A Lasting Impression
Dentists don’t forget a great impression material
Editor’s Note: First Impressions would like to acknowledge the contribution of DUX Dental (Oxford, Calif.) and GC America (Alsip, Ill.).
The good news is, when it comes to dental impression material, dentists have an array of choices. But, it’s up to distributor reps to help their customers make the selection that best suits their needs. Advancements in technology have led to products that are truly hydrophilic (they work well in a blood-and-saliva environment in the mouth), tear-resistant, highly viscous and better tasting. With a little gentle probing, sales reps can provide an impression material that no one will forget.
What’s on the market?
Most dental practices and some specialists require impression material. Materials today are suitable for a variety of functions, including removable and fixed prosthetics. Alginate and alginate substitute materials are designed to capture tooth position for splints, night guards, bleaching trays, opposing models, indirect provisionals and removable dentistry. There are also such materials as polyether, polyvinylsiloxane and reversible hydrocolloid, designed for crown and bridge impressions. That level of accuracy is the foundation for a successful fixed or implant restoration.
Alginates are relatively easy and inexpensive to use. Traditionally, they have been poured in the office, but they also can be sent to the lab for pouring or scanning. Fixatives are available as well, which permit the alginate to remain stable on the bench for up to one month before pouring. This flexibility removes the stress and immediacy from the staff, particularly when emergency visits arise.
Alginate substitutes are fast-setting polyvinylsiloxane (PVS) materials, packaged in cartridges and chub paks, which eliminates the hand mixing traditionally associated with alginate impressions. These materials are said to offer greater dimensional stability than alginates, and they can be poured weeks after being taken. They have seen inroads in the orthodontic market, where some offices choose to mail their impressions to cross-country labs for pouring and scanning. Alginate substitutes require more time in the mouth, however, and they cost significantly more than alginates.
Zinc-oxide eugenol pastes are among the original materials used for making edentulous impressions. Because they are light and fluffy, they tend not to distort soft tissue. They also are fast setting. Today, their use is limited to edentulous impressions.
Edentulous impressions are also made using alginate or rubber-based (polysulfide) materials. These elastic materials reportedly provide options in viscosity and can capture greater detail than alginates, especially when making removable edentulous impressions. Because rubber-based materials are said to offer greater stability than alginates, they can be poured long after the patient has departed, as well as mailed to a lab. Some rubber-base materials give off a sulfur odor, but they offer accuracy, enhanced detail and are appropriate for both fixed and removable dentistry.
Materials commonly used for fixed dentistry include polyether, polyvinylsiloxane and reversible hydrocolloid. These materials all reportedly capture much detail, but function in different ways.
Polyether and PVS materials are packaged in cartridges for mixing guns or chub paks for mixing in auto-mix systems, making it easier to fill inter-oral syringes and impression trays. These materials have little or no odor or taste, and can be sent to the lab to be poured up to four weeks afterward. They feature elastic recovery and dimensional stability, and may be poured multiple times.
Polyethers are hydrophilic, adhere well to the work area and pick up a lot of detail. However, they are rigid, with low tear resistance. Polyvinylsiloxanes, on the other hand, tend to demonstrate greater tear strength, but they are hydrophobic and therefore tend to pick up less detail than polyethers. Recently, one vendor introduced a product to the market that, it says, combines the best of the polyether and PVS worlds: The impression material is said to be hydrophilic; flows well under pressure, adheres to the work area and picks up a lot of detail; demonstrates good tear resistance and comes in a mint flavor.
Reversible hydrocolloids are the oldest of the indirect impression materials, but some experts consider them an accurate alternative. Reversible hydrocolloid is pre-mixed and packaged in polytubes, which are heated in a water bath and remain at an elevated temperature to be usable throughout the week. The cost of the heating unit is comparable to the cost of mixing devices for polyether and polyvinylsiloxane materials. Hydrocolloid functions best in a wet environment, so normal mouth moisture (blood and saliva) is not an issue. Hydrocolloid impressions may be poured only once, so a second impression is often made.
How to sell
Distributor reps should update their dental customers on all available products and technology. Probing questions, such as the following, are helpful in determining customers’ needs:
- "Doctor, a big part of your business is restorative dentistry. Is the cost of impression-making important to you?"
- "Doctor, does moisture ever play a part in, or delay, the making of your impressions?"
- "Doctor, you do a lot of quadrant dentistry and bridges. Wouldn’t it be easier to eliminate the need for a syringe?"
- "Doctor, your staff is busy pouring alginate impressions all day long. Did you know there are fixatives available so you could pour them all at once - or up to weeks later - or you could even send them to the lab?"
- "Doctor, can I refer you to other dentists who have had great results using some of the newer impression materials available today?"
With continual advancements in technology and upgrades in materials, dental customers depend on their reps to steer them to a product that ensures a lasting impression for their patients.
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