While there has been a significant improvement in oral health in recent decade a significant number or people suffer with complete edentulism and require complete dentures. Traditionally a two-step impression construction technique is taught and recommended. However recent studies have suggested that a single step impression technique is effective.

The aim of this review was to assess importance of a two-step impression technique in the fabrication of complete dentures.

Methods

A search of the PubMed/Medline database for prospective randomised controlled trials (RCTs) comparing complete denture construction using a one or two-step impression technique was conducted without language or date limits. Studies were selected independently by 3 reviewers with two reviewers assessing study quality using the Cochrane Risk of bias tool.

Results

• 7 RCTs were included
• The authors did not consider the studies to be of low quality.
• All studies compared single impression step with prefabricated trays against a second impression using a customized tray.
• A range of impression materials and evaluation approaches were used so a qualitative summary was presented.
• No significant differences between dentures obtained by traditional or simplified techniques when evaluated according to user’s perception and various clinical aspects were demonstrated in the included studies.

Conclusions

The authors concluded: –

The clinical studies considered for this review suggest that, among other procedures, a two-step impression procedure contributed significantly to the costs and time in making complete dentures and is not mandatory for the success in terms of technical quality, users’ degree of satisfaction and improvements in oral health- related quality of life and masticatory function.

Comments

Only a single database was used to identify studies for this review so it is possible that relevant trials could have been excluded. While all the included studies compared one-step impression against verses two-step impression techniques a wide range of impression material and evaluation criteria were used so meta-analysis was not possible. The study sizes were only reported for 4 of the included studies and these ranged from 122 to 42 patients so the number of patients included in these studies is relatively small given the potential pool of edentulous patients. So while this review found a small number RCTs that suggest that a single impression technique may be sufficient for complete denture construction more studies to clarify the best impression material and most appropriate patients for one-step impression approaches would be helpful.

Links

Primary paper

Regis RR, Alves CC, Rocha SS, Negreiros WA, Freitas-Pontes KM. The importance of a two-step impression procedure for complete denture fabrication: a systematic review of the literature. J Oral Rehabil. 2016 Jun 21. doi: 10.1111/joor.12418. [Epub ahead of print] Review. PubMed PMID: 27328133.

Other references

Dental Elf -25^th Feb 2013

Trial suggests that simplified technique for complete denture fabrication results in similar masticatory performance as traditional approaches

Dental Elf -23^rd Jan 2013

Limited available evidence suggests that a one-step impression technique is sufficient for the majority of edentulous patients