Tissue Management, Impression Making, Definitive Casts and Dies (Pt. I) Flashcards by J L

Introduction

oImpression must include:
n Sufficient \_\_\_\_ tooth structure immediately adjacent to the margins
pTo identify contour of tooth and prepared surfaces
n All teeth in \_\_\_\_
pAllows casts to be accurately \_\_\_\_
pLingual surfaces anterior teeth
nInfluence \_\_\_\_
n Soft tissues immediately surrounding
tooth preparation

unprepared
arch
anterior guidance

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Include unprepared tooth structure to develop ____

contours

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Avoid:

(1) ____
(2) Tears
(3) ____
(4) Other imperfections

For optical impressions, avoid: ____

> >

Inaccuracies in ____

air bubbles
thin spots
artifacts
restoration fabrication

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Introduction

oMoisture control
n One of the most important aspects of \_\_\_\_ making
n Control \_\_\_\_
n Control \_\_\_\_
n Moisture may result in \_\_\_\_

successful impression
saliva
bleeding
VOIDS

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(1)Tissue Health

oMust evaluate health of surrounding soft tissues
o____ must be treated and resolved before fixed prostheses placed
oAttempt to minimize ____ damage during preparation
n Especially with ____ preparations, may be unavoidable
oWell-____ provisional restoration imperative to restoring gingival health

Soft tissues must be returned to optimum state of health prior to impression making

periodontal disease
soft tissue
subgingival
contoured

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(1)Tissue Health
Poor contours contribute to ____ and ____ of gingival tissues

Must reduce ____ prior to impression

inflammation
recession
inflammation

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(1)Tissue Health

oOften better to ____ impression making and improve oral health
n Quality ____restorations
n Reinforce homecare

oMinor gingival hemorrhage
n ____
n Infiltrating a ____ directly into gingival papilla

delay
provisional
astringent
local anesthetic

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(2)Saliva Control

oSeveral techniques for dry field
n \_\_\_\_
n \_\_\_\_
n 􏰀\_\_\_\_􏰁 angles
n Different \_\_\_\_ available
pAntisialagogic action pPrescribe cautiously

cotton rolls
saliva ejectors
dry
medications

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(3)Displacement of Gingival
Tissues

oOften needed to gain access to prepared tooth oCan be achieved by
n Mechanical
p____ (most effective)
p____ with direct pressure

n Chemical
p____ or epinephrine cause
localized soft tissue shrinkage

n Surgical
p____, excision with scalpel or electrosurgery or laser

gingival retraction cord
foam or paste

aluminum sulfate
curettage

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(3)Displacement of Gingival
Tissues

oDisplacement cord
n Non-____ cord
n Chemically impregnated cord or dipping cord in astringent
pContain ____ or iron salts
and cause transient ischemia
n____ the gingival tissue pEpinephrine-containing cord
nUse with caution due to ____

oSulcus closes within ____ seconds, once removed
n Make impression ____

impregnated
AI
shrinking
tachycardia
30
immediately

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(3)Displacement of Gingival
Tissues

o\_\_\_\_
(hemodent)and \_\_\_\_ (astringident)
n Medicaments which help control seepage of \_\_\_\_
p\_\_\_\_ hemostatic gel
p\_\_\_\_ tissue damage

aluminum chloride
ferric sulafte
gingival fluid
coagulative
minimum

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(3)Displacement of Gingival
Tissues

oContact between the astringent and prepared tooth surfaces must be minimized to maintain ____
n Subsequent dentinal tubule sealing may be desirable to decrease ____

smear layer

post op sensitivity

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(3)Displacement of Gingival
Tissues

oTechniques
n Single cord technique 
n Double cord technique
pThin cord placed without \_\_\_\_ at bottom of gingival crevice
n Left during \_\_\_\_
n Minimize \_\_\_\_

pSecond ____ cord placed on top for lateral tissue displacement
n Removed prior to ____

overlap
impression
seepage

larger
impression-making

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(3)Displacement of Gingival
Tissues

oIsolate prepared teeth
n ____
n ____

oGently dry
n Do not excessively ____
pPostoperative sensitivity

oCut length of cord sufficient
to ____ tooth
oDip cord in astringent and squeeze excess with gauze
n If place dry cord, moisten before ____ to prevent tearing epithelium

cotton rolls
saliva ejector
dessicate
encircle
removal

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(3)Displacement of Gingival Tissues

oLoop the cord around the tooth
oGently push cord into sulcus
n Start \_\_\_\_ 
peasier
n Angle instrument toward \_\_\_\_ to push directly into sulcus
n Second instrument may aid placement

interproximally

tooth

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(3)Displacement of Gingival Tissues
oTissue must be displaced gently but with sufficient firmness to place just ____ to gingival margin
oAvoid overpacking due to tearing of gingival attachment
n ____ recession
oRepeated use may also cause gingival recession

apical

irreversible

Impregnated ____ cord prepacked into entire crevice

Impregnated ____ cord on top

extra thin

thin

(3)Displacement of Gingival
Tissues

oEvaluation
n When looking at tooth,
view from occlusal aspect
pNo \_\_\_\_ folded over
n When remove cord, should be able to see entire preparation margin \_\_\_\_

soft tissue

circumferentially

(3)Displacement of Gingival Tissues
oOther tissue displacement methods:
n (a)Displacement paste
p____-containing paste injected into ____
n (b)Electrosurgery
pRemoves ____ of gingival sulcus to improve access
nPossible ____ n

