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Tissue Management: The Key to an Ideal Impression

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Restorations, such as crown and bridge procedures, can be both challenging and complex for a number of reasons. Requiring extensive planning and attention to detail every step of the way, the quality of restorative results is largely determined by the degree of accuracy at each stage of the process. Soft tissue management goes a long way towards achieving the high level of accuracy these procedures demand.

While it is difficult to place paramount importance on a single step of the restorative process, obtaining an acceptable impression is inarguably a critical component of success. An ideal impression provides an exact record of the prepared tooth along with the area adjacent to its margins. This allows dental laboratory technicians to produce a die that is a duplicate of the tooth in question and craft a restoration that fits its contours precisely. Common impression errors include voids, tears, air bubbles and flow problems all of which can be mitigated via tissue management.

Whether using conventional impression material or a digital scan, proper gingival displacement is key to capturing an accurate impression. For conventional material, a 0.2mm space must be created between the tooth and gingiva so that the material can flow into the sulcus and ultimately be removed from the mouth without tearing. If the gingival tissue isn’t adequately displaced to permit this, the resulting impression is prone to imperfections including voids, marginal inaccuracies and tears, the latter of which can lead to ongoing gingival irritation and inflammation. Digital impressions do not require as large of a space, although tissue displacement is still necessary to achieve an optimal scan of the entire prepared area.   

Moisture control, including hemostasis and drying of saliva, is an equally vital aspect of tissue management and the greater impression making process. Conventional impression materials have varying levels of hydrophilicity, meaning any moisture can potentially produce voids in the resulting impression. Likewise, for digital impressions, moisture can obscure the prepared tooth and margins, causing errors in the scan. For these reasons, a clear, dry field of operation is essential to obtaining an acceptable impression.

To learn more and find products that can help with tissue management for capturing impressions, visit Premier Dental’s website.

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