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ROBERT H.LIEBE T ■ ' : ' - ' ADVANCED 
IMPRESSION TAKING 
SCIENTIFIC AND CORRECT METHOD BASED 
UPON PRINCIPLES FOUNDED 
BY DRS. GREENE 
BY 
ROBERT H. LIEBERTHAL, D.D.S., M.D. 
WITH FORTY-THREE 
HALF-TONE ILLUSTRATIONS 
NEW YORK. 
PROFESSIONAL PUBLISHING CO. 
PUBLISHERS Copyright, 1918 
by 
Robert H Lieberthal DEDICATED TO 
DRS. PETER THOMAS GREENE 
AND 
JACOB WESLEY GREENE 
WHOSE PATIENT ENDEAVORS HAVE STIMULATED 
KEENER STUDY OF A MUCH NEGLECTED 
BRANCH OF DENTISTRY PREFACE 
This book is an earnest effort to make plain 
the principles and outline the technic of Scien- 
tific Impression Taking. The author's efforts 
are centered in minutely explaining in detail the 
Advanced Method of Taking Scientifically Cor- 
rect Impressions, Based on the Greene Princi- 
ple. The author takes this opportunity to pay 
especial tribute to the Fathers of Successful Im- 
pression Taking. 
A complete and concise system has been ar- 
ranged eliminating steps which are unnecessary 
and confusing. 
In order to place before the profession a sub- 
ject so important as is this branch of dentistry, 
it is necessary that the principles of technic be 
firmly established, to avoid even the slightest 
confusion in following this method. 
Careful observation prompts me to say that 
the dental profession at large knows very little 
about the Advanced Method of Taking Scien- 
tifically Correct Impressions. Why? For the 
V VI 
PREFACE 
very good reason that in 1895 the Drs. Greene 
first perfected this method to a degree where it 
was ready to be brought before the dental pro- 
fession. Unfortunately both gentlemen at that 
time were well along in years, 57 and 67, respec- 
tively, and being engaged in general practice, had 
very little time to devote to the teaching of their 
method to the dental profession in general, ex- 
cept occasional clinics, demonstrating usually by 
the taking of an impression of their own mouth. 
In 1907 the Drs. Greene gave up their private 
practice to enable them to devote their entire time 
to the teaching of their method. Unfortunately 
Dr. Peter Thomas Greene died in February, 
1909, which left the entire task upon Dr. Jacob 
W. Greene, aged 70, and most unfortunately he 
departed from his earthly home in 1916. 
Since then a number of attempts have been 
made to render instruction in this important 
branch of dentistry by persons not thoroughly 
conversant with all the fundamental principles. 
This naturally has caused a certain skepticism 
to be thrown about the method by those who un- 
fortunately have been victims of such ill-advised 
attempts. 
The success which attended the work of the PREFACE 
VII 
Drs. Greene, however, can be equally yours, if 
you will follow the method here outlined, which 
is based on the Greene Principle and simplified 
to assure its correct application. INTRODUCTION 
"Every art has its own methods of training, 
its distinctive discipline, its secrets of experience 
and skill; and mastery depends upon practice of 
these methods, submission to this discipline, pos- 
session of the fruits of this experience and com- 
mand of this skill. Between the untrained man 
and the artist, in every department of creative 
work, there must be an educational process se- 
vere and prolonged. This necessity is imposed 
on men of genius no less rigorously than on men 
of talent."-Hamilton Wright Mabie. 
The inaccurate and uncertain results obtained 
in denture work by plaster impressions is in itself 
sufficient justification for the study of a more 
accurate system of impression taking. It was 
this recognition which led the Drs. Greene to the 
discovery of a system of accurate impression tak- 
ing by the Modeling Compound Method. Such 
a radical departure in the method of taking im- 
pressions as the Drs. Greene proposed met with 
the usual suspicion, jealousy and envy, which 
has accompanied advanced methods in the past; 
but the courageous persistency of the founders 
IX INTRODUCTION 
X 
in the face of these difficulties has resulted in its 
recognition by the leaders in the dental profes- 
sion as a much improved method for denture 
work. 
Of the many inventions and discoveries for the 
convenience of mankind which the last century 
produced, this method of the Drs. Greene is by 
no means a trivial one. Many individuals suf- 
fered untold discomforts with the old fashioned 
plates, which depended upon suction for reten- 
tion, with the resultant effect that the plate 
seemed to ride all over the mouth and eating and 
conversation became a hardship instead of a 
pleasure. Until recently this was the only 
known method to the dental profession. The 
new system, expounded concisely within these 
pages, enables the production of a better fitting 
plate with the added advantage of a more natural 
response to the movements of the jaw and teeth. 
Guesswork is entirely eliminated. Accuracy is 
readily attained, but a close study of its basic 
principles and constant practice are essential. 