(c)Soft tissue laser
pCan remove ____ amount of tissue before impression making

aluminum chloride
sulcus
inner epithelial lining
gingival recession
controlled

(3)Displacement of Gingival
Tissues
(a)Displacement Paste
oProvides good ____ with less discomfort than cord
oProvides ____ tissue displacement than cord
oCan make subsequent lab steps more ____

Foam placed and pressure placed with ____

hemostasis
less
problematic
hollow cotton roll

(3)Displacement of Gingival Tissues
(b)Electrosurgery
Tissue only removed from ____ of sulcus

Tip of electrode passed through the ____

inner surface

hyperplastic tissue

(3) Displacement of Gingival Tissues
(b) Electrosurgery

 oContraindicated with \_\_\_\_
oNot suitable on \_\_\_\_ attached gingiva
n Ex. Labial \_\_\_\_
oCannot use with \_\_\_\_ due to possible electric shock
oProfound soft tissue \_\_\_\_ mandatory

electronic medical devices
thin
maxillary canines
metal instruments
anesthesia

3) Displacement of Gingival Tissues
(c) Laser

Trough made with ____ before impression making

Results in ____ or no patient discomfort and is more ____ than conventional displacement for hemostasis

laser
minimal
effective

Impression Making
Procedure

oEvaluate custom tray in mouth to verify fit
n Correct as needed
oTray adhesive applied
n Extend few mm onto ____ surface of tray
oIsolate abutment teeth oPlace

external

gingival retraction cord

``` Impression Making Procedure oMix impression material n (1)2 paste technique pMix catalyst and base together nBlend thoroughly ``` nFor light body oLoad syringe nFor heavy body oLoad tray

Impression Making Procedure oMix impression material n (2)Automix technique pCartridge inserted into gun- like device n Bleed cartridges before tip placed pBase and catalyst extruded into mixing tip n Place light body directly on tooth with ____ oOr in syringe n Heavy body into ____

tip | tray

Impression Making Procedure ``` oMix impression material n (3)Machine mixing technique p____ mixing technique pConvenient pProduces ____ impressions ```

alternative | void-free

Impression Making Procedure oRemove ____ oGently dry preparation with ____ oPlace tip of syringe nozzle against ____

displacement cord compressed air margin

Impression Making Procedure ``` oInject material slowly n Insert tip at ____ first pPrevents material from flowing down over prep and trapping air bubbles n Tip moved to follow the ____ rather than traveling ahead of it n Cover all margins n Extend additional material pEdentulous spaces pLingual anterior teeth pOcclusal surfaces posterior teeth ```

distal embrasure | material

Impression Making Procedure oSeat tray n MUST REMAIN ____ while material undergoes polymerization p____ minutes depending on material p**____ impression removal is a common cause of impression distortions

immobile 6-12 premature

Impression Making oClosed-Mouth Impression Technique (Dual arch or Triple Tray) n For ____ units n Made at ____ pAt patient’s OVD n Impression material supported by thin ____ pInaccurate if patient closes down on ____ of tray n Need to perform laboratory steps VERY CAREFULLY pNo ____relationships recorded n Controversial

``` single maximum intercuspation mesh frame side eccentric ```

Impression Making Disinfection oDisinfect all impression materials according to recommendations for each material oImmediately rinse with ____ and dry oSuitable chemicals such as ____ or iodophor sprays n See if compatible with impression material pPolyether or 􏰀hydrophilic􏰁 addition silicone impression materials should be sprayed n Do not soak in ____ oEssential for preventing ____ and exposure oShould not affect impression accuracy if done correctly

tap water glutaraldehyde glutaraldehyde cross-infection

Impression Making Disinfection TABLE!

Impression Making Preclinical Technique oTry in custom tray in dentoform n Adjust as needed oBrush thin layer PVS adhesive and air dry ____ minutes. oPlace #1 retraction cord around #19 once and then, cut oBlock out interdental spaces of #22-#27 with beading wax n Not to extend onto the ____ surfaces

10 | occlusal/incisal

``` Clinic materials (PVS) Clinic materials (Polyether) tables! ```

Impression Making Summary oDifferent methods to gain access of ____ margins n ____, chemical,____ pNarrow cord with mild astringent recommended oCustom tray should be used with ____ impression materials oAll impression materials should be rinsed, dried, disinfected oGood impression crucial to accurately fitting restoration

subgingival mechanical surgical elastomeric