1. ChairSide Essentials For more than 100 years, your most
Profitable Dental
Impressions:
TISSUE MANAGEMENT
You intend for impressions to
make you money, but often times
they can cut into your profits.
New technologies for “impressions” continue to hit the market making
this necessary task easier and more predictable. Regardless of the tech-
nology used to obtain the impression, one factor remains critical to get-
ting a good impression: Tissue management, the ability to effectively
create and maintain a dry field with adequate retraction. *
This article discusses techniques to help achieve this task so that
whether you take a traditional or digital impression, you’re more likely
to get the results you desire.
I deally, a first impression on a prepped tooth will be all that is need-
ed to create a well fitting restoration. In many offices, this is fre-
quently not the case. Many times, multiple impressions are taken to ren-
der one the lab can work with. Or worse, problems arise when a techni-
cian has to call requesting additional definition of the margin. Even
worse, the lab attempts to create a restoration from the questionable
impression. Then upon attempting to seat the restoration, it does not fit
requiring additional remakes, patient appointments, and lab involve-
ment. This problem is not only frustrating and often times embarrassing,
but it is the cause of lost revenue to the practice.
www.nashvilledental.com 16 615-860-7100
2. trusted source for dental supplies and equipment. Spring 2009 Edition
A large number of offices complain of retakes and
remakes. In discussing this issue with a number of labs, a
common issue is poor tissue management. While there
are a number of things that can contribute to problems
with an impression, this article will deal with tissue man-
agement and the tools available to provide the best pos-
sible field for recreating the margin with dental impres-
sions.
When creating a cast or ceramic restoration, the ability
to record the prepared margin is a critical factor in fabri- Poor Retraction and Syringing Technique
cating a well fitting result. Soft tissue management for a
final impression is dependent on the ability to create suf-
ficient space to visualize the prepared margins while
maintaining a dry field. This is true for traditional
OFFICE MANAGEMENT
impression materials as well as for the newer digital
TISSUE MAINTENANCE
impression systems. Even with CAD/CAM systems, the
operating field must be well isolated during the imaging
process to record an accurate image of the margin.
Tissue Management consists of two key elements: Poor Retraction - Insufficient Tear Resistance
hemostasis and retraction. These can be achieved in a
number of ways. It is best to keep a few different tools at Ferric Sulfate is a very popular fast acting agent giving
your disposal depending on the situation. Common rapid coagulation. In some patients, ferric sulfate has
tools include: been known to blacken the tissue, leading to the need to
A. Hemostatic Liquids/Gels clean the area prior to taking the impression. In many
B. Retraction Cords cases, this can often cause hemorrhaging to recur.
What causes Ferric Sulfate to stain the soft tissues?
C. Retraction Pastes The so-called “staining” is the ferric ion combined with the
D. Electrosurge coagulum plugging the once bleeding blood vessels. Because
of this, in thin tissue patients or areas with an excessive num-
E. Lasers ber of open vessels, the coagulum plugs may be more visible
and discoloration of the affected tissues would be noticeable.
Hemostatic Liquids/Gels - come in different chemical This will clear in the normal 24 to 48 hours.
compositions that react differently with tissue.
Sometimes when ferric sulfate is used for fluid control, a stain
is left around the gingival margins and has been know to last
Buffered aluminum chloride has been a traditional
20 days or more in some cases. The "staining" that the den-
chemical that gives adequate hemostasis in most sit- tists are seeing may be the coagulum plugs in the cut capillar-
uations. A well known product containing this ies. Like any cut tissue injury, it will take time for the tissue to
chemical is Hemodent by Premier Dental. heal and the coagulum to dissipate, at which time the tissues
should return to their original state. It is important for the
Epinephrine is a well known hemostatic agent due dentist to rinse really well with a firm air/water spray after
to it’s ability to constrict the vessels. It is limited to placing the ferric sulfate and cord as well as when the cord is
removed. This will wash any residual chemical off the tissues.
use on patients with no known heart conditions. Note: If ferric sulfate is used with epinephrine there is a reac-
Gingi-pak makes Orostat, an epinephrine solution tion that can cause the gingival tissue to temporarily turn a
that pellets, cords and other cotton products may be dark blue or black color. It is best to use ferric sulfate with
dipped in. Many retraction cords come impregnated plain, non-impregnated cords. It is also important to thor-
with epinephrine. oughly rinse any residual chemical from the site prior to
bonding. (A hibiclens or CHG wash can further assure a
clean site for bonding.)
