Dentaltown September 2022 - 44

A common misperception of intraoral
scanners is that they will alleviate some of the
problems associated with traditional analog
impressioning methods. The technique
plays an important role, but adherence to
a few principles will be critical to achieve
a satisfactory impression regardless of the
method. In other words, both methods
allow the practitioner to achieve a highly
successful impression.
The principles
Before taking a final impression for
indirect restorative cases, each situation
must be analyzed and treated as unique. I've
already discussed appropriate preparation
design, but it's important to evaluate tooth
condition after preparation but before
impressions. Some factors that may inhibit
a successful impression are excessive tissue,
blood and saliva.
To take a great final impression, a
few principles must be adhered to, and
remain constant regardless of technique,
for predictable success. Once again, these
principles remain constant regardless of
technique:
* Visualization.
* Retraction.
* Moisture control.
Visualization
To take an impression, the entire
preparation must be visible and free of
contamination. This includes the occlusal
surface, margins and axial walls. The
preparation should be free of undercuts and
rough edges, as previously outlined for ideal
preparations. A great way to visualize this is
to use an occlusal mirror or hover over the
prep with the wand of an intraoral scanner
before impressioning. The entire prep must be
visible, or it will not be captured, regardless
of method of impressioning
Retraction
After preparation, tissue can collapse or
cover the margin, decreasing visibility and
hindering the ability to fully capture the
margin. The necessity for retraction persists
even with the most ideal of preparations.
In practice, we have several items at
our disposal that can assist with retraction.
In some instances, multiple items may be
needed to accomplish appropriate retraction.
Below is a list of several items commonly
used to retract the tissue:
* Retraction cord, mostly Sizes 1 and 2
(multiple manufacturers).
* A diode laser (BlueWave, Clinicians
Choice; AMD Picasso, AMD Lasers).
* Retraction paste (Voco Retraction
Paste, Voco; 3M Retraction Paste,
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Dentaltown September 2022

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