Impression techniques

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<ul><li> 1. Level II: Advanced Implant Placement and Restoration Course Dr. David Dalise Dr. Gary McCabe Ross</li></ul> <p> 2. Impression Techniques 3. Impression Techniques </p> <ul><li>Closed Tray </li></ul> <ul><li><ul><li><ul><li>May be least accurate for multi unit cases. </li></ul></li></ul></li></ul> <ul><li><ul><li>Stock Trays </li></ul></li></ul> <ul><li><ul><li>Custom Trays </li></ul></li></ul> <ul><li>Open Trays </li></ul> <ul><li><ul><li><ul><li>May be more accurate for multi unit impressions </li></ul></li></ul></li></ul> <ul><li><ul><li><ul><li>May be required due to implant/abutment angulations and path of insertion withdrawal.</li></ul></li></ul></li></ul> <ul><li><ul><li>Stock Trays </li></ul></li></ul> <ul><li><ul><li><ul><li>Modifications required </li></ul></li></ul></li></ul> <ul><li><ul><li>Custom Trays </li></ul></li></ul> <p> 4. Impression Materials </p> <ul><li>PVS </li></ul> <ul><li><ul><li>Minor bone toxicity </li></ul></li></ul> <ul><li><ul><li>Very stable </li></ul></li></ul> <ul><li><ul><li>Multiple viscosities available </li></ul></li></ul> <ul><li>Polyether </li></ul> <ul><li><ul><li>Toxic to bone </li></ul></li></ul> <ul><li><ul><li>Very rigid </li></ul></li></ul> <ul><li><ul><li>Very Stable </li></ul></li></ul> <ul><li><ul><li>Most hydrophilic </li></ul></li></ul> <ul><li>Rubber base </li></ul> <ul><li><ul><li>Toxic to bone </li></ul></li></ul> <ul><li><ul><li>Relatively Stable </li></ul></li></ul> <ul><li><ul><li>Slow set </li></ul></li></ul> <ul><li><ul><li>Unpleasant taste to patient </li></ul></li></ul> <ul><li>Others (hydrocolloids) </li></ul> <ul><li><ul><li>Least stable</li></ul></li></ul> <ul><li><ul><li>Low tear strength </li></ul></li></ul> <ul><li><ul><li>Least desirable to use due to limitations of material </li></ul></li></ul> <p> 5. Considerations, Complications, and Solutions </p> <ul><li>What material and why </li></ul> <ul><li><ul><li>Use a material suitable to situation and operator familiarity </li></ul></li></ul> <ul><li>Managing difficult patients or situations </li></ul> <ul><li><ul><li>High anxiety/apprehension </li></ul></li></ul> <ul><li><ul><li><ul><li>IV sedation </li></ul></li></ul></li></ul> <ul><li><ul><li><ul><li>Non-IV conscious sedation </li></ul></li></ul></li></ul> <ul><li><ul><li>Gag reflex </li></ul></li></ul> <ul><li><ul><li><ul><li>Salt on tongue </li></ul></li></ul></li></ul> <ul><li><ul><li><ul><li>Non-IV conscious sedation </li></ul></li></ul></li></ul> <ul><li><ul><li>Medical complications </li></ul></li></ul> <ul><li><ul><li><ul><li>Have emergency kit in office and appropriate training for use for doctor and staff </li></ul></li></ul></li></ul> <ul><li><ul><li><ul><li>Bleeding </li></ul></li></ul></li></ul> <ul><li><ul><li><ul><li><ul><li>Direct pressure </li></ul></li></ul></li></ul></li></ul> <ul><li><ul><li><ul><li><ul><li>Vasoconstrictor</li></ul></li></ul></li></ul></li></ul> <ul><li><ul><li><ul><li><ul><li>Vessel ligation </li></ul></li></ul></li></ul></li></ul> <ul><li><ul><li><ul><li><ul><li>Appropriate referral/911 </li></ul></li></ul></li></ul></li></ul> <p> 6. What to send to the Lab? </p> <ul><li><ul><li>Lab prescription</li></ul></li></ul> <ul><li><ul><li><ul><li>Detailed with all required prosthetic design and case details. </li></ul></li></ul></li></ul> <ul><li><ul><li>Appropriate and accurate impressions </li></ul></li></ul> <ul><li><ul><li><ul><li>Implant level</li></ul></li></ul></li></ul> <ul><li><ul><li><ul><li>Abutment level </li></ul></li></ul></li></ul> <ul><li><ul><li>Preoperative mounted models </li></ul></li></ul> <ul><li><ul><li>Diagnostic wax up </li></ul></li></ul> <ul><li><ul><li>Necessary restorative components for implant </li></ul></li></ul> <ul><li><ul><li><ul><li>Implant analog </li></ul></li></ul></li></ul> <ul><li><ul><li><ul><li>Impression analog </li></ul></li></ul></li></ul> <ul><li><ul><li><ul><li>Necessary abutment screws </li></ul></li></ul></li></ul> <ul><li><ul><li><ul><li>Temporary abutments </li></ul></li></ul></li></ul> <p> 7. Pre Op X-ray 8. Periapical X-ray 9. 10. 11. 12. 13. #8 HS Bur 14. 15. Pilot Drill w/out Drill Stops 16. 17. 18. 19. Periapical X-ray 20. Tissue Punch 21. Removal of Tissue Plug 22. 23. Countersink Drill 24. 3.3mm Osteotome 25. 26. 27. 3.5mm Osteotome 28. 29. 30. ISI 4mm x 12mm CB 31. Placement of ISI with Ultem Cap 32. Ratchet Wrench Seating ISI Implant 33. ISI Ratcheted to Final Seating 34. Torqued to 40+ N/Cm 35. 36. Periapical X-ray 37. 4.0 TRIP and 4.0 AC 38. TRIP Snapped Into Margin 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76. 77. 78. 79. 80. 81. 82. 83. 84. 85. 86. 87. 88. 89. 90. 91. 92. 93. THANK YOU Questions?</p>

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