* This article assumes that the practitioner is attaining adequate axial and occlusal reduction and is maintaining adequate biologic width. It also assumes that the correct
instrumentation is being used to create the appropriate margin for the restoration type selected. These things being true, tissue management continues to be critical in final
impression accuracy.
1-800-861-6105 17
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3. ChairSide Essentials For more than 100 years, your most
Profitable Dental Impressions
...continued from page 17
...continued
Aluminum Sulfate is a fast act- Twisted Cord - tration by even the smallest of pack-
ing chemical that contains no Gingi-pak’s ing instruments. Because of the
epinephrine and is safe on heart Original 2-Ply and unique weave characteristics, the
patients. While hemostasis is Crown-Pak® 4-Ply retraction cords braided cords create a more visible
slightly slower than the ferric were the first impregnated dry pack retracted tissue than knitted cords
sulfate products, aluminum sul- cords produced for the dental pro- because they do not collapse under
fate achieves excellent hemosta- fession. Introduced in 1955, they pressure.
sis and tends to leave a cleaner remain the product of choice for
field with less need for clean up those dentists who want the ability STEP 1 Regardless of which
before impressions are taken. to adjust the physical quantities of cord is chosen, the
the cord to match clinical situa- most recommended technique for
Hemostatic gels have become very tions. The soft 2-ply and 4-ply achieving and maintaining a dry
TISSUE MANAGEMENT
popular because of their ease of cords are loosely wound and the blood free field for impression
placement and ability to control strands are easily separated, twisted material is the double cord tech-
and lubricate the cord for easier or combined to make it readily nique where the first cord is left in
packing. A clear version is available adaptable for use in the gingival sul- place for the impression. This cre-
from Pascal that aids in visibility cus, regardless of the sulcus size and ates a “V” shaped sulcus which aids
when packing the cord. is suitable for all techniques, includ- in the impression material captur-
ing the 2-cord technique. Several ing the margin much better.
companies now offer a twisted Syringe a hemostat-
cord. STEP 2 ic gel around the
sulcus. This not only begins the
Knitted cord con- hemostatic reaction but it also lubes
sists of 100% cot- the cord and helps to facilitate pack-
ton cord knitted ing and retention of the cord. (Note:
into interlocking chains to facili- When using a hemostatic gel, or wetting a
tate easy packing of the cord into cord with a hemostatic solution, different
the sulcus. This minimizes chemicals should not be mixed. This
unraveling and fraying during could cause temporary and even perma-
nent discoloration of the tissue. Be sure to
packing. During crown prepara- use like solutions if wetting impregnated
tion knitted cord will not entan- cords.)
gle diamond burs. Cord can be
soaked in a hemostatic solution Choose two sizes of
STEP 3 cords. The first is a
of choice. Knitted loops absorb
and transport significantly small size cord packed to help with
greater quantities of hemostatic hemostasis and to open the tissue
solution or gel providing more up. The second cord is a larger cord
effective hemostasis. that achieves the primary objective
of retraction. Leave the cords in
Retraction Cords come in a wide Braided cord has a place for 3-5 minutes.
selection of sizes and composition. unique braided con-
Each type has its benefits. The figuration giving the Slowly remove the top cord. Rinse
most common types of cords are 100% cotton cord clean and dry the area leaving the
twisted, braided & knitted. A com- excellent handling characteristics first cord in place. Take the impres-
plete listing of cords can be found that packs easily and remains in sion before removing the second
on page 23. place. The tight weave resists pene- cord.