The broad possibilities of this advanced method 
are even yet dimly comprehended by those who 
have not given it careful study. It has passed 
the evolutionary stages and is now recognized as 
a science. In the light of our present knowledge INTRODUCTION 
XI 
most of the theory as well as the practice of even 
a few years ago seems strikingly crude. Now, 
however, some of our best colleges are establish- 
ing chairs for the study of plate prosthesis in ac- 
cordance with this advanced method. A field, 
almost limitless in extent, awaits the student and 
practitioner who will give close application to 
the study and practice of this scientific method 
of impression taking. CONTENTS 
CHAPTER PAGE 
Introduction 9 
I Full Upper Impressions 15 
II Full Lower Impressions 51 
III Upper Partial Impressions 63 
IV Lower Partial Impressions 73 
Converting Impressions 75 
Suggestions 76 
Roofless Dentures 73 ADVANCED IMPRESSION 
TAKING 
CHAPTER I 
FULL UPPER IMPRESSIONS 
FIRST we will treat with the full upper 
mouth or jaw only. Make a plaster 
model of the jaw to be fitted, and select 
a tray nearest in size, as shown in Figure No. 1. 
Fig. No. 1 
Showing plaster model of jaw to be fitted and tray for same 
15 16 
ADVANCED IMPRESSION TAKING 
Shape the tray as follows: Place tray on model, 
turn Bunsen flame on tray, moving flame over 
surface of tray until it becomes soft enough and 
shows signs of adapting itself to model, as shown 
Fig. No. 2 
Showing tray on model with flame moving over full surface of tray 
in Figure No. 2. Wet fingers and form tray to 
model, using only slight pressure. Dip model 
with tray on it in cold water and remove tray. 
It is now ready to he trimmed as to the height of 
rim and length in rear. This is accomplished 
by passing the edge of tray over the flame, as FULL UPPER IMPRESSIONS 
17 
shown m Figure No. 3, and in this semi-soft 
condition it may be cut with a pair of small seis- 
Fig. No. 3 
Heating edge of tray over flame before cutting 
sors to the desired height and length. Caution 
should he used in cutting or trimming of tray 
as a poorly fitted tray will hamper greatly the 
work of muscle trimming. It is necessary that 
the muscles (or labial and buccal frenae) have 
free play to enable their reproduction in the soft 
compound while in function. Be sure then 
to trim tray so that it will not strain the tissues,  ADVANCED IMPRESSION TAKING 
18 
as shown in Figure No. 4. The fitted tray should 
be at least an eighth of an inch shorter all around 
Fig. No. 4 
Method of trimming tray 
than the proposed plate. Try the tray in the 
mouth and see that it does not encroach upon the FULL UPPER IMPRESSIONS 
19 
tissues or muscles, as shown in Figure No. 5. A 
properly fitted tray will stay in the mouth, 
Showing trimmed tray with accurate reproduction of palate and 
ridge of model 
Fig. No. 5 
and unless it does it requires more trimming.1 
The compound should be immersed in hot 
water. Heat water to the boiling point, remove 
from flame and it will then be ready to receive 
i The tray referred to is made of a composition which will with- 
stand the required amount of heat necessary to soften compound 
and still retain its rigidness without changing form and is known 
as Dr. Lieberthal's Nometal Impression Tray. The Greene soft 
aluminum tray is easily swadged on a model made of artificial 
stone. 20 
ADVANCED IMPRESSION TAKING 
the compound. The best compound is Keir's 
Perfection Impression Compound, owing to its 
uniform qualities. Form the soft compound 
Fig. No. 6 
Compound in form of ball heated over a flame to be attached 
to tray 
into a ball and heat one side over a gas or alco- 
hol flame until it sizzles, as shown in Figure 
No. 6. Attach the side so heated to the tray 
and with wet fingers shape the soft compound 
into a cone in the center of the tray; a depression FULL UPPER IMPRESSIONS 
21 
all along where the alveolar ridge will come; and 
a relatively high rim to go up under the lip and 
cheeks, as shown in Figure No. 7. A small piece 
Compound as it should be formed in tray 
Fig. No. 1 
of compound is stuck fast to the tray to serve as 
a handle for the first insertion. (After the first 
insertion simply break off handle.) Heat the 
entire surface of compound over alcohol or gas 
flame and dip surface of compound into hot 
water, which will serve to equalize the heat and 
avoid discomfort to the patient, as shown in Fig- 
ure No. 8. The tray with compound so prepared 22 
ADVANCED IMPRESSION TAKING 
should be quickly inserted into the mouth and 
with a slight wave-like up and down motion press 
impression to place. Insert finger into the 
Heating impression over flame 
Fig. No. 8 
mouth and press rim of compound on labial and 
buccal surfaces upward against the ridge, as 
shown in Figure No. 9. Cool compound by 
means of cold water sprayed into the mouth and 
remove what we will speak of as our preliminary 
impression. The margins of the impression as 
it first comes from the mouth, are generally thick FULL UPPER IMPRESSIONS 
23 
Fig. No. 9 
Manner of pressing compound on labial and buccal surfaces up- 
ward against the ridge. This eliminates, to a certain extent, 
the necessity for adding compound to the rim for muscle 
trimming 
enough to distend the tissues of the lips and 
cheeks. Where this condition exists it is essen- 24 
ADVANCED IMPRESSION TAKING 
tial to trim the margins after the manner shown 
in Figure No. 10, until they are of the thickness 
Fig. No. 10 
How margins are trimmed when they appear to affect the facial 
expression 
desired in the finished denture and give the pa- 
tient the desired expression. 
The preliminary impression is now ready to 
receive the bite block. Shape a roll of soft com- 
pound 1 and attach it to ridge of tray. Heat 
the center of one side until it sizzles and attach 
the side so heated to anterior portion of ridge of 
tray and in like manner attach both ends in con- 
i The best results are obtained with Kerr Perfection Impres- 
sion Compound. FULL UPPER IMPRESSIONS 
25 
dyle region, as shown in Figure No. 11. Shape 
occlusal edge of the roll to form somewhat of a 
wedge (which we will speak of as bite block). 
