Best Practices to Avoid Case Remakes
Save Money, Reduce your Chair Time, & Increase Patient Satisfaction by taking a few minutes to read these IMPORTANT TIPS:
Carefully inspect your impression before releasing your patient. Any pull, voids, bubbles, unset or sticky material indicates contamination or a mixing problem. This will lead to a remake.
If you use a desensitizing substance on prepared teeth, apply it AFTER taking your impression. These substances effect impression materials and if used improperly will guarantee a remake.
Retraction cord containing epinephrine, or other material containing epinephrine will cause deterioration, sticky or unset margins in some impression materials. AGGRESSIVELY rinse and clean the prepared teeth before injecting your wash material.
If you are using “sideless” triple trays, PLEASE check to see that the patient did not bite into, or onto the tray. If they did, when we mount the models, the bite will be off, and you will lose precious time adjusting the occlusion and possibly ruining the crown, or sending it back for repairs. A preliminary check could save hundreds of dollars later.
PLEASE take some time to make sure your temporaries are in occlusion, and that contacts are tight. For long span bridges, or cosmetic make-overs, consider our lab processed temporaries. Believe it or not, we have seen three and four unit bridge cases with single crown temporaries on the abutments. That’s a great way to guarantee your bridge will NOT fit!
Materials containing Ferrite sulfate will cause some impression materials to not set properly, especially in thin areas such as margins. Save yourself a remake; clean and rinse your preps well before taking the impression
We recommend a two cord technique. A combination of #00 and #2 cords will provide adequate retraction for nice clear exposure of your margins.
For anterior cases, please send an impression of the temporaries, or a diagnostic wax up, so that we can try and match patient expectations. Photos, shade maps and other tools will ensure a happy patient and a happy doctor.
When injecting wash impression around the margins, use a stirring motion and “jiggle” the material constantly to avoid air bubbles or voids. Never stop and restart an impression. If you don’t think the cartridge has enough material left to completely encircle the prep, use a new cartridge. If the case has loose tissue, of if the prep is very subgingival, use the cartridge tip to push the tissue away as you inject the material to prevent it from laying over onto the margin.
DO NOT use the “touch” technique to determine if your impression is set; use an inexpensive egg timer or other timing device. The manufacturer has done extensive tests to determine the best setting time and conditions. The material you are touching has been exposed to air, and may set before the was material has, and it is important to have this part intact and accurate. Don’t touch; thime it or you may end up remaking it. 11)All crown preps should have adequate prep reductions of at least 1.5 mm for both PFM and All Ceramic Crowns.