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Case Study
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Utilization of Elastometric Impressions in Fixed Prosthodontics

A Case Presentation

Learning Objectives:

This study illustrates a technique protocol that yields accurate, predictable impressions on a consistent basis. Upon reviewing this study, the reader should have:

  • As understanding of the basic principles involved in obtaining impressions for simple and complex restorations.
  • An awareness of the advantages and disadvantages of several impression taking protocols

 

The technical complexity inherent in fixed prosthodontic treatment is compounded by the necessity to utilize an indirect approach, where fabrication occurs extraorally at the dental laboratory and the completed restorations are subsequently retrofitted in the oral cavity. One fundamental aspect in the fabrication of indirect restorations is the procurement of an accurate impression from which a refractory model can be created to precisely replicate the intraoral environment. Although numerous materials and techniques have been advocated, predictable impression taking remains a challenge for a majority of practitioners--particularly in cases that involve multiple abutments. 

Whereas the companion presentation to this will discuss the impression procedure and the role of refractory dies and models, the following will address material selection and soft tissue management in elastomeric impressions. 

For the clinician involved in complex reconstructions, the ability to consistently attain accurate impressions acquires added significance due to the additional time and effort involved in preparation for the impression procedure, as well as the increased expenses associated with remakes that result from inaccuracies.  The technique for the clinical impression procedure and the role of refractory dies and models are also important considerations that should be readily understood by the savvy clinician. 

 

*Director, Postdoctoral Periodontal Prosthesis, University of Pennsylvania, Philadelphia, Pennsylvania; private practice, Bryn Mawr, Pennsylvania

 

 

Related Reading:

  1. Ferracane JL. In: Materials in Dentistry: Principles and Applications Philadelphia, PA: JB Lippincott, 1995.
  2. Chai J, Takahashi Y, Lautenschlager EP. Clinically relevant mechanical properties of elastomeric impression materials. Int J Prosthodont 1998;11(3):219-223.
  3. Lacy AM, Fukui H, Bellman T, Jendresen MD. Time-dependent accuracy of elastomer impression materials. Part II: Polyether, polysulfides, and polyvinylsiloxane. J Prosthet Dent 1981;45(3):329-333.
  4. Henry PJ, Harnist DJ. Dimensional stability and accuracy of rubber impression materials. Aust Dent J 1974;19(3):162-166.
  5. Stauffer JP, Meyer JM, Nally JN. Accuracy of six elastic impression materials used for complete-arch fixed partial dentures. J Prosthet Dent 1976;35(4):407-415.
  6. Lin CC, Ziebert GJ, Donegan SJ, Dhuru VB. Accuracy of impression materials for complete-arch fixed partial dentures. J Prothet Dent 1988;59(3):288-291.
  7. Dounis GS, Ziebert GJ, Dounis KS. A comparison of impression materials for complete-arch fixed partial dentures. J Prosthet Dent 1991;65(2):165-169.
  8. Block PL. Restorative margins and periodontal health: A new look at an old perspective. J Prosthet Dent 1987;57(6):683-689.
  9. Azzi R, Tsao TF, Carranza FA Jr, Kenney EB. Comparative study of gingival retraction methods. J Prosthet Dent 1983;50(4):561-565.
  10. Chiche GJ. Double-string technique for final impressions: Practical applications. Dent Econ 1995;85(1):72-73.
  11. Benson BW, Bomberg TJ, Hatch RA, Hoffman W Jr. Tissue displacement methods in fixed prosthodontics. J Prosthet Dent 1986;55(2):175-181.
  12. Nemetz H, Donovan T, Landesman H. Exposing the gingival margin: A systematic approach for the control of hemorrhage. J Prosthet Dent 1984;51(5):647-651.
  13. Laufer BZ, Baharav H, Ganor Y, Cardesh HS. The effect of marginal thickness on the distortion of different impression materials. J Prosthet Dent 1996;76(5):466-471.
  14. Eames WB, Sieweke JC, Wallace SW, Rogers LB. Elastomeric impression materials: Effect of bulk on accuracy. J Prosthet Dent 1979;41(3):304-307.
  15. Millstein P, Maya A, Segura C. Determining the accuracy of stock and custom tray impression/casts. J Oral Rehabil 1998;25(8):645-648.
  16. Federick DR, Caputo A. Comparing the accuracy of reversible hydrocolloid and elastomeric  impression materials. J Am Dent Assoc 1997;128(2):183-188.
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