Fig. No. 11 
Showing how roll of compound is attached to ridge of tray 
Soften occlusal surface of bite block over flame, 
insert impression with softened bite block at- 
tached into the mouth, and instruct patient to 
swallow and bring jaws together until the lips 
touch in repose, as shown in Figure No. 12. It 
is advisable never to use the word bite when in- 
structing patient during the procedure of bite 26 
ADVANCED IMPRESSION TAKING 
taking. The act of deglutition will automati- 
cally establish a correct bite. Cool and remove 
Fig. No. 12 
Impression with bite-block attached, in mouth after patient has 
swallowed and brought jaws together until lips touch in 
repose 
Cut away compound on occlusal surface until 
only slight indentations remain of opposing teeth. 
The preliminary impression is now ready to be 
converted into a finished impression. Place im- 
pression in the mouth and instruct patient to FULL UPPER IMPRESSIONS 
27 
close in correct bite and raise the lips so a clear 
view can be had of the rim of impression, as 
Inspecting rim of impression as to height 
Fig. No. 13 
shown in Figure No. 13. That portion of rim 
which extends well up into the soft tissues will 
be high enough for muscle trimming. Wher- 
ever the rim is found lacking in height, compound 28 
ADVANCED IMPRESSION TAKING 
should be added by using the stick and tracing 
on to proper height. Having thus established 
Showing bite-block after compound has been trimmed so that only 
slight indentations of opposing teeth remain 
Fig. No. 13 A 
the correct bite, as shown in Figure No. 13A, 
the next step is to equalize the pressure on the 
soft and hard tissue. This is accomplished by 
warming the palatal surface of the impression 
over alcohol or gas flame, dipping the surface 
so heated in hot water, inserting impression into 
the mouth without pressing impression to place, 
instructing patient to close in correct bite, while FULL UPPER IMPRESSIONS 
29 
the operator holds the impression in the region 
of six fronts, and presses firmly against ridge 
which will serve to prevent impression from slid- 
ing forward. The jaws must be held firmly to- 
gether for a minute or two until compound be- 
comes hard. The above properly executed will 
bring equalized pressure to bear under normal 
biting stress in every case. FULL UPPER IMPRESSIONS 
31 
MUSCLE TRIMMING OF UPPER IMPRESSION 
From condyle to fraenum on one side of im- 
pression soften rim of compound by passing over 
gas or alcohol flame. Dip softened rim in hot 
Fig. No. 14 
Passing impression into mouth holding the cool side, thereby per- 
mitting adjustment of warm side without distortion 
water to equalize heat, quickly pass impression 
into the mouth (cool side first to prevent distort- 
ing soft rim), as shown in Figure No. 14, in- 32 
ADVANCED IMPRESSION TAKING 
Fig. No, 15 
Grasping lip at medium line between thumb and index finger 
drawing lip together as in whistling position 
struct patient to close in correct bite and draw 
the lips forward as in whistling position and 
backward as in extreme smiling position. This 
is repeated two or three times successively. In FULL UPPER IMPRESSIONS 
33 
cases where patient is not capable to make lip 
movements the operator can accomplish the same 
Fig. No. 16 
Stretching lip backward as in extreme smiling position 
by grasping the lip at medium line between the 
thumb and index finger, as shown in Figure No. ADVANCED IMPRESSION TAKING 
34 
15, drawing the lip together and stretching lip 
backward as in whistling and extreme smiling 
position, as shown in Figure No. 16. Cool thor- 
Fig. No. 17 
Showing how compound which is curled downward is trimmed 
away 
oughly by means of spraying cold water on com- 
pound. Remove impression and muscle trim 
opposite side in like manner. The next step is 
to establish palatal length and proper adapta- 
tion. Soften compound at rear of palatal por- 
tion by passing over alcohol flame. Dip into 
hot water, insert impression into the mouth, and FULL UPPER IMPRESSIONS 
35 
instruct patient to close in correct bite, and swal- 
low. Cool thoroughly and remove impression. 
That portion of compound which has markedly 
curled downward should be cut away, as shown 
in Figure No. 17; having thus established the 
rear length, the margin so cut is slightly warmed 
over gas or alcohol flame. Again insert impres- 
sion in the mouth, instructing patient to close in 
correct bite, and with the tongue pressed up 
firmly at the rear for a minute, the compound 
having become partly cooled, the patient is asked 
to open the mouth, and, with index finger being 
wet with cold water, press margin against rear of 
palate, at the same time holding impression to 
place. Cool thoroughly and remove. Dip the 
rim of impression into hot water, quickly insert 
into the mouth, instruct patient to close in cor- 
rect bite, bringing pressure to bear in molar re- 
gion for masseter reproduction, and immediately 
open the mouth sufficiently to permit the oper- 
ator with thumb and index finger to draw the 
cheeks inward; then releasing pressure and re- 
peating once or twice, as shown in Figure No. 18. 
