Precision Prosthodontic Rehabilitation of Flabby Ridge with a Modified Window Technique: Case Report

Abstract

Flabby ridge, also known as a soft (mobile), movable, or displaceable ridge, presents a common clinical challenge in dental practice. It primarily affects the alveolar ridges of the upper (maxillary) or lower (mandibular) arches. The anterior region of the maxilla is especially susceptible in edentulous patients. The flabby ridge lacks the firmness and stability required, leading dentures to become loose and unstable. Consequently, this instability can result in discomfort, speech and eating difficulties, and reduced quality of life for denture wearers. The flabby ridge often does not provide the necessary contour and resilience needed to establish an effective seal and maintain suction between the denture base and the underlying tissues. This compromises denture retention, making them susceptible to dislodgement during typical oral functions. Therefore, rehabilitating a completely edentulous patient with flabby tissue presents a formidable challenge for prosthodontists, as it undermines the retention, stability and support of complete dentures. Methods for managing flabby ridges encompass surgical removal, ridge augmentation, specialized impression techniques, balanced distribution of occlusal loads and implant therapy. Various impression techniques have been proposed to address the complexities of such cases. By carefully applying the principles of complete denture construction, a palliative treatment approach can be achieved. Special impressions often employ the window technique to capture a static impression of the flabby area, which introduces its own set of challenges. This innovative case report introduces a modified window technique that incorporates precise record transfer of the flabby ridge using tissue (blotting) paper. Specifically designed for the anterior mandibular flabby ridge, the technique employs a custom tray with a window positioned over the flabby tissues. A mucostatic impression material is utilized to minimize pressure on the flabby tissue, thereby reducing potential tissue distortion during the impression process. The procedure is executed in two steps: first, stable structures are recorded, followed by capturing the mobile tissues using light-body polyvinyl siloxane (PVS) elastomeric impression material within the window area. This method ensures an accurate record of the denture-supporting structures while maintaining the contour and details of the flabby tissues without displacement. Importantly, the technique is crafted for straightforward implementation by general dental practitioners within a primary dental care setting.