Sectional Impression Tray With Reusable Handle: A Single Solution for All Microstomia Cases

A dimensionally accurate impression is one of the primary determinants for the precise fabrication of complete denture prostheses in microstomia patients. This can be achieved with the help of sectional trays. This technical report describes the fabrication of a sectional impression tray with a reusable sectional handle using magnets. The handles can be sterilized and reused, thus saving clinical time for future use. The proposed method provides ease of reassembling and disassembling, easy placement, and guided orientation of the two tray segments.


Introduction
Microstomia is a condition that affects the size of the oral orifice, resulting in an abnormally small opening. It can be caused by a variety of conditions such as surgery, trauma, burns, radiotherapy, or temporomandibular joint diseases [1][2][3]. While it is not a disease in itself, it can lead to other medical issues, including difficulty with eating and speaking. Microstomia can significantly impact the quality of life and should be treated as soon as possible to minimize any long-term effects.
The insertion of a standard stock and custom impression tray presents initial difficulty in prosthetic rehabilitation. Various sectional impression trays are described in the literature [4][5][6][7][8][9]. These sectional tray designs are successful in making an accurate impression, but every time a new case comes to the hospital, a new tray design needs to be planned instead of using a standardized design for all patients.
The purpose of this article is to describe the standardized technique for the fabrication of sectional dentulous stock impression trays and edentulous custom impression trays for multiple microstomia patients using the reusable metallic sectional handle. Fabricated sectional handles can be sterilized and reused, thus saving clinical time for future use.

Fabrication of a tray handle
The handle has two parts, the male and the female unit ( Figure 1).

FIGURE 4: Secondary impression
A: sectional custom tray; B: interlocked custom tray

Discussion
A dimensionally accurate impression is one of the primary determinants for the precise fabrication of complete denture prostheses in microstomia patients. This can be achieved with the help of sectional trays. A sectional tray with a reusable handle helps ease the placement and guided orientation of the two tray segments. The added advantage is that it's simple to use and provides the ease of separating and rejoining the tray in the patient's mouth. Hence, a rigid nonelastic impression material was used. Both elastomeric and non-elastomeric impression materials were used in a similar technique [8][9].
Sectional handles were fabricated using magnets since their strong attractive force forms a stable assembly in all directions once the right and left units are interlocked. If magnets are not available, different interlocking attachment designs can be fabricated in the handle itself, but care needs to be taken that it has to be done with a lot of precision to prevent misalignment of the two sections.
Lego blocks [4,7] and locking levers [9] were used for the fabrication of mandibular sectional impression trays, but their use in maxillary sectional impression trays was questionable. It can also be used for both edentulous as well as dentulous patients for making an impression of both arches.
The disadvantage of this technique is that modification of metal stock trays is not as easy as compared to plastic stock trays.

Conclusions
This clinical report describes the fabrication of a sectional tray with a reusable handle retained by magnets for a microstomia patient. A sectional impression tray provides ease of reassembling and disassembling and is stable in all directions, thus overcoming difficulties associated with making impressions in microstomia patients.

Additional Information Disclosures
Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue.

Conflicts of interest:
In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.