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Chairside® Magazine Case of the Week – Episode 54: The Good, The Bad, and The Ugly: A Tale of Three Impressions

Case Study of Impressions - Dental CE Course
Launch Course

Course Objectives (2 CE Credits)

Michael C. DiTolla, DDS, FAGD

In restorative dentistry, the laboratory’s ability to fabricate a prosthesis that meets the esthetic and functional needs of the patient is directly related to the amount of biological information the clinician can convey to it. In this Case of the Week featured in Chairside® magazine, Dr. Michael DiTolla uses three impressions taken by working dentists to present the best and worst in VPS communication, highlighting both attributes to confirm and pitfalls to avoid in order to ensure a smooth transition between tooth preparation and prosthesis acquisition. Participants who view this presentation will acquire useful clinical information on what to look for and methods to implement to effectively and accurately transmit intraoral structures to the laboratory, including:

  • Tray rigidity and impingement
  • Material viscosity transitions
  • Gingival retraction methods
  • The Two-Cord Impression Technique
  • Pulls and fluid inclusions
  • Margin material around the preparation
  • Occlusal translucency

Summary

When taking conventional impressions to communicate intraoral structures to a dental laboratory, adhering to a regimen that promotes ample gingival retraction, sufficient impression rigidity and maximum intercuspation can go a long way to reducing the need for later adjustments to the resulting restoration. Effectively capturing a patient’s unique biology, as well as pinpointing potential impression pitfalls while still chairside, will increase both the quality and swiftness of the patient care a clinician is able to provide. In this presentation, Dr. Michael DiTolla uses a case example from Episode 54 of Chairside Live to highlight key components of a quality impression, as well as attributes detrimental to a successful restorative outcome, when attempting to convey error-free information to the laboratory.

CAUTION: When viewing the techniques, procedures, theories and materials that are presented, you must make your own decisions about specific treatment for patients and exercise personal professional judgment regarding the need for further clinical testing or education and your own clinical expertise before trying to implement new procedures.


References

  1. Hoyos A, Soderholm KJ. Influence of tray rigidity and impression technique on accuracy of polyvinyl siloxane impressions. Int J Prosthodont. 2011 Jan-Feb;24(1):49-54.
  2. Rajapur A, Dixit S, Hoshing C, Raikar SP. The influence of tray space and repeat pours on the accuracy of monophasic polyvinylsiloxane impression. J Contemp Dent Pract. 2012 Nov 1;13(6):824-9.
  3. Small BW. Revisiting impressions using dual-arch trays. Gen Dent. 2012 Sep-Oct;60(5):379-81.
  4. Mechanic E. Making a great impression. Dent Today. 2010 Dec;29(12):88, 90-1.
  5. Nash RW. Impression techniques: clinical properties that matter. Dent Today. 2014 Apr;33(4):110, 112-3.
  6. Lawson NC, Burgess JO. Are you removing your PVS impression materials too soon? Alpha Omegan. 2013 Spring-Summer;106(1-2):38-9.
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