|
Here’s a fast, cordless
technique that’s compatible with any impression technique.
by John A. Smith
Greenwood, MS
I hate retraction cord!
Patients make faces when I place it. And in my hands, cord seems
to stimulate bleeding that can be hard to stop.
Here’s a very simple technique that eliminates the hassle and
patient discomfort of packing cord as well as the bleeding.
First, there’s the prep. I place a shoulder of 0.5mm
to 1.5mm (depending on the esthetic requirements) 360° around
the prep. I believe this is the easiest margin for a lab to read.
Second there’s the cleaning procedure. I use aluminum
chloride hemostatic agent in a small syringe with a fuzzy- tip applicator.
I rub this at the margin while I liberally express the liquid, keeping
the HVE nearby. This simultaneously removes debris and stops any
bleeding.
Third is the temporization. I fabricate a temporary using
autopolymerizing resin. You can use virtually any technique - strip
crowns - thermo-plastic buttons - free-hand - whatever.
Fourth is the retraction. After the temporary material has
set, I clean the interior of the crown with alcohol and the prep
with aluminum chloride in a fuzzy-tipped syringe* to remove the
oxygen-inhibited layer. If I left this thin layer of unset resin,
it would prevent the vinyl impression material from setting properly.
To avoid wasting a mixing tip, I spatulate a small amount of Cinch-90
on a pad and overfill the temp. I immediately seat the crown and
ask the patient to bite down firmly. The hydraulic pressure this
creates forces the impression material down into the sulcus atraumatically.
About 2 minutes later I remove the temp to reveal a dry, blood-free
prep and beautifully retracted tissue.
Since I don’t use the primary impression to drive the wash,
I don’t have to worry that the hydraulic force will distort
my working impression and affect the final crown fit. And there’s
another benefit. When I examine the Cinch-90, I get a sneak-preview
of what my final impression will look like. If I discover something
wrong, I can go back and refine the preparation before I take the
working impression.
If the “retraction-impression” looks good, I simply proceed
to the working impression. I use either the Laminar Flow or the
H&H technique, but you can take whatever type of impression
you’re comfortable with.
Because the retraction-impression applied pressure to any subtle
hemorrhages and pushed the tissue away from the tooth, my subsequent
working impression is crystal clear. No bleeding. Easy-to-read margins
and no retraction cord!
I’ve been using this technique for more than 2 years now with
tremendous success. My patients appreciate my going cordless (Not
to mention the doctor!) I would never go back.
* Though aluminum chloide may not be the best
cleaning agent in the world, it’s adequate - and it simultaneously
stops any bleeding,
To
see how Dentists use Cinch, please click
here .
Click
here for
all Cinch product MSDS Sheets.
©2002 Parkell, Inc. Notice
|