This will serve to adapt the margins by means 
of normal cheek pressure. The author does not 
approve of massage, which at best is only guess 
work, for the reason that massage is dependent 36 
ADVANCED IMPRESSION TAKING 
upon pressure with no guide as to the amount of 
pressure to be used for the individual case. Cool 
Open mouth permitting operator with thumb and index finger to 
draw cheeks inward. This should be repeated once or twice 
Fig. No. 18 
impression and proceed with "Masticating Fit 
Test." Saturate a piece of cotton or tissue pa- 
per with cold water, insert it into the mouth, and FULL UPPER IMPRESSIONS 
37 
isk patient to chew as though food were being 
masticated, biting in region of anterior teeth as 
well as posterior. If the impression does not 
come loose as a result of the above test, the im- 
pression is correct. A denture duplicated from 
such an impression will prove very satisfactory. 
Should the impression come loose during "Masti- 
cating Fit Test," corrections should be made 
with the cause as a basis, viz.: in the case where 
impression comes loose or drops while biting on 
the front teeth the fault will be found to exist in 
the rear third of the vault (extreme rear of pal- 
ate) ; cause: too short or faulty adaptation; this 
condition or any other that may cause impres- 
sion to come loose is corrected with precisely the 
same technic as outlined in muscle trimming. 
Simply heat portion to be corrected, insert im- 
pression into the mouth and instruct patient to 
close in proper occlusion and proceed with muscle 
trimming for correction. After impression has 
stood the "Masticating Fit Test" mark on labial 
surface of bite block a perpendicular medium 
line and horizontal high and low lip lines before 
removing impression from mouth. This will 
serve as a guide for mounting on articular. 
The foregoing applies to the case that pre- 
sents practically normal conditions of ridge, 38 
ADVANCED IMPRESSION TAKING 
palate, etc. This type of case we will speak 
of as Class A, as shown in Figure No. 19. 
Fig. No. 19, Class A 
A normal upper jaw 
Class B is that case which presents the follow- 
ing conditions: Extreme hard centre of palate FULL UPPER IMPRESSIONS 
39 
Fig. No. 20, Class B 
Showing extreme hard center of palate with a mound or lump 
which in this case is connected directly with muscles of de- 
glutition 
with a mound or lump which sometimes is con- 
nected directly with muscles of deglutition, as 
shown in Figure No. 20. 
Class B cases are treated precisely the same 40 
ADVANCED IMPRESSION TAKING 
as Class A with the added technic as follows: 
After the equalizing of pressure under normal 
biting stress has been accomplished, warm over 
alcohol or gas flame that portion of the impres- 
sion which constitutes the mound or lump. Do 
not dip in hot water. Insert impression into the 
mouth and instruct patient to bring jaws together 
firmly in correct bite, exerting extreme pressure 
and holding the jaws in this firm position for at 
least a minute or two. The compound being soft 
in the region of the mound or lump, when pres- 
sure is brought to bear, the soft tissues yield to the 
pressure of the hard compound and you have ac- 
curately created sufficient relief as per the re- 
quirement of the individual case. The author 
does not approve of mechanical relief in these 
cases. Where the muscles of deglutition are con- 
nected directly with the mound or lump the fore- 
going technic permits the finishing of the rear of 
the impression directly on the hard mound or 
lump. 
Class C is that case which is practically the re- 
verse of B in that the entire palatal surface is 
very soft and spongy, as shown in Figure No. 21. 
Class C cases differ in technic only in so far as 
it is necessary to compress or displace the spongy, 
soft tissue. This is accomplished by warming FULL UPPER IMPRESSIONS 
41 
Fig. No. 21, Class C 
Soft and spongy palatal surface 
that portion of the impression which constitutes 
the alveolar ridge over alcohol or gas flame and 
permitting the heat to penetrate the compound 42 
ADVANCED IMPRESSION TAKING 
before inserting impression into mouth (after 
ridge portion of impression has been passed over 
flame twice, wait about half a minute, during 
which time the heat will penetrate), immediately 
pass impression into the mouth and instruct pa- 
tient to close in correct bite, exerting extreme 
pressure and holding the jaws firmly closed for 
at least a minute or two until the compound be- 
comes hard. By carefully applying the above 
technic the spongy tissue will be comoressed or 
displaced under normal biting stress. FULL UPPER IMPRESSIONS 
43 
Fig. No. 22, Class D 
A soft and flabby ridge in the anterior region 
Class D is that case which presents a very soft, 
flabby ridge, as a rule, in the anterior region, but 
sometimes is confined to only one side of the jaw  ADVANCED IMPRESSION TAKING 
44 
in the region of bicuspids and first molar, as 
shown in Figure No. 22. 
Class D cases differ in technic from the Full 
Upper in so far as the tray is trimmed so that it 
only reaches up to and on the soft ridge but not 
beyond. The impression is taken as described in 
full upper, and the soft flabby ridge is pressed 
with the index finger back to its normal position 
and held there until the compound becomes hard. 
With the Kerr trace-on compound stick, which 
is the most practical for building or adding pur- 
poses, build up the labial or buccal portion of im- 
pression in region of flabby ridge; place impres- 
sion in the mouth, holding it to place with finger 
of left hand, and with index finger of right hand 
gently press the soft compound up against soft 
ridge. The base impression will prevent the 
flabby ridge from turning in toward the palate and 
in this manner you will have reproduced the soft 
flabby ridge in its normal position. The impres- 
sion is then finished as described in Full Upper. 