www.nashvilledental.com 18 615-860-7100
4. trusted source for dental supplies and equipment. Spring 2009 Edition
Expasyl
E
very so often, a product is introduced that has a composed of
significant impact on the way we practice den- kaolin (a clay sub-
tistry. When that product provides quick, pre- stance) and alu-
dictable soft-tissue management for crown and bridge minium chloride
procedures, it's a certain success. Expasyl has proven to (an astringent
be a valuable adjunct for taking accurate impressions. that controls gin-
One significant advantage of Expasyl versus convention- gival bleeding).
al retraction methods is its time savings. Also, the control
of soft-tissue deflection combined with hemostasis It is dispensed
means the quality of final impressions and the fit of labo- into the sulcus
ratory restorations are significantly improved. Expasyl with a special
TISSUE MANAGEMENT
also creates the ideal environment for bonding of final delivery gun. It is thick and firm allowing the material to
restorations. gently displace the gingival tissue. The hemostasis is
achieved with the presence of the aluminium chloride. It
Expasyl is a paste-like material that is used for gingival creates a beautifully dry and clean sulcus that is ready for
retraction and hemostasis leaving the prepared field an impression or restorative procedure in a much short-
clean, retracted and dry, ready for impressions or for er time than conventional techniques and is gentler to
other restorative procedures. This product is primarily the soft tissues.
Images courtesy of Kerr Dental and Dr. Christopher CK Ho, BDS HONS (SYD), GRAD DIP CLIN DENT (ORAL IMPLANTS), Sydney Austrailia
Alternative Retraction Materials & Pastes
Expasyl™ Gingival Magic FoamCord -
Retraction System - Coltene Whaledent
Kerr The first expanding VPS
A fast, safe and painless alter- material designed for easy
native to packing retraction and fast retraction of the sul-
cords. Expasyl is a paste for cus without pressure or pack-
gingival retraction that not only ing.
opens the sulcus but also
leaves the field dry, ready for Intro Kit
the impression taking or Contains: 2 - 50 ml cartridges, 30 mixing tips yellow (C6550) and 30
cementation. oral mixing tips (C6555), 10 each Comprecap Anatomic #1, #3 and
#5.
Starter Kit C6735 . . . . . . . . . . . . . . . . . . . . . . . 139.99
Contains: 6 Capsules Retraction Paste (1g each-6g total) 12 Applicator
Tips, Applicator Gun Refill
32379 . . . . . . . . . . . . . . . . . . . . . . . 345.59 Contains: 2 - 50ml cartridges
Capsules (20/pk) C6737 . . . . . . . . . . . . . . . . . . . . . . . . 112.99
31172 . . . . . . . . . . . . . . . . . . . . . . . 304.99
Applicator Tips (40/pk)
31173 . . . . . . . . . . . . . . . . . . . . . . . . 85.39
Applicator Tips (100/pk)
32264 . . . . . . . . . . . . . . . . . . . . . . . 159.69
Applicator Gun
33167 . . . . . . . . . . . . . . . . . . . . . . . 337.59
1-800-861-6105 19
www.nashvilledental.com
5. ChairSide Essentials For more than 100 years, your most
L a se r Tissu e M anageme nt
The lower price of diode lasers has put them in the forefront as a viable instrument of choice for this procedure.
While this option does not offer speed, with practice, it can become as quick as cord assisted management with
more predictable hemostasis. With careful control of the power settings and fiber tip movement, the diode laser
offers excellent tissue management and hemostasis with little risk of recession after healing.
TISSUE MANAGEMENT
www.nashvilledental.com 20 615-860-7100
6. trusted source for dental supplies and equipment. Spring 2009 Edition
Tr oughin g with an E lec tr osu r ge
The use of electrosurgery to excise gingival tissues has been a common choice for clinicians for some time. The elec-
trosurge will cut and simultaneously create effective hemostasis. One key cosmetic concern with electrosurgery is
the heat generation due to misuse that can lead to irreversible damage to the alveolar crest. This effect can lead to
recession having a negative effect on the gingival margin. The PerFect® TCSII by Coltene Whaledent claims a choice
OFFICE MAINTENANCE - EQUIPMENT ROOM
of settings that fine tune the instrument for this sensitive procedure. When used as recommended, the PerFect®
TCSII has been successfully used in this procedure with uneventful healing.
