Dental Products Report - April 2011 - (Page 72)
Technique in PracTice
CaPTURE PREP DETail
Taking quality impressions for minimally invasive restorations.
by D R .
M I C H A E L M I YA SA K I 1 2
Information provided by Discus Dental.
Dentists are used to providing dental treatment requiring removal of diseased tooth structure, and although it would seem intuitive to preserve tooth structure, it is sometimes a difficult concept for some clinicians to accept when dealing with esthetics. With today’s strong, yet translucent, esthetic materials, and the accuracy we can attain with a high-quality polyvinylsiloxane impression material, such as Discus’s Precision impression material, our goal of tooth preservation can be predictably attained. Today’s materials and patients’ wants are changing esthetic techniques. The pendulum is swinging to very minimal tooth alteration and away from invasive tooth preparations. Today’s materials allow us to be more conservative and oftentimes not have to anesthetize our patient or make temporaries, and require very little ﬁnishing time. it is this author’s belief in providing purely elective esthetic treatment that, when possible, little or no tooth removal would be best.
The patient presented with discolored, worn teeth and is interested in correcting the esthetics and remedy the ‘dark gumline’ of the second left bicuspid (Fig. 1). STEP Diagnostic models were made with Discus’ medium-body/monophase Splash impression material. From these accurate impressions, STEP diagnostic wax-ups were created with wax being added to the unprepared models (Fig. 2). STEP a Splash putty stent was relined with Precision light-body material (Fig. 3).
01 02 03
over the unprepared teeth. The material was allowed to set for 2½ minutes, the stent was peeled oﬀ, and the patient was allowed to evaluate the occlusal, length and color diﬀerence, and the ‘thickness’ that might be felt (Fig. 4). This overlay allowed us to address any of our patient’s concerns preemptively and only takes minutes of chair time (Fig. 5). STEP Tooth nos. 9, 11 and 12 had u ndergone prior root canal treatments, which were judged to be clinically acceptable but darker than the adjacent teeth. During the procedure, the pulp chambers were debrided, carefully sealed internally just below the ceJ with a bonded restorative and internally bleached with DayWhite 38% carbamide peroxide with acP. This lightened the teeth up considerably (Fig. 6) so that no further treatment was required to control the color, which is a concern when doing very thin translucent porcelain restorations. STEP The mesials of tooth nos. 8 and 9 were opened up in the preparations due to large old composite restorations that were deemed clinically unacceptable with leaking margins and underlying decay. if it had not been for these failing restorations the mesial contacts also would have been preserved.
AT A GLANCE
1. Patient presents with discolored and worn teeth with a ‘dark gumline’ of the second left bicuspid.
2. Diagnostic wax-ups were created with wax being added to the unprepared models. 3. Splash putty stent relined with Precision light-body material.
4. Overlay of Perfectemp II fabricated over the un-prepared teeth. 5. Overlay removed showing where recontouring can be done.
Moisture-displacing chemistry allows capture of needed detail in a moist environment 2:45–3:45 minute setting time that is thermally activated Flexible working time permits both single- and full-arch impressions
STEP The relined putty stent was ﬁlled
self-curing mate04 with(Perfectemptemporaryplaced rial ii) and
Table of Contents for the Digital Edition of Dental Products Report - April 2011
Dental Products Report - April 2011
Table of Contents
From the Editor
Clicks & Picks
Ivoclar Vivadent’s Bluephase G2
Ultradent’s Opalescence Trèswhite Supreme 15%
Bisco’s DUO-LINK™ Composite Luting Cement
The Invisible Gorilla
Capture Prep Detail
Create a Stable C&B Platform
Think Like a CEO
Looking For a Few Good Co-Pilots
Communicating with Hygiene Patients
The Rx for Patient Commitment
Your Continuing Care Tool Box
Developing a Hygiene Philosophy of Care
Products in Practice
Not the Glass Ionomer You Remember
5 Reasons to Buy Sterillium Comfort Gel
5 Reasons to Buy Lightwalker™ Lasers
Dental Products Report - April 2011