Class E is that case which presents abnormally 
large condyles on both sides, as shown in Figure 
No. 23. It is, however, not infrequently found 
that on one side the condyle is of normal size and 
on the other side an abnormally large condyle 
exists, as shown in Figure No. 24. FULL UPPER IMPRESSIONS 
45 
Fig. No. 23, Class E 
Abnormally large condyles on both sides 
Class E cases, where large condyles exist on 
both sides, the impression is taken the same as 
outlined in Full Upper, except that only one con- 
dyle is accurately reproduced while the condyle 
on the opposite side is reproduced by placing a 
piece of soft compound over the exposed condyle. 46 
ADVANCED IMPRESSION TAKING 
Fig. No. 24, Class E 
Large condyle on one side and normal condyle on opposite side 
following the same principle as explained in par- 
tial upper. 
In cases where only one condyle is abnormally 
large, the rim of that side of impression should FULL UPPER IMPRESSIONS 
47 
be built up and muscle trimmed completely before 
building up the opposite side. In removing im- 
pression from the mouth be certain first to re- 
lease the side with normal condyle; when placing 
impression in the mouth insert the side with large 
condyle first and the impression will go to place 
without difficulty. Fig. No. 25 
Showing facial expression without upper impression in the mouth 
48 Showing facial expression with upper finished impression in mouth 
Fig. No. 26 
49 CHAPTER II 
FULL LOWER IMPRESSIONS 
FOR taking lower impression, select a tray 
nearest in size to accommodate lower 
ridge. Soften compound as heretofore 
Showing roll of compound ready for attachment to tray 
Fig. No. 27 
explained and roll it into stick form to about the 
thickness of three eighths of an inch, as shown in 
Figure No. 27. Stick it fast to tray by means 
of heating one side of roll of compound over alco- 
hol or gas flame until it sizzles; attach the side so 
heated to tray, insert tray with compound so at- 
tached into the mouth without bringing any pres- 
sure to bear on ridge, hold in place for a minute, 
51 52 
ADVANCED IMPRESSION TAKING 
cool and remove from the mouth and place what 
we will call our compound impression tray into 
cold water until compound becomes perfectly 
hard, as shown in Figure No. 28. This insertion 
Fig. No. 28 
Compound on tray before insertion in mouth (on the right). 
Compound impression trav after taken from mouth (on the 
left) 
is made omy for the purpose of obtaining an ap- 
proximate outline of the ridge, which will serve 
as a guide and permit the compound tray with 
softened bite block in place to seat itself without 
assistance from the operator. Shape a roll of 
compound slightly smaller than that which was 
used for impression; have it long enough to reach 
from heel to heel. Heat end of roll on one side FULL LOWER IMPRESSIONS 
53 
and attach to heel portion of ridge of tray, then 
heat remaining portion of roll over small flame 
and attach to tray. While compound is semi- 
Showing roll of compound attached to ridge of tray before heat- 
ing portion which constitutes impression before insertion into 
the mouth 
Fig. No. 29 
soft, form the occlusal edge to more or less of a 
wedge shape, as shown in Figure No. 29. Heat 
that surface of compound which represents the 
impression over alcohol flame, and then pass the 
wedge-shaped, occlusal edge over flame once or 
twice. Quickly insert into the mouth, the upper 54 
ADVANCED IMPRESSION TAKING 
Showing how lower impassion with bite-block in place is inserted 
into the mouth 
Fig. No. 30 
preliminary impression with the hite block being 
in place (or opposing teeth, whichever the case 
might be), as shown in Figure No. 30; instruct 
patient to swallow, and bring the jaws together FULL LOWER IMPRESSIONS 
55 
Fig. No. 31 
Showing upper teeth imbedded into bite-block of lower impression 
after lips have touched in repose, thereby establishing auto- 
matically the correct bite 
until the lips touch in repose, as shown in Figure 
No. 31. While in that position, instruct patient 
immediately to raise the tongue to the palatal 
surface of the upper bite block or teeth, and move 56 
ADVANCED IMPRESSION TAKING 
Fig. No. 32 
Showing lips in smiling or laughing position with jaws held 
firmly together FULL LOWER IMPRESSIONS 
57 
Showing lips in whistling position with jaws held firmly together 
Fig. No. 33 58 
ADVANCED IMPRESSION TAKING 
the tongue from side to side (the mouth being 
closed while the tongue movements are accom- 
plished. The operator can plainly see whether 
or not the patient is following instructions by 
watching the registrations directly beneath the 
chin, which are caused by the tongue move- 
ments). Then quickly move the lips as in smil- 
ing and whistling, as shown in Figures 32 and 
33. Cool impression and bite block by means 
of ice water and remove impression from mouth. 
Showing lower impression witli bite-block trimmed so that only 
slight indentations appear 
Fig. No. 34 FULL LOWER IMPRESSIONS 
59 
We now have a lower impression with bite ac- 
complished under natural biting stress. Trim 
bite block so that only slight indentations of op- 
posing teeth remain, as shown in Figure No. 34. 
Should there be any excess compound (that por- 
tion of compound which has curled up is excess), 
cut it away with a knife and reheat the margins 
so cut. Insert impression into the mouth and 
instruct patient to swallow and close in correct 
Showing muscle trimmed impression with surplus cut away, thereby 
producing uniform thickness of rim 
Fig. No. 35 60 
ADVANCED IMPRESSION TAKING 
bite, and repeat tongue and lip movements as 
above. This step should be repeated where com- 
pound continues to curl up. Soften slightly 
compound of buccal rim in region of condyle 
on right and left side. Insert impression into 
the mouth and instruct patient to close in correct 
bite and exert pressure on both sides, which will 
serve to reproduce the action of the masseter as 
in biting, as shown in Figure No. 35. 
