November 2014
Volume 10, Issue 11

Making a Positive First Impression

Imprint™ 4 VPS impression material line offers time savings, excellent accuracy

Scott A. Arne, DDS, FAGD

As the starting point for all indirect restorative procedures, the goal of an impression is to accurately capture the smallest detail of the prepared tooth, right down to the finest marginal detail, while relating it to the surrounding hard and soft tissue in an accurate, static relationship. Achieving this requires an exceptional impression material.

The right impression material can ensure accuracy and predictability. It should be easy to use, not technique sensitive, and offer fast setting but with sufficient working time. A quality material can offer significant economic as well as clinical benefits; when it enables the clinician to avoid the need to capture a second impression, it saves time and money and positively affects the patient experience.

To meet the above criteria and more, 3M™ ESPE™ Imprint™ 4 Super Quick VPS Impression Material demonstrates the shortest intraoral setting time—just 75 seconds.1 Sufficient working time is maintained, thanks to its unique, active, self-warming feature.

Intraoral setting time is independent of the working time used. Imprint 4’s super-hydrophilicity delivers precise details, greatly reducing the need for a retake. These factors help provide the most predictable and efficient outcome.

To refine the restoration to the highest degree and ensure accurate articulation of the casts created from the impressions, a complete bite registration is necessary. Imprint 4 VPS Bite Registration Material from 3M ESPE is an exceptional tool, offering good flow behavior for a high degree of accuracy, quick intraoral setting for a fast procedure, and high final hardness with low flexibility. These material properties make for easy cutting and trimming, which allows for an accurate stone model relationship.

Case Presentation

A 48-year-old female patient presented with pain in the lower left posterior region. Clinical and radiographic evaluation revealed periapical pathology associated with the mesial root of tooth No. 30. Patient history showed that the original endodontic treatment had been completed 12.5 years prior. Endodontic access was obtained through the occlusal aspect of the present full-coverage restoration, compromising both its strength and esthetics. To retain the tooth, retreatment of the endodontic failure was necessary.

After completion of endodontic retreatment, a bonded core buildup was created using a combination of 3M™ ESPE™ Filtek™ P60 Posterior Restorative and 3M™ ESPE™ Filtek™ Bulk Fill Flowable Restorative (Fig­ure 1). Before tooth crown preparation, a bite registration was captured with Imprint 4 bite registration material. The bite registration was performed at this juncture to avoid inaccuracies due to a long appointment. The patient’s need to open wide for the procedure can create swelling within the superior joint space of the temporomandibular joints, resulting in an inaccurate inter-arch relationship. An inaccurate inter-arch relationship may also result from the subsequent loss of proprioception from the use of local anesthetic. For this reason, a bite registration should always be captured before the administration of anesthesia. The tooth was then prepared for the eventual fabrication of a 3M™ ESPE™ Lava™ Zirconia full-coverage restoration.

At the impressioning appointment, a multiple retraction cord technique was used with two untreated cords of increasing size (Figure 2).2 The second cord was left in place for 5 minutes and removed immediately prior to capturing the impression. The first cord was left in place to ensure hemostasis during the procedure.

Imprint 4 Super Quick VPS impression material was used to capture a complete and accurate impression. The light-body material was syringed around the prepared margins, followed by insertion of a tray filled with heavy-body material. The hydraulic pressure of the higher viscosity material in the tray, although not set, assists in pushing the light body impression material into the sulcus. The tray was removed after 75 seconds, revealing an ideal high-contrast impression (Figure 3).

Once this impression was completed, a second (more traditional) bite registration was captured using Imprint 4 Bite VPS Bite Registration Material. This bite registration is always taken over the most distal prepared tooth in the arch (Figure 4). The laboratory uses this bite registration to articulate the case while using the preoperative bite registration to verify its accuracy. A final impression was captured using 3M™ ESPE™ Imprint™ 4 Preliminary VPS Preliminary Impression Material prior to placing the temporary crown (3M™ ESPE™ Protemp™ Plus Temporization Material) worn while the definitive crown was being fabricated.

Conclusion

When evaluating impression materials, laboratories look for high resilience, a balance between tear strength and good elastic recovery, and flexibility and flowability of die materials. All of these necessary characteristics can be found in Imprint 4 materials. These factors, coupled with the clinical techniques described, resulted in an impeccable restoration that needed no adjustment at the insertion appointment.

The line of Imprint 4 materials allows for a predictable and reliable outcome (Figure 5). Ultimately, this results in increased practice profitability and more importantly, happy patients.

Reference

1. Imprint™ 4 VPS Impression Material Technical Data Sheet. 3M ESPE website. http://solutions.3m.com/wps/portal/3M/en_US/3M-ESPE-NA/dental-professionals/products/imprint-4. Accessed October 2, 2014.

2. Gupta A, Prithviraj DR, Gupta D, Shruti DP. Clinical evaluation of three new gingival retraction systems: a research report. J Indian Prosthodont Soc. 2013;13(1):36-42.

For more information, contact:

3M ESPE
800-634-2249
www.3mespe.com

About the Author

Scott A. Arne, DDS, FAGD

Private Practice,
Deerfield, Illinois

Fellow,
Academy of General Dentistry

Member,
Academy of Cosmetic Dentistry
American Equilibration Society

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