TISSUE MANAGEMENT
Receive Free
8 pack of
electrodes when
you buy a
complete unit.
PerFect TCS II S8115 -
®
$1,289.00
Includes: 115 Volt Unit, Cord Assembly, handpiece
• •
holder, 3 sheaths: coag ball, 45 straight knife, 45
straight loop, user guide/technique video
1-800-861-6105 21
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7. ChairSide Essentials For more than 100 years, your most
H em ostati c Age nts
Gel Cord Blue - 25% Aluminum Sulfate Hemodettes
30g Jar (bulk jar for dispensing into a dappen dish and (Unit-Dose)
dipping the cord into or applying with a microbrush
20% buffered alu-
applicator.)
15-510 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22.69
minum chloride
lubricating hemostatic gel with saturated cotton pellets
Pro Pack 12 Syringe
packaged in unique plastic cups with attached finger ring.
Contains : 12 - 1gm syringes and 14 tips Unit-Dose packaging eliminates cross-contamination.
15-540 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41.99 Light blue color indicates area of placement. The gel vis-
cosity enhances placement and eliminates migration
Pro Pack 40 Syringe from the site. Cranberry flavor.
Contains : 40 - 1gm syringes and 50 tips
15-545 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111.79 13150 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22.49
Gel Cord Clear - 25% Aluminum Sulfate Styptin - DUX
30g Jar (bulk jar for dispensing into a dappen dish and 20% buffered aluminum
dipping the cord into or applying with a microbrush chloride
applicator.) A fast-acting, hemostatic solution in
15-810 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19.99 a lubricating base. The blue color shows the operator
Pro Pack 12 Syringe where the solution is placed. The increased viscosity pre-
TISSUE MANAGEMENT
Contains : 12 - 1gm syringes and 14 tips vents the solution from migrating from the site. Squeeze
bottle allows easy dispensing and minimizes the possibil-
15-840 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41.99
ity of cross-contamination. Cranberry flavor.
15ml Squeeze bottle
Stat Gel FS - 15.5% Ferric Sulfate 13157 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.49
30g Jar (bulk jar for dispensing into a dappen dish and
dipping the cord into or applying with a microbrush
applicator.)
Hemogin-L - DUX
15-710 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19.99 25% aluminum chloride
Pro Pack 12 Syringe A lubricating glycerin base. An eye dropper
is provided to eliminate cross contamina-
Contains : 12 - 1gm syringes and 14 tips
tion. Applied with cotton pellets to the gin-
15-740 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41.99 gival tissue, or pre-saturate retraction cord.
Pro Pack 40 Syringe 10cc dropper bottle
Contains : 40 - 1gm syringes and 50 tips 13057 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.99
15-745 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111.79 40cc bottle
13052 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45.99
Quick Stat FS Gel -
15.5% Ferric Sulfate - Stat-Flo Hemostatic Delivery Tips -
Vista Dental Vista Dental
Value Pack (40 prefilled
syringes with stat-flo delivery
tips)
502800 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .76.39
19ga Prebent (Yellow) Single Use - Disposable Tip
Curved cannula for optimal entry. The soft bristle end
Stasis® - Gingi-Pak allows for non-evasive brushing of solutions. Has a uni-
versal luer lock style hub to be used with any luer lock
syringe. Polyester bristle allows for spreading of viscous
A 21% liquid ferric sulfate hemostyptic
solutions while stiff enough to avoid metal canula contact
formulation offering unsurpassed hem-
with soft tissue.
orrhage control, when measured against
any non-epinephrine solution. 40ml
20pk refill
312102 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.99
13115 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34.69 100pk refill
312100 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48.49
FS Hemostatic
Solution - Premier
A 15.5% ferric sulfate liquid
solution. Epinephrine Free.
