Dental Products Report - April 2011 - (Page 72) CliniCal 360° 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 HOW TO 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. Clinical steps 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. 3 05 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 4. Overlay of Perfectemp II fabricated over the un-prepared teeth. 5. Overlay removed showing where recontouring can be done. 5 06 6 PRECISION FEATURES 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 discusdental.com Discus Dental 800-422-9448 http://www.discusdental.com http://www.DENTALPRODUCTSREPORT.COM 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 10 Questions Green Products Product Watch New Products Ivoclar Vivadent’s Bluephase G2 Ultradent’s Opalescence Trèswhite Supreme 15% Bisco’s DUO-LINK™ Composite Luting Cement The Invisible Gorilla Handpiece Evolution Clinical 360° Evolving Education Capture Prep Detail Create a Stable C&B Platform Motorola CLS1410 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 Byte-by-Byte Dental Products Report - April 2011 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201302 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201301 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201212 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201211 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201210 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201209 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201208 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201207 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201206 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201205 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201204 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201204supp2 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201204supp http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201203 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201202 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201201 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201112 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201111 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201110 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201109 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201109supp http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201108 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201107 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201107supp http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201106 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201106supp http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201105 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201104 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201104supp http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201103supp http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201103 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201102 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201101 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201012 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201011 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201010 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201009 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201008 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201007 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201006 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201005 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201004 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201003 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201002-1 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_201001 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_200912 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_200911 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_200910 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_200909 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_200908 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_200907 http://digital.dentalproductsreport.com/nxtbooks/advanstar/dpr_200906 http://www.nxtbook.com/nxtbooks/advanstar/dpr_200905 http://www.nxtbook.com/nxtbooks/advanstar/dpr_200904 http://www.nxtbook.com/nxtbooks/advanstar/dpr_200903 http://www.nxtbook.com/nxtbooks/advanstar/dpr_200902 http://www.nxtbook.com/nxtbooks/advanstar/dpr_200901 http://www.nxtbook.com/nxtbooks/advanstar/dpr_200812 http://www.nxtbookMEDIA.com