Tissue Management, Impression Making, Definitive Casts and Dies (Pt. I) Flashcards
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
Include unprepared tooth structure to develop ____
contours
Avoid:
(1) ____
(2) Tears
(3) ____
(4) Other imperfections
For optical impressions, avoid: ____
> >
Inaccuracies in ____
air bubbles
thin spots
artifacts
restoration fabrication
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
(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
(1)Tissue Health
Poor contours contribute to ____ and ____ of gingival tissues
Must reduce ____ prior to impression
inflammation
recession
inflammation
(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
(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
(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
(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
(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
(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
(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
(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
(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
(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
YA
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!
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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!
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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