1oz Dropper Bottle
9007057 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.19
2oz Refill Bottle
9007058 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.29
www.nashvilledental.com 22 615-860-7100
9. ChairSide Essentials For more than 100 years, your most
Soft Tissue Lasers
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Hoya - The DioDent Micro 980™ Ivoclar - Odyssey Navigator Kavo - GENTLEray 980 Classic
Represents the next generation of diode soft-tissue The Odyssey Navigator features technology that The GENTLEray 980 soft tissue diode laser, used
dental lasers from HOYA ConBio™. It is ideal for provides more convenience, easier operation, for oral soft tissue procedures, is the easiest to
dental professionals who would like an affordable
more flexibility and unmatched portability: integrate into your practice.
DIODE SOFT TISSUE LASERS
way to enter the world of laser dentistry. The versatil-
ity, efficiency, and cost-effectiveness of the DioDent * Touch screen monitor
* Intuitive design and navigation ability make The GENTLEray 980 diode laser delivers excel-
Micro 980™ allow for a rapid return on investment
program simple and easy. lent clinical results and outstanding ease of use
and increased growth potential for dental practices.
* Inverted screen capability with the handpiece design you know and trust
The DioDent Micro 980™ is used for aesthetic smile * Allow for incredible flexibility by keeping the screen from KaVo. The 980nm wavelength provides the
designs, periodontal therapies, fibroma recoveries, readable in any orientation. best combination of clean cutting and excellent
gingivectomies, implant recovery, tooth exposures, * Uni-dose fiber tips hemostasis in a wide range of soft tissue indica-
gingival troughing, and frenectomies. Its light weight * No cleaving, no stripping of fiber just snap on and tions.
and portability make the DioDent Micro 980™ ideal for you’re ready to lase.
dental professionals with multiple operatories. * Ergonomic hand piece design
* Arc design fits comfortably in your hand The well-balanced, patented KaVo handpiece
Why Choose the DioDent Micro 980™? * Lithium Polymer battery 45 minutes of portable provides individual adjustment of the fiber length
* Next-generation diode laser — built on years of lasing in combination with superior touch and feel. The
experience • Portability direct fiber running through the handpiece
* Single Strip laser fiber (The jacket may be C-Flex or ensures maximum transmission of laser energy
The Odyssey Navigator is the first truly portable
Silicon tubing) reaches the treatment point.
diode laser. The unique design features a docking
* Autoclavable laser fiber storage spool www.kavousa.com
cradle that secures the Odyssey Navigator on a
* Intuitive touch screen controls
countertop and provides a charging base for the
* Pre-programmed & customized presents
rechargeable battery. Incorporating a state-of-the-art
* Grab-and-go handle
lithium polymer battery allows you complete freedom
* Dimensions: 9”W X 2”H X 7”D
to use the Odyssey Navigator in any operatory in
* Low entry price, rapid return on investment
your office.
658-0500 . . . . . . . . . . . . . . . . . . . . . . . .$8,249.00 603302 . . . . . . . . . . . . . . . . . . . . . . . .$11,749.00 1005.2900 . . . . . . . . . . . . . . . . . . . . . .$9,995.00
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Ivoclar - Odyssey 3W Ivoclar - Odyssey 2.4G Kavo - GENTLEray 980 Premium
The Odyssey 3Watt Diode Laser is a high per- The Odyssey 2.4G Diode Laser is a high perform- All the benefits of the GENTLEray 980 Classic
formance soft tissue laser that combines 810 nm ance soft tissue laser that combines 810 nm laser plus:
laser wavelength with excellent design, innovative wavelength with excellent design, innovative and
and user friendly features and consistency and user friendly features and consistency and safety • Includes water cooling accessories
safety for clinicians and patients. for clinicians and patients. • Frequency 20,000 Hz, burst mode
• 2 standard laser fiber handpieces
The Odyssey 2.4G Diode Laser has several
The Odyssey 3Watt Diode Laser has several • 2 water cooling handpiece kits
unique features all of them providing operators
unique features all of them providing operators • 2 Laser Fiber Diameter, 200ìm / 300ìm
efficiency, convenience and performance. For full
efficiency, convenience and performance. For full details, click on the featured items to the right.
