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Gtc 4 - Impressions & Retraction Cord (Ppsg Lectures)

Gtc 4 - Impressions & Retraction Cord (Ppsg Lectures)

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Published by Aisha Mutiara

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Published by: Aisha Mutiara on Jun 13, 2013
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• An impression is an imprint or negative likeness. • It is made by placing some soft, semi fluid material in the mouth and allowing the material to set. • The impression must be handled properly until it is poured up in a gypsum product.

An impression for a cast restoration should meet the following requirements : 1. It should be an exact duplication of the prepared tooth

2. Other teeth and tissue adjacent to the prepared tooth must be accurately reproduced
3. It must be free of bubbles

• The custom tray must be rigid. thin layer of 2to 3 mm. . and it should have stops on the occlusal surfaces of the teeth to orient the tray properly when it is seated in the mouth.Custom resin tray • Custom resin tray have been utilized in elastomeric impression techniques because these material are more accurate in uniform.

4. 7.Armamentarium : 1. 2. 6. 5. Diagnostic casts Autopolimerizing acrylic resin Measuring vial for monomer Measuring scoop for polymer Waxed paper cup Spatula Baseplate wax . 3.

8. Arbor bands 13. Bunsen burner 11. Laboratory knife with no. Matches 12. Adhesive for impression material used . 25 blade 10. Aluminum foil 9.

forming solid stops for the tray. . • Cut a 3 x 3 mm hole through the wax over posterior teeth on both sides of the arch and in the incisor area. • The tray resin will touch the teeth in these areas. • Adapt it to the cast and trim any excess that extends more than 2 to 3 mm beyond the necks of the teeth.Construction of custom tray : • Heat a sheet of baseplate wax in a flame until it is softened • Fold it in half and place it on the diagnostic cast of the arch to be restored.

• On the side where the prepared tooth is situated. • Leave some extra bulk in the middle. • As soon as it is pliable and will not stick to your fingers. • Mix the resin in the waxed paper cup. . using one measure of powder and one vial of liquid. the stop should be distal to the preparation. around the incisor). form it into a rod that is approximately the length of the dental arch (molar to molar.5 cm wide and 5. • Flatten it out to form an oblong shape about 2.0 cm thick.

Cutouts for stops (arrows) in the spacers for fabrication of a custom impression tray Tray resin ready for adaption to the cast .

• Make sure that the tray does not extend beyond the trimmed distal border of the cast in the retromolar area. uniform coat of adhesive. • Paint the inside of the tray with a thin. . • The wings can be used to get better leverage on the tray for removal from the mouth. • The bulk left in the middle of the tray should be used to shape a horizontal handle in the middle and a narrow ledge or “wing” on either side of it. • Allow the resin to polymerize. using the one specified for the impression material being used.

allow it to dry for a minimum of 15 minutes.To achieve maximum adhesion of the impression material to the tray. Finished custom impression tray with a handle in front and wings on the side to facilitate removal Inside of the tray is painted with adhesive .

.Gingival retraction • It is essential that gingival tissue be healthy and free of inflammation before cast restorations are begun. the finish line of the tooth preparation must be reproduced in the impression. • Because the marginal fit of a restoration is essential in preventing recurrent caries and gingival iritation. • To start tooth preparations in the face of untreated gingivitis makes the task more difficult and seriously compromises the chances for succes.

DE plastic filling instrument IPPA . Evacuator (saliva ejector) 2.Armamentarium : 1. Fisher Ultrapak Packer (small) 7. Explorer 6. Cotton pliers 4. Scissors 3. Mouth mirror 5.

Retraction cord 10. 2 x 2 gauze sponges . Dappen dish 12. Hemodent liquid 11. Cotton rolls 9.8. Cotton pellets 13.

• Gently slip the cord between the tooth and the gingiva in the mesial interproximal area with a Fisher packing instrument or a DE plastic instrument IPPA. and apply slight tension in an apical direction.Retraction procedure : • Form the cord into a “U” and loop it around the prepared tooth. • Hold the cord between the thumb and forefinger. . • Once the cord has been tucked in on the mesial. use the instrument to lightly secure it in the distal interproximal area.

It should also be tacked lightly into the distal crevice (B) to hold the cord in position while it is being placed. .A loop of retraction cord is formed around the tooth and held with the thumb and forefinger Placement of the retraction cord is begun by pushing it into the sulcus on the mesial surface of the tooth (A).

• Gently press apically on the cord with the instrument. . • If the tip of the instrument is inclined away from the area in which the cord has been placed.• The tip of the instrument should be inclined slightly toward the area where the cord has already been placed. the cord may be displaced and pull out. • Then push the cord into the crevice. directing the tip slightly toward the tooth. • Slide the cord gingivally along the preparation until the finish lineis felt.

