印模与模型制作.ppt

,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,InserttraySeatposteriorportionRotatetheanteriorportionintopositionBordermoldtheimpression,Completedimpression,MaxillaryAlginateImpression,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,ScribearedlineatthedepthofthevestibuleScribeablueline2mmabovetheredline.Thebluelinedeterminesthetrayextension,Blockoutundercutareas.Theusualareasare:FrenumBuccalsurfaceofthetuberosityRugaeFlabbyportionsofthealveolarridges,个别托盘的制作,Markthevestibularregionaspreviouslydescribedwithredandbluepencil.Blockouttheundercuts.Theusualareasare:MylohyoidridgeFrenumLingualsideofthemandibleoppositetheretromylohyoidspace,下颌个别托盘,Whenthewaxblockoutiscompletesoakthecastinwaterfor5minutes.Thencoatthesurfaceofthecastwithatinfoilsubstitute,涂分离剂,制作个别托盘MakingtheTray,Thetraymaterialisadaptedtothecastandtheexcessistrimmedawaywithaknife,Mixapproximatelycupoftrayresinforeachtrayandapplyathinlayerofvaselinetoyourfingers,MakingtheTrayTrayResin,Waitforthematerialtogettoadoughyconsistencybeforeyouapplyittothetemplate.Pressmaterialwithaglassslabtoobtaintheproperthickness,MakingtheTrayTrayResin,Adapttheresinmaterialtothecastasshown.Trimexcesswithaknife,MakingtheTray,PlaceadditionalresintocreatehandlesTrimexcessmaterialwithabladeAllowtheresintopolymerizeRemovethetrayfromthecastTrimthetraywithanacrylicburtothedesiredextensionsandcontoursRemoveanywaxadheringtothetissuesurfaceofthetray,MakingtheTray,Trayperipheryshouldbe2-3mmthick.Theedgesshouldberounded.Therestofthetrayshouldbeabout1-2mminthickness,Trayhandle-10mmhigh,CompletedMaxillaryTrayCheckList,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,Checkextensionalongthebuccalvestibule,CheckthelabialflangeextensionCheckfrenumclearance,个别托盘CustomTray,Mixapproximatelycupoftrayresinforeachtrayandapplyathinlayerofvaselinetoyourfingers,MakingtheTrayTrayResin,Trayperipheryshouldbe2-3mmthick.Theedgesshouldberounded.Therestofthetrayshouldbeabout1-2mminthickness,Trayhandle-10mmhigh,CompletedMaxillaryTrayCheckList,Armamentarium,DentalcompoundKingsleyscraperSlowspeedhandpieceAcrylicbur#7waxspatulaIndeliblemarkingsticksRedhandledknifeCustomimpressiontraysHanautorchWaterBath,BorderMolding,Heatthemodelingcompoundoveraflame,边缘整塑BorderMolding,干燥托盘,在边缘滴加融化的材料,边缘整塑BorderMolding,InsertthetraywithcompoundbeingcarefultoretractthecheekwithamouthmirrororyourindexfingerArea“A”ismoldedbyinstructingthepatienttomovethemandiblelaterallyandanteriorly,puckerandsmile,边缘整塑BorderMolding,Posteriorpalatalsealarea,Thesetissuesmustbecompressedinordertoobtainandmaintainperipheralseal,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,Finishmixingthepolysulfidematerialwiththeflatedgeoftheblade.Thistechniquewillminimizethenumberofairbubblesincorporatedintothematerial,Applyathinlayerofimpressionmaterialtothetraywithacementspatula,Keyfactorsforasuccessfulimpression,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,Bordermoldingthebuccalflange-Area“A”,完成整塑的部分边缘,高宽回切0.5mm为印模材料留出空间,边缘整塑-回切,涂粘结剂,Mixpolysulfideaspreviouslydirectedandapplyathinlayerofimpressionmaterialtothetray,Donotoverloadthetray,MandibularImpression,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,Whatfactorsmakeforagoodimpression?,SmoothwelldefinedperipheriesMaximumextensionEvenpressuredistribution(thereshouldbenoareaswheretheunderlyingtrayorcompoundshowsthrough)Thereshouldbeintimatetissuecontact,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,与运动时的唇、颊和舌侧粘膜皱襞和系带相紧密贴合充分让开系带，不妨碍唇、颊和舌的运动边缘圆钝厚度2-3mm上颌后缘到翼上颌切迹，和后颤动线下颌盖过磨牙后垫，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,思考,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,无牙