details, click on the featured items to the right. Water Cooling provides fast healing and
• Features Laser wavelength of 810+/-20nm that has the more comfort for your patient
highest affinity hemoglobin and melanin making the laser • Reduction of heat effects results in lower pain
• Features laser wavelength of 810+/-20nm that has the a precise, least invasive and least traumatic tool to perform
highest affinity hemoglobin and melanin making the laser sensation for the patient before and after treat-
soft tissue procedures.
a precise, least invasive and least traumatic tool to per- • Aiming beam to assist with the location and placement of
ment
form soft tissue procedures. the laser. 630 nm laser pointer that serves as a guide • Reduction of charring and coagulation zones
• Aiming Beam Control – provides 5 Levels of illumination • Blood is removed from dental pockets after scal-
• Aiming beam to assist with the location and placement in 20% increments. It is elective, does not need to be on ing and root planing, so that sulcular debridement
of the laser. 630 nm laser pointer that serves as a guide for the Odyssey 2.4G to be effective can be performed more efficiently
• Aiming Beam Control – provides 5 Levels of illumination • Three user defined programs, each determines power, • Increased efficiency and fast cutting results in
in 20% increments. mode of operation and aiming beam intensity of illumina- less treatment time for doctor and patient
tion. www.kavousa.com
• Offers two modes of operation – Continuous Wave • Wireless Pedal – the first dental laser featuring wireless
and Pulsed Mode technology for portability, flexibility and ease of use.
603286 . . . . . . . . . . . . . . . . . . . . . . . . .$8,499.00 595126 . . . . . . . . . . . . . . . . . . . . . . . . .$9,915.00 1005.2899 . . . . . . . . . . . . . . . . . . . . .$13,295.00
*Six payments of $1,416.15 plus tax *Six payments of $1,652.50 plus tax *Six payments of $2,215.83 plus tax
www.nashvilledental.com 24 615-860-7100
10. ChairSide Essentials For more than 100 years, your most
Dental Impression
Technology Advances
Dental Impressions have long been a critical step in the crown and bridge procedure. Getting a good
dental impression is still one of the most important aspects of producing a well fitting restoration that
requires little adjustment. In order to achieve this, the dental profession as well as materials manufac-
turers have developed hundreds of techniques and materials. All these materials claim to be a key fac-
tor in reducing or eliminating retakes and remakes. In spite of these innovations and product enhance-
ments, in the December 2005 issue of Dentistry Today, it was estimated that among US dentists,
remakes cost the dental profession a combined total of $3.2 billion dollars in dental revenues. This was
DENTAL IMPRESSIONS
directly linked to quality of dental impressions. This article will look at the newest technologies avail-
able for getting a good impression and will compare traditional impression systems to the new digital
impression technology. ...continued on page 28
www.nashvilledental.com 26 615-860-7100
11. trusted source for dental supplies and equipment. Spring 2009 Edition
DENTAL IMPRESSIONS
1-800-861-6105 27
www.nashvilledental.com
12. ChairSide Essentials For more than 100 years, your most
Impression Systems:
Traditional Dental Impressions:
R
egardless of technique, some steps are always
required in order to get optimum results.
Adequate axial and occlusal reduction, parallel
sides, good tissue management, and adequate mainte-
nance of 3-4 mm of biologic width are some of the non-
negotiable criteria that must be performed well to get
the desired results.
Beyond this, there are critical issues specific to tradi-
DENTAL IMPRESSIONS
tional impression taking in order to get optimum
results. Factors that play into poor performance of a
good material can include technique of the operator Caulk), and Imprint 3 (3M/ESPE). Due to the
and the patient’s ability to comply during the critical extremely hydrophyllic properties of these materials,
intraoral set time of the material. A good impression they have captured the largest share of the impression
requires the following: material market.