All Full Lower cases are treated alike. 
In the cases where the Full Upper and Full 
Lower teeth are to be supplied, the upper pre- 
liminary impression is first to be taken. A bite 
block is formed with a flat occlusal surface of the 
height represented by the lip length. With the 
blade of a small knife mark the medium line and 
corner lines on labial and buccal surfaces of bite 
block and remove preliminary impression with 
bite block so marked from the mouth; continue 
the three lines on the occlusal surface of bite 
block. Directly on the lines marked on the oc- 
clusal surface, trace on small V-shaped com- 
pound as shown in Figure No. 36; these will 
serve as bite guides when taking lower impres- 
sion. The next step is to take lower impression 
and complete the same before muscle trimming FULL LOWER IMPRESSIONS 
61 
upper preliminary impression. By completing' 
the lower impression first, the muscle trimming 
Fig. No. 36 
Showing V shapes on upper occlusal surface of bite block 62 
ADVANCED IMPRESSION TAKING 
of the upper is accomplished with the same ease 
as in the case where lower teeth are in place, as 
shown in Figure No. 37. 
Fig. No. 37 
Showing completed lower impression with upper V shapes 
reproduced in lower bite block CHAPTER III 
UPPER PARTIAL IMPRESSIONS 
THE first step is to plan the type of den- 
ture to be supplied. Where elasps or ad- 
hesion are to be depended on to retain the 
denture, the following key will be found of great 
assistance for final diagnosis. In cases where 
the eight posterior teeth are to be supplied, it is 
advisable that clasps should not be relied upon 
for retention, and in that case the impression 
must extend to the rear third of the vault as in a 
full upper. In practically no case is it necessary 
to use clasps where a full palate plate is to be 
constructed. Where a horseshoe or roofless plate 
is desired, the author prefers the use of properly 
constructed clasps rather than to depend upon 
retaining the denture by means of contact with 
the natural teeth; such retention will be at the 
expense of all the teeth involved. Suffice it to 
say that the objection is well founded and is 
based upon practical tests. 
The author's Nometal Tray facilitates the securing of a cor- 
rect bite in all partial cases. This cannot be secured when using 
a metal tray, for the reason that the thickness of the metal tray 
interferes with upper and lower teeth occluding in proper relation. 
63  ADVANCED IMPRESSION TAKING 
64 
All partials consist of the Base Impression 
and Face Piece (or Pieces). 
For convenience of illustration we will first 
treat with the case where the bicuspids and 
molars are to be supplied. 
Fig. No. 38 
The biting surface of tray being adapted to occlusal surface of 
teeth. (For convenience of illustration models mounted on 
anatomical articulator are shown) 
Adjust the tray as follows: Pass occlusal 
surface over gas or alcohol flame, dip the sur- 
face so heated in hot water, insert tray into the 
mouth and have patient close on tray, exerting 
slight pressure, thereby causing the biting sur- UPPER PARTIAL IMPRESSIONS 
65 
face of tray to adapt itself to occlusal surfaces 
of the teeth. The tray so adapted will facilitate 
the taking of basic impression under normal bit- 
ing pressure, as shown in Figure No. 38. 
Soften compound as heretofore explained, 
form the soft compound into a ball and heat one 
side over a gas or alcohol flame until it sizzles. 
Attach the side so heated to tray; with wet fin- 
gers shape the soft compound into a cone, well 
forward in the center of tray, a depression all 
along where the alveolar ridge will come, and a 
relatively high rim to go up under the cheeks, 
disregarding the labial portion of the standing 
teeth. Immerse the tray portion in cold water 
which will serve to chill compound in contact 
with tray. Heat the entire surface of com- 
pound over gas or alcohol flame and dip surface 
so heated into hot water. This will serve to 
equalize the heat and avoid discomfort to pa- 
tient. The tray with compound so prepared 
should be inserted into the mouth, in the same 
manner as it is proposed to insert the finished 
denture, carrying the tray partly to position, im- 
mediately instructing patient to close firmly onto 
the tray, driving impression the rest of the way 
to position. Instruct patient to hold the jaws 66 
ADVANCED IMPRESSION TAKING 
firmly closed, as shown in Figure No. 39. In- 
sert finger into the mouth and press rim of com- 
pound on buccal surface upward against the 
Showing manner in which softened compound distributes itself 
under normal biting stress 
Fig. No. 39 
ridge. That portion of compound which is 
found to encroach upon the labial surface of the 
standing teeth is removed with the blade of a 
small pen knife. The jaws should be kept 
firmly closed during this operation, permitting 
patient to open the mouth as soon as compound 
has become stone hard and not sooner. Remove UPPER PARTIAL IMPRESSIONS 
67 
impression from the mouth. The next step is 
to muscle trim the buccal rim, and establish 
palatal length and proper adaptation. This is 
accomplished in the same manner as explained in 
full upper. 
