Common mistakes – and how to avoid them
Featured Products Promotional FeaturesPosted by: Dental Design 1st June 2023
Making mistakes is a natural part of career development – it is what we learn from, and use as an incentive to find a more efficient course of action for the future. In dentistry, a skill-heavy profession, mistakes are a good source of education and learning, but as you flourish in your role, easily-avoidable mistakes can be costly.
For example, a poorly-taken impression can throw a spanner in the works for the entire workflow, forcing you to not only recall the patient for another appointment, but spend time and money retaking the impression. You may have to potentially remake the prosthesis should it not fit properly. Especially in today’s climate, where many dental practices are short-staffed and are having to watch costs more closely, the possibility of having to retake/remake an impression should be kept to a minimum as best possible. Traditional impression materials are still a steadfast part of many clinicians’ workflows – how can many common errors be avoided to ensure a successful outcome?
Distortion
Distortion is a commonly-encountered error, of which there are several causes. For example, it may occur as the result of exceeding the product’s working time, or when using an incompatible tray and when removing it from the mouth.[i]
It is likely that most clinicians experience distortion when taking impressions, but with a few simple steps you can help to minimise this risk. First and foremost, choosing the right material is key to preventing most, if not all commonly encountered errors, especially material distortion in most cases. Many materials on the market will come with varying setting time options, so be sure to choose wisely. Being mindful of storage temperature will also help to minimise this risk. Tray selection is vital here, too. Ideally, a tray made of metal, acrylic or plastic should be used, and it must also be sturdy enough to avoid tray deformation. The right shape is vital, covering the patient’s teeth without touching the soft tissues of the mouth, to ensure all detail from the full arch is captured.
Inadequate setting
It is important to always follow the manufacturer’s instructions to ensure the material has set properly, and ensure the material is stored appropriately. To further avoid inadequate setting, the impression material must be mixed sufficiently. Many clinicians may opt for hand mixing the materials, but this can take time and the margin for error may be wider – automatic mixing can help to speed up the process and is relatively straightforward. Poor setting of vinyl polysiloxane (VPS) material in particular may occur if you wear latex gloves, as they can affect the polymerisation of the VPS.[ii] As such, it may be best to choose nitrile or non-latex gloves when handling the material.
No margin for error
For a well-fitting, successful final outcome, you must capture adequate marginal detail – which is a crucial step. As such, marginal tearing must be avoided where possible. Again, the right material here is vital – select one that has a high tear resistance, and be sure to allow it to completely set prior to removing the impression from the mouth. The gingival tissues must be retracted so that you can capture the prepared area successfully, recording the finish line and ensuring the thickness of the gingival sulcus is sufficient.[iii] You may choose a retraction cord or paste for this endeavour – a high quality product will ensure that you are able to gently displace the gingival tissues atraumatically for the most predictable outcome.
There are other issues that can occur with margins, including the incomplete reproduction of preparation margins. This can also be the result of poor retraction, but it can occur due to blood and saliva contamination – the prepared site should be thoroughly rinsed and dried, with bleeding stemmed using an adequate retraction method and a haemostatic agent. Contamination can cause voids on the margins, in addition to an inappropriate syringe technique. Ensure that you keep the mix tip of the syringe immersed in the paste to help avoid the formation of air bubbles.
Pair the right products with the right techniques
Many commonly-encountered mistakes can be avoided when you choose the right materials, follow manufacturer’s instructions and use simple, yet effective techniques. To help clinicians streamline their workflow and reduce the risk of error, 3M Oral Care has partnered with five experts to create Success Simplified, a useful resource that details all the steps of an indirect restorative workflow. Clinicians are recommended the best 3M products for each stage, with simple, actionable techniques for successful outcomes. Available as an on-demand webinar or a downloadable booklet, Success Simplified is your key to beautiful, long-lasting results.
Mistakes are an inevitable aspect of professional life, but they can be minimised when you have developed a simple yet effective foundation of materials and techniques to support your workflow.
Visit the website today to watch the webinar or download your FREE booklet here: https://www.3m.co.uk/3M/en_GB/dental-uk/indirect-restorations/success-simplified/
For more information, call 08705 360036 or visit www.3m.co.uk/Dental
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[i] Kulkarni, M.M. (2015). Dimensional Changes of Alginate Dental Impression Materials-An Invitro Study. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4576653/ [Accessed 31 Jan. 2023].
[ii] Kumar, P. and Aggarwal, H. (2015). Glove over glove technique for manipulation of vinyl polysiloxane impression material with latex gloves. The Journal of Indian Prosthodontic Society, [online] 15(3), p.289. doi:10.4103/0972-4052.164916.
[iii] Rajambigai, M.A., Raja, S.R., Soundar, S.I.J. and Kandasamy, M. (2016). Quick, painless, and atraumatic gingival retraction: An overview of advanced materials. Journal of pharmacy & bioallied sciences, [online] 8(Suppl 1), pp.S5–S7. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5074041/#:~:text=The%20goal%20of%20gingival%20retraction [Accessed 31 Jan. 2023].