As the cord is being placed subgingivally. toward the root to facilitate the subgingival placement of the cord. the cord already packed will be pulled out (B) The instrument must be angled slightly. the instrument must be pushed slightly toward the area already tucked into place (A). If the force of the instrument is directed away from the area previously packed. .

0 or 3. • Pack all but the last 2.0 mm of cord. do not apply greater force. • If cord persists in rebounding from a particularly tight area of the sulcus. the cord will rebound of the gingiva and roll out of the sulcus. • Instead. .• If the instrument is directed totally in an apical direction. change to a smaller or more pliable cord. maintain gentle force for a longer time. if it still rebounds.

the retraction cord will be pushed against the wall of the gingival crevice. Placement of the distal end of the cord is continued until it overlaps the mesial. and it will rebound. .If the instrument is held parallel to the long axis of the tooth. The force of the instrument must be directed toward the cord previously packed.

and jeopardize the longevity oh the restoration that they place. • Do not over pack. • Heavy-handed operators can traumatize the tissue. B. create gingival problem. correct. so that the cord will rest at the finish line. . Placement of the retraction cord in the sulcus : A.• Tissue retraction should be done firmly but gently. incorrect.

• The accelerator. • The impression material is packaged in two tubes : a base and an accelerator. acts as an oxidation initiator on terminal thiol groups on the polymer.Impression materials (polysulfide): • Polysulfide is an elastomer that is known as mercaptan. • The base contains a liquid polysulfide polymer mixed with an inert filler. thiokol. . which is usually lead dioxide mixed with small amounts of sulfur and oil. or simply as rubber base.

Two 2 x 2 inch gauze sponges 8. Polysulfide impression kit (regular base and accelerator) 2. Two disposable mixing pads 5.Armamentarium : 1. Alcohol 9. Adhesive (butyl rubber cement) 4. Two stiff spatulas 6. Custom resin tray . Polysulfide impression kit (light base and accelerator) 3. Syringe with disposable tip 7.

0 cm each of light (syringe) base and accelerator. • Insert the retraction cord and place a large gauze pack in the mouth. . On second pad place 12. • The following steps require an assistant : On one disposable mixing pad squeeze aout 4.Impression Making With Polysulfide : • Try the custom tray in the mouth to make sure it fits without impinging on the prepared tooth.5 cm strips of regular (tray) base and accelerator.

mix with a back-and-forth motion. • Change directions often to produce a smooth. • Do not take more than 1 monute to mix it. • Be careful not to incorporate bubbles. homogenous mixture. . • Holding the spatula flat against the pad.• The assistant should start mixing the tray material on one pad 30 seconds before the operator begins mixing the syringe material on the other. • Pick up the dark accelerator on the spatula and incorporate it into the white base. pressing hard against the pad.

. • Fold a sheet previously removed from the mixing pad in half and then fold it to make a cone.The mixture should be free of streaks and bubbles. Mixing is started with the dark accelerator. • Open it up and wipe the syringe material from the spatula onto the crease.

Fully extended mixing pad sheet. The sheet is folded in half The sheet is folded to form a cone Impression material is wiped on the crease .

• Fold the cone over. closely spaced sweeps of the syrunge will fill it. • Insert the plunger and express all the air from the syringe. • Squeeze the syringe material from the cone into the back end of the syringe. with a minimum of material spilled. • In a second method of loading the syringe. . the back end of the syringe is brought in contact with the pad. and quick.

The cone is inserted into the syringe The plunger is placed into the syringe Scraping the back end across the mixing pad to scoop up material. .The paper is refolded to form cone again.

• Use an air syringe to direct a stream of air against the material to spread it evenly over the surface of the preparation and drive it into small detail such as grooves and boxes. • Impression material is also forced more completely into the gingival crevice. • Immediately inject polysulfide syringe material into the sulcus.• Remove the 2 x 2 gauze squares from the patient’s mouth. . • Be sure that the retraction cord is slightly damp before removing it from the sulcus.

.Impression material is injected into the sulcus An air syringe is used to drive the impression material into the sulcus and preparation detail.

• After the material has polymerized. • The wings on the sides of the tray can be used for added leverage in this task. the impression is removed. • The set of the material can be tested with a blunt instrument. • The tray should be held with light pressure for 8 to 10 minutes without movement.• Seat the tray slowly until the stops hold the tray solidly in one position. .

.Wings on either side of the tray (arrows) are grasped to remove the impression from the mouth.

Soal midterm • • • • • • • Pasien kehilangan 3 dan2 RA kanan .buat design GTC porselein fused metal 2. 1.jenis pendak yg sdr pakai .jenis preparasi gigi abutment 4.gigi mana sebagai abutment 3.bagaimana hukum Ante diterapkan pd pemilihan gigi abutment tsb 5.

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