In cases where two or three teeth are to be 
supplied on each side in the posterior region, also 
several teeth in the anterior region, the principle 
is the same as described above, except in that the 
compound should extend up to and on the ridge 
between the standing teeth but not beyond the 
ridge, as the labial or buccal portion, whichever 
the case might be, will be reproduced with what 
we speak of as face piece or pieces. 68 
ADVANCED IMPRESSION TAKING 
ESTABLISHING CORRECT BITE 
To permit the upper and lower teeth to meet 
in proper occlusion without interference of tray, 
the occlusal surface of tray directly beneath the 
Showing occlusal surface of tray removed beneath standing teeth 
to facilitate direct occlusion 
Fig. No. 40 
standing teeth is removed by means of a vulcanite 
file or separating disc, viz.: dent the piece to be 
removed and it can readily be broken away, ex- 
posing compound underneath the piece of tray 
so removed, as shown in Figure No. 40, attach UPPER PARTIAL IMPRESSIONS 
69 
a small roll of compound to that part of occlusal 
surface of tray which remains, soften the occlusal 
surface of the compound by passing over flame, 
Showing lower teeth in direct occlusion with upper 
Fig. No. 41 
insert impression into the mouth, and instruct 
patient to swallow and bring the jaws together. 
The tray being properly trimmed, the lower 
teeth will imbed themselves into the softened 
compound until the upper and lower teeth prac- 
tically touch, as shown in Figure No. 41. Cool 
compound by means of ice water and remove im- 
pression and bite from the mouth, remove ex- 70 
ADVANCED IMPRESSION TAKING 
cess compound from occlusal surface, insert im- 
pression with bite attached into the mouth, and 
have patient close in correct bite. Form a small 
Fig. No. 42 
Showing face pieces for reproduction of labial and buccal surfaces 
of teeth 
roll of softened compound and place it under the 
lip opposite the labial border of standing teeth, 
draw the lip over the compound and press on the 
outside of lip with finger. This will conform 
compound over labial surface of teeth, as shown UPPER PARTIAL IMPRESSIONS 
71 
in Figure No. 42. Allow compound to cool 
thoroughly. Remove the impression by taking 
hold of some part of that which constitutes the 
base impression, and remove it in the same man- 
Fig. No. 43 
Showing completed impression with face pieces which are to be 
waxed in position for model-making 
ner as the finished denture is to be removed; the 
face-piece will either remain in position or will 
open up sufficiently to allow the impression to 
pass over the bell-shaped portion of the teeth. 72 
ADVANCED IMPRESSION TAKING 
Immediately upon removing impression and 
face-piece from the mouth, care should be exer- 
cised in accurately placing the face-piece on the 
impression; when the compound is not thor- 
oughly cooled the face-piece is apt to bend 
slightly and should be pressed back to position, 
as shown in Figure No. 43. LOWER PARTIAL IMPRESSIONS 
73 
LOWER PARTIAL IMPRESSIONS 
The technic as outlined in upper partial im- 
pressions is followed in lower partial impressions 
except muscle trimming, and this is accomplished 
precisely the same as muscle trimming in full 
lower, viz.: the act of swallowing, raising the 
tongue to the roof of the mouth and moving from 
side to side, lip and cheek movements (as in 
whistling and laughing) and masseter reproduc- 
tion as in biting. 
In cases where the bicuspids and molars are 
to be supplied, the author prefers a denture con- 
structed with a lingual bar. The position of the 
bar is automatically established, for the reason 
that the sub-lingual attachments plainly indicate 
their highest point while talking, swallowing, 
etc., anterio-lingually, and a bar placed on a cast 
made from this type of impression if bent prop- 
erly to conform to the lingual border will prove 
most satisfactory. 
The simplest and, in the opinion of the au- 
thor, the best way to construct a bar is as fol- 
lows: Take round wire of either 11 or 12 gauge 
B. & S. as per the requirements of the case in 
hand, form wire to fit lingual border, flatten the 
two ends and serrate ends where rubber attach- 74 
ADVANCED IMPRESSION TAKING 
ment is used. Place a thin piece of card bristol 
or wax of about 30 gauge over lingual border 
and set the round wire bar against the card bris- 
tol or wax and see that it is about one-eighth of 
an inch higher than is indicated by the sub-lingual 
attachments. The bar so placed will be certain 
to be free from interference with either the tis- 
sues or the tongue. CONVERTING IMPRESSIONS 
75 
"converting the impression into a 
FINISHED DENTURE" 
Too much stress cannot be laid on the impor- 
tance of the proper technic in the prosthetic end 
of the denture work. In order that an impres- 
sion may be duplicated to the minutest detail in 
the form of a finished plate, it is necessary to fol- 
low an absolutely correct technic. First, it is 
important that a model be made of the impres- 
sion from a material which will not change dur- 
ing the process of vulcanization. Second, that 
the model be so made that it will reproduce, to the 
minutest detail, the entire impression, including 
the thickness of rim and the extreme rear palatal 
length. Third, that the plate should not be filed 
at the rim or rear length of palate after it is taken 
out of the vulcanizer. If any one of these three 
procedures is not followed with perfect results, 
the entire work will be for naught; for the suc- 
cess of the denture depends entirely upon the 
duplication of the tested impression. 