1. Uniform, homogeneous mix of material
(no air bubbles, no glove residue or hemostatic chemical inhibi- Because this is such an important component in the
tion.) crown & bridge procedure, attempting to cut costs on
2. Tray is sufficiently filled with impression material impression material is rarely a profitable decision. With
3. Thoroughly applied tray adhesive chair time ranging from $300 - $600 per hour, one
4. Rigid, sturdy impression tray remake a month could cost an office from $3,600 -
5. No voids or pulls on margin detail (tissue mgmt is $7,200 per year. If purchasing an economy impression
critical as well as material strength and elastic properties) material saved the office even $1,000 a year, the net
6. Detailed margins with no tears or rough surfaces cost of this decision to the office would be a minimum
7. No tray show-through of the impression material of $2,200. So when choosing an impression material,
(adequate syringe mtrl around prepped area is critical) make sure to invest in high quality materials.
8. Good blend between heavy body and light body
materials While the properties of the material are not always the
9. Strong bond between impression material and tray cause of a poor impression, quite often, a high quality
10. No tooth contact with the tray (controlled, careful seat- material can help to minimize the effects of inadequate
ing of the tray and patient ability to comply during set) tissue management. It is very difficult to find an office
11. Complete information about the impression mate- that is impression perfect one hundred percent of the
rial used provided to the dental laboratory (good time. There are numerous parameters that can affect
communication with the lab and ability to adjust technique as
the final results of this process. However utilizing good
needed)
material and techniques can help to reduce the failures.
When using traditional techniques, the choice of a high
quality material is critical. While many different mate- Nashville Dental stocks a majority of the best perform-
rials are available: hydrocolloid, rubber base, alginate, ing impression materials sold. In addition, we stock
addition silicone, polyether, and vinyl polysiloxane everything needed to choose your armamentarium for
(VPS), the most prevalent are polyether (Impregum), tissue management. If your impressions are not achiev-
and VPS materials. According to SDM, a company ing the optimum results, ask your representative to dis-
dedicated to market research of the dental materials cuss the various options that are available and allow us
market, the top products sold in 2008 in the US market to find the right product for your technique.
were Impregum(3M/ESPE), Aquasil Ultra(Dentsply
www.nashvilledental.com 28 615-860-7100
13. trusted source for dental supplies and equipment. Spring 2009 Edition
Digital Dental Impressions:
S
ome of the common problems with traditional occlusion. From there, the
impressions include: patients with a strong gag Lava C.O.S. continues to maxi-
reflex, selection of appropriate material, avoiding mize productivity by elimi-
residual sulfur or chemicals on the prepped area that can nating steps at both the
inhibit set, impression distortion, drags and pulls, mate- dental office and the lab.
rial tears at the margin, retakes, and material waste.
With new technology, the ability to eliminate these Steps Eliminated at the Dentist Office
problems is quickly becoming a reality for the everyday » Tray Selection
dental practice. » Material Dispensing
DENTAL IMPRESSIONS
» Material Setting
The in-office CAD/CAM systems have been well » Disinfection
received in many offices; however, not all offices want to » Packaging
adjust their scheduling to accomodate the time required » Shipping Impression
to deliver the restoration the same day, nor do their
budgets allow for the up front costs of a milling station. Steps Eliminated at the Lab
For those offices that prefer to utilize their chair time » Plaster Pouring
with traditional scheduling, the digital impression sys- » Base & Pin
tems are ideal. » Die Cutting
» Trimming
The Digital Workflow, beginning with a digital dental » Articulation
impression, is a highly efficient, indirect restorative » Scanning
process used by dentists and labs to deliver a comfort-
able patient experience and a high-quality, precise-fit- Whether you decide to use a traditional process, like
ting restoration. PFM, or sophisticated CAD/CAM processes, including
Lava™ Restorations, the Lava C.O.S. initiates the digital
The efficiency begins with the very first step: capturing a
workflow by providing a highly accurate digital impres-
digital impression with the Lava™ Chairside Oral
sion resulting in an extremely precise model for creating
Scanner C.O.S. As long as tissue management is good,
the restoration desired.
this new system will allow you to quickly take digital
impressions of the prepped arch, opposing arch and
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