CATEGORY 66 AUSTRALASIAN DENTIST LINICAL The process of taking precision impressions is riddled with potential errors. Errors in the process can compromise the quality of the impression, which in turn has a decisive impact on the fit of the final restoration. Therefore, it is important to know how to avoid them. Experience from more than 100 training courses in dental offices shows that everyone taking impressions tends to make the same mistakes and that these mistakes are usually easily avoidable. This article summarizes the most frequent errors that occur in the procedure and reveals proven strategies for success. Potential sources of error There are essentially four different areas where missteps might occur that could have a negative impact on the quality of the final impression: 1. Practice management: Errors that fall in the category of practice management include those caused by inconsistencies in the materials and workflows and an unclear allocation of tasks in the team. Organizational issues, like long distances between the mixing device and the chair, and suboptimal storage conditions are also factors that might affect the impression quality. 2. Tray and material selection: An inaccurate impressionmay be the result of a wrong tray size or a lack of rigidity. Limited suitability of the selected material for the preferred technique, inappropriate setting times or lack of compatibility between tray and wash material may also lead to inaccuracies. 3. Impression procedure: Critical points in the procedure include mixing tip attachment, tray filling, and tray insertion and removal from the mouth. 4. Follow-up measures: Finally, immediate disinfection, storage in moist conditions or unsteady temperatures, and high intensity UV daylight exposure during transport to the laboratory may have a negative effect on the quality of the impression. Practice management: How to standardize One of the most effective measures contributing decisively to a high quality and accuracy of the precision impression is standardization of the whole impression taking procedure. Within the practice team, tasks have to be allocated clearly, so that every single person knows exactly what to do. The ideal situation would be that every dental practitioner in an office uses the same materials and adheres to the same protocols, so that one dental assistant can substitute for another without errors stemming from process missteps. When establishing standardized procedures, the team should not only define when to use which kind of materials and devices, but also focus on: u Finding the right place for the equipment. An automatic mixing unit, for example, should always be positioned close to the chair to facilitate ideal time management even when working with quick-setting impression materials. u Assuring a suitable storage area: Ideal temperatures may differ from material to material. VPS is usually more sensitive to higher than recommended temperatures than polyether. In both cases, a too-high storage temperature will shorten the material’s working time. If your storage area swings warm, the use of a less quick-setting material variant may be advisable. If storage temperatures are below the recommended minimum, mixing problems may occur. If this describes your storage situation, the material should be stored at room temperature (not on a heater!) for one day before it may be used again. When selecting a Troubles? No way! Strategies leading to accurate impressions Accurate impressions for precisely fitting restorations: Effective measures shared by an experienced trainer help minimize risks in the impression procedure. Originally published in 3M Oral Care’s Brain Floss dental blog By Guenther Schlosser, 3M Training Manager, Global Customer Innovation Center, Seefeld Germany
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