorporated into the materialApply
15、a thin layer of impression material to the tray with a cement spatulaKey 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 按摩颊部按摩颊部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 impres
16、sion material to the trayDo not overload the trayMandibular 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? 1)Smooth well defined peripheries2)Maximum extension3)Even pressure distribution (there should be no areas where the underlying
17、tray or compound shows through)4)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索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1.与运动时的唇、颊和舌侧粘膜皱襞和系带相紧密贴合2.充分让开系带，不妨碍唇、颊和舌的运动3.边缘圆钝4.厚度2-3mm5.上颌后缘到翼上颌切迹，和后颤动线6.下颌盖过磨牙后垫，下缘跨过下颌舌骨嵴并且不妨碍口底和舌的运动临床操作技巧 使组织受压均匀 保持稳定位置 患者主动肌功能修整 材料的精细程度和流动性思索结合无牙颌的组织特点和全口义齿的固位原理，阐述怎样制取一副规范的无牙颌功能印模总结l无牙颌的修复难点是固位力，固位力的主要来源是大气压力和吸附力，全口义齿通过规范的印模获得这些力l无牙上、下颌牙槽嵴和周围软硬组织的阴模，用于复制无牙颌的阳性模型，临床意义是制作全口义齿的基础和获得固位力的关键l印模分初印模和工作印模。初印模的要求是适度伸展，系带清晰，压力均匀；目的是制作个别托盘。工作印模的要求是适当扩大覆盖面积，精确再现粘膜表面的细微结构，印模边缘与功能状态下的边缘封闭区软组织紧密贴合感谢聆听感谢聆听 欢迎交流！欢迎交流！您已完成本课学习，可点击考试按钮参加考试！您已完成本课学习，可点击考试按钮参加考试！
