surgery for ridges aim to:
1- Vertical dimension.
2- Speech.
3- Modify ridge for stability.***
Hypermobile ridges or soft edentulous crests are a common phenomenon. The mucostatic or minimal displacement impression technique is one of the treatment options in this scenario. Conventional mucostatic methods such as the use of a window tray technique, double braces, multiple raised holes, can be used. Even manual placement and manipulation of a custom tray can deform tissue. This may violate the principles of the mucostatic impression technique. Soft crests can be treated surgically by excision, augmentation of the ridge, injection of sclerosing solutions and also by prosthesis preserved by implant. Proper registration of these hypermobile tissues and stable occlusal contacts may help manage flabby tissue to some extent. This case report is a surgical and prosthodontic approach to the management of soft and maxillary edentulous crest using a minimal displacement impression technique.
The glossary of prosthodontic terms defines the soft ridge as an excess of moving tissue.
Poor stability and support are the disadvantages of excessively mobile tissue for the complete prosthesis.
A complete radiographic examination, a visual and digital examination, as well as a notation of the history of the patient's prosthesis are the conditions required for a preliminary oral examination.
As proposed by Desjardin and Tolman, various aetiological agents for soft crest development are atrophy, bone resorption, nutritional deficiencies, pressure, functional forces, and patients with parafunctional habits.
Retention, stability and support are negatively affected in such cases.
Soft crests can be treated surgically by excision, augmentation of the ridge, injection of sclerosing solutions and also by prosthesis preserved by implant. Proper registration of these hypermobile tissues and stable occlusal contacts may help manage flabby tissue to some extent.
This case report deals with the surgical approach followed by the prosthodontic management of a soft and maxillary edentulous ridge using a mucostatic impression technique.
There are surgical and prosthetic treatment options for managing soft tissues with their own pros and cons. Nowadays, surgical excision is mainly a historical concept.
This procedure results in a shallow ridge with little or no retention and resistance to lateral forces.
Increasing the peak with autogenous or allogeneic graft is another option, which has disadvantages such as resorption up to 50% and graft migration.
The next option would be the injection of sclerosing solutions, the disadvantages being anaphylactic reactions, patient discomfort and technical sensitivity. Surgical treatment is therefore appropriate only when age, general health, dental history, motivation and personality are favored.
In this particular case report, everything was favorable to surgery and a second surgery was not necessary because it was planned to use alloplastic graft material.
A muco-displacive impression technique shows excellent retention of the prosthesis during function, the reason being the displacement of the vascular contents of the blood vessels in the interstitial spaces. But at rest, retention and stability are affected and the prosthesis becomes loose because the blood enters the tissues again and changes the contours.
According to the theories of impression taking, muco-displacement impression techniques lead to an unstable and non-retentive prosthesis. Selective pressure or minimum displacement printing techniques minimize these limitations. The use of lightening holes, windows and wax relief reduces hydraulic pressure and minimizes the movement of stressed fabrics. The "pressure" is the only principle on which the impression taking ideas rest, in particular for hypermobile tissues.
It is impossible to register the soft tissues in an unstressed position, as the mere introduction of trays and the amount of force applied causes tissue displacement.
In this case, the mucostatic technique allowed a satisfactory recording of generalized hyperplasia of the ridge, thus avoiding overcompression.
The choice of printing techniques depends on personal preference based on the principles of impression taking.
The two main printing techniques reported are:
- Mucodisplacif, in which the tissues are compressed
Mucostatic in which tissues are recorded at rest - in position.
1- Vertical dimension.
2- Speech.
3- Modify ridge for stability.***
Hypermobile ridges or soft edentulous crests are a common phenomenon. The mucostatic or minimal displacement impression technique is one of the treatment options in this scenario. Conventional mucostatic methods such as the use of a window tray technique, double braces, multiple raised holes, can be used. Even manual placement and manipulation of a custom tray can deform tissue. This may violate the principles of the mucostatic impression technique. Soft crests can be treated surgically by excision, augmentation of the ridge, injection of sclerosing solutions and also by prosthesis preserved by implant. Proper registration of these hypermobile tissues and stable occlusal contacts may help manage flabby tissue to some extent. This case report is a surgical and prosthodontic approach to the management of soft and maxillary edentulous crest using a minimal displacement impression technique.
The glossary of prosthodontic terms defines the soft ridge as an excess of moving tissue.
Poor stability and support are the disadvantages of excessively mobile tissue for the complete prosthesis.
A complete radiographic examination, a visual and digital examination, as well as a notation of the history of the patient's prosthesis are the conditions required for a preliminary oral examination.
As proposed by Desjardin and Tolman, various aetiological agents for soft crest development are atrophy, bone resorption, nutritional deficiencies, pressure, functional forces, and patients with parafunctional habits.
Retention, stability and support are negatively affected in such cases.
Soft crests can be treated surgically by excision, augmentation of the ridge, injection of sclerosing solutions and also by prosthesis preserved by implant. Proper registration of these hypermobile tissues and stable occlusal contacts may help manage flabby tissue to some extent.
This case report deals with the surgical approach followed by the prosthodontic management of a soft and maxillary edentulous ridge using a mucostatic impression technique.
There are surgical and prosthetic treatment options for managing soft tissues with their own pros and cons. Nowadays, surgical excision is mainly a historical concept.
This procedure results in a shallow ridge with little or no retention and resistance to lateral forces.
Increasing the peak with autogenous or allogeneic graft is another option, which has disadvantages such as resorption up to 50% and graft migration.
The next option would be the injection of sclerosing solutions, the disadvantages being anaphylactic reactions, patient discomfort and technical sensitivity. Surgical treatment is therefore appropriate only when age, general health, dental history, motivation and personality are favored.
In this particular case report, everything was favorable to surgery and a second surgery was not necessary because it was planned to use alloplastic graft material.
A muco-displacive impression technique shows excellent retention of the prosthesis during function, the reason being the displacement of the vascular contents of the blood vessels in the interstitial spaces. But at rest, retention and stability are affected and the prosthesis becomes loose because the blood enters the tissues again and changes the contours.
According to the theories of impression taking, muco-displacement impression techniques lead to an unstable and non-retentive prosthesis. Selective pressure or minimum displacement printing techniques minimize these limitations. The use of lightening holes, windows and wax relief reduces hydraulic pressure and minimizes the movement of stressed fabrics. The "pressure" is the only principle on which the impression taking ideas rest, in particular for hypermobile tissues.
It is impossible to register the soft tissues in an unstressed position, as the mere introduction of trays and the amount of force applied causes tissue displacement.
In this case, the mucostatic technique allowed a satisfactory recording of generalized hyperplasia of the ridge, thus avoiding overcompression.
The choice of printing techniques depends on personal preference based on the principles of impression taking.
The two main printing techniques reported are:
- Mucodisplacif, in which the tissues are compressed
Mucostatic in which tissues are recorded at rest - in position.
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