The author does not approve of the use of air 
chambers, reliefs or tin foiling the palatal por- 
tion of the model, as the two former will pro- 
duce a vacuum which is undesirable and the lat- 
ter will tend to cause sufficient change to impair 
the fit of the denture. 76 
ADVANCED IMPRESSION TAKING 
"suggestions on upper and lower 
impressions" 
Should the tray become exposed through the 
compound, it indicates that that portion of tissue 
has been impinged. The exposed portion must 
therefore be filed, ground or scraped down and 
new compound added to cover it up. This added 
compound should then be heated and the impres- 
sion reinserted in mouth and an impression of 
that portion of the impinged tissue taken. 
When it is necessary to add compound to rim 
or any other part of impression, the most satis- 
factory results are obtained by immersing the 
entire impression in cold water after the soft 
compound with the Kerr Trace on Stick has been 
added. This will make the whole compound 
hard and facilitate the heating of the added por- 
tion. The even temperature of the immersed 
impression permits of an even expansion of the 
heated surface and avoids a lapping over of the 
soft compound which invariably occurs, when one 
portion of the impression is hard and the other 
soft. 
When only one denture is to be made, be sure 
to take an impression of the oposing teeth. A UPPER AND LOWER IMPRESSIONS 
77 
model is afterwards made of this impression and 
the teeth are set into the indentations formed 
by the opposing teeth on the Bite Block. This 
is necessary for mounting on the articulator. 
A practical method of bringing the masseter 
muscles into action is to place the index fingers 
on the patient's right and left cheeks in the region 
of the condyles and instruct patient to bite hard, 
and then not so hard, repeating this two or three 
times. This is easily accomplished without the 
objectional method of opening and closing the 
mouth. 
Clasps constructed with movable tails elimi- 
nate the necessity of crowning the tooth which is 
clasped, as the clasp will move independently of 
the plate and permit the natural movement of the 
tooth without interference from the clasps. If 
the clasp is properly fitted, it will not ride up and 
down the tooth and no abrasion will ensue. A 
properly constructed movable tail clasp averts a 
direct strain on the tooth so clasped, and thus in- 
sures against a weakening of the tooth. 
The author has used the movable tail clasps 
with very satisfactory results, and a number of 
dentists who have used these clasps, at the au- 
thor's suggestion, have pronounced them a sue- 78 
ADVANCED IMPRESSION TAKING 
cess. In order to obtain perfect results, it is es- 
sential that the proper material be used and that 
the technic of construction is thoroughly under- 
stood. 
"roofless dentures or plates" 
The name Roofless Plate means a denture 
whose roof center is lacking. Nearly 50 per 
cent, of full upper cases might be made roofless. 
A normal ridge and well defined condyles pre- 
sent a suitable case for the construction of a den- 
ture of this type. It is important also that the 
patient manifests a real desire for a roofless den- 
ture, as it requires greater perseverance to wear 
this kind of denture than the wearing of a full 
palate plate. 
It must be understood that immediate satis- 
faction to the patient cannot be expected with a 
denture of this type. Unless your patient is of 
a persevering nature and is willing to help retain 
the denture for the first week or two, it would not 
be advisable to attempt the construction of a 
roofless plate. 
The technic, as outlined in full upper, is fol- 
lowed precisely the same in the construction of 
a roofless plate, with the exception that the tray ROOFLESS IMPRESSIONS 
79 
should be fitted to cover only that portion of the 
palate which the finished denture is to cover. 
It is inadvisable to end the palatal portion of 
the plate directly on a hard part. If the extreme 
center of the palate is hard, it is best to end the 
plate forward of that hard center. 
THE END INDEX 
Full Upper Impressions 
Bite Block-preparation of . . 24-25-26-27-28 
Bite Block-lip registration of 37 
Compound-formation of and manipulation 20-21 
Compound-preparation of and insertion . 22-23 
Classification of cases 
Class A-Normal Case 38 
Class B-Hard Center 39-40 
Class C-Soft and Spongy Palate . 40-41-42 
Class D--Soft and Flabby Ridge . . . 43-44 
Class E-Large Condyles . . . 44-45-46-47 
Impression-trimming margins of . . . .24 
Impressions-facial expression without ... 48 
Impressions-facial expression with . . . .49 
Margins-adapting of 35-36 
Muscle trimming 31-32-33-34 
Palate-length establishing of ... . 34-35 
Palate-adapting extreme rear 35 
Rim-heighth inspection of 27 
Tray-selection of 15 
Tray-adapting of 16 
Tray-trimming of 17-18 
Tray-trimmed and reproduction completed . 19 
Test-masticating fit 36-37 
Full Lower Impressions 
Bite Block-trimming of 59 
Compound-formation for first insertion . 51-52 
Compound-formation for second insertion . 52-53 
Impression-insertion of 53-54-55 
Impression-trimming of 59 INDEX 
Margins-trimmed, reheating of 60 
Muscle trimming 55-56-57-58 
Tray-selection of 51 
Combination-Full Upper and Full Lower 
Impressions 
Bite Block-formation of 60-61-62 
Upper Partial Impressions 
Bite-establishing of 68-69 
Compound-formation of 65 
Compound-face pieces 70-71-72 
Diagnosis 63-64* 
Impression-insertion of 65-66 
Impression-trimming of and removing . . 66-67 
Muscle trimming 67 
Tray-adjusting of 64-65 
Lower Partial Impressions 
Impression-outline of 73 
Impressions-converting into finished dentures . 75 
Lingual Bar-construction of ... . 73-74 
Suggestions 
Upper and Lower Impressions . . . 76-77-78 
Roofless Dentures or Plates 
Impressions-outline of 78-79