Dentaltown October 2017 - 48

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Is There a Better Crown
Impression Technique?
This Townie in Florida is getting good results with crown-and-bridge impressions,
but wonders if there is a better way to control bleeding

kidesperanto
Member Since: 08/03/09
Post: 1 of 65

So, my current crown and bridge technique is pretty simple. It's a dual cord technique with
either a triple tray or a full tray. Both techniques use a light-body and heavy-body PVS. I gross
prep, pack the first cord, finalize prep, pack the second cord, pull that cord, and impress. I get
great impressions. The technique works well and I could go my entire career using it with no
real issues.
However, I'm wondering if there's a better way. Specifically, I have an older patient base with
not-so-great OH and on blood thinners, so I'll often get bleeding when pulling the second cord,
even if it's dipped in hemostat and ViscoStat is used before the impression. I can usually displace
this blood with my A/W syringe, but not always.
Second, I seem to get slightly crisper impressions with the triple-tray technique than the full
tray, probably due to the added force placed on the PVS from the bite. So, I'm wondering if I
could change a few things to make life easier. I've considered switching out the second cord with
a 3M retraction paste instead to avoid the bleeding.
I've also considered using a putty PVS with Saran Wrap and then a wash after it has set, like
I do for KOR cases and RPDs. I get great impressions from this and my partials fit very well.
Anyone have any thoughts on this? Should I just screw all the ticky-tacking and just electrosurge
the sulcus? ■
7/22/2017

John Wilkes Tooth
Member Since: 06/07/11
Post: 2 of 65

Keep doing what you are doing. I've added retraction paste on top of the last cord sometimes
because you can usually see the tissue health when placing cord and can decide then to add it.
I did it this way for a while and we switched two years ago to the True Definition scanner, and
haven't had issues. ■
7/22/2017

Triad
Member Since: 06/18/03
Post: 9 of 65

Hogo's modified H&H technique has been giving me great results, but considering buying
a scanner eventually. ■
7/22/2017

kidesperanto
Member Since: 08/03/09
Post: 10 of 65

Too many situations where I've got to blow PVS past tissue and displace blood to use a
scanner. With a scanner, I still need that second cord to see the margin. That second cord is the
thing that causes the bleeding, unless I don't pull it? ■
7/22/2017

alanrw
Member Since: 05/16/11
Post: 11 of 65

If the second cord is below your finish line ... leave it in, it comes out in the impression
(double-check that), take the impression and send in the case with the second cord still on the
impression. But I would think the lab has to pour the model with the cord still on the impression
and remove it after the stone sets, which could still damage your finish lines. ■
7/22/2017

OCTOBER 2017 // dentaltown.com

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