April 2017

Impression Precision

Tissue Management
Starts with
Success
The Set-Up for
Taking a dental impression is a professional craft with both conventional impressions and digital
scans; the expertise comes from long practice. From the beginning, you are experimenting with
and honing your techniques and materials to achieve efficiency and confidence in your abilities.

According to Gordon Christensen, DDS, MSD, PhD

“40,000,000 impressions
are taken each year; 90% do not
have all margins taken.”

The precision of your impressions forms the critical foundation for subsequent procedures.
Attaining predictably effective impressions requires identifying the most effective materials (from Fig 1. Conventional impression.
more than hundreds of brands) to facilitate your preferred technique. This is also the case of
digital impressions, where preparation and technique can affect capturing the margins.

GOALS FOR YOUR IMPRESSION TECHNIQUE:

Consistent quality Sharper margins Less pressure on Supporting a Avoid retakes
sensitive tissue healthy gingival
environment

Inadequate margins can be due to problems with soft tissue retraction, bleeding, and moisture.
The inability to achieve a dry, well-retracted field can result in the eventual failure of a restoration
and contribute to a periodontal condition for the patient. Therefore, it is critically important for a
clinician to have confidence that a material can provide this foundation consistently.
Fig 2. Digital margin.

Impression Precision Starts

with Tissue Management
Tissue Management
Recalibrate Your

Traditional cord retraction is a time-consuming process; the

availability of alternative gingival retraction paste offers
significant benefits to a busy practice and greater comfort to
patients. Many operators who previously used the “double cord”
technique now use the initial smaller cord and prefer retraction
paste in lieu of the second cord. Additionally, cordless retraction
is especially useful with digital impressioning to achieve crisp
margins without soft tissue obscuring the view of the margin.
Paste materials can offer faster, easier, and effective retraction.
These materials are much less likely to stimulate bleeding in the
gingival sulcus during placement or immediately after removal
when compared to retraction cord. Paste materials also respect
the biological width, which can be damaged when packing cord.
“Clinical Implications: When a 1- to 2-mm-deep subgingival
preparation finish line is formed on a healthy gingival margin,
the displacement paste and cap application may be the first
choice, giving the benefits of hemostasis, time saving, and ease
of application.”1

“I have enjoyed using Traxodent

as an adjunct and also as a replacement
to traditional cord placement, while
enjoying the same level of success
Acar O et al. A clinical comparison of cordless and conventional displacement
1. with our impressions.”
systems regarding clinical performance and impression quality. J Prosthet Dent. Virginia Lee, DDS (USA)
2014;111(5):388-394.

Impression Precision Starts

with Tissue Management
Example
Material

Traxodent contains 15 percent aluminum chloride in a proprietary

clay matrix that absorbs crevicular fluid, saliva, and blood while also
providing sulcular retraction. The soft paste produces gentle pressure on
the sulcus while it absorbs excess crevicular fluid and blood. Retraction
caps are included with Traxodent to provide you with the option for
enhancing and simplifying retraction. The aluminum chloride creates an
astringent effect without irritating, staining, or discoloring tooth structure
and surrounding tissue. This is critical in ceramic restorations where show-
through can occur. Additionally, the aluminum chloride acts topically to
shrink and contract tissue, thus avoiding the risk of a systemic side effects.

TRAXODENT IS VERSATILE AND HAS BEEN SUCCESSFULLY USED FOR:

• Replacing the second cord in the double cord technique
• Hemostasis and moisture control prior to composite restorations
in class II, III and V cavities Fig 3. Traxodent syringe and new Unit Dose.
• Tissue management prior to veneer or crown cementation
• Hemostasis after removal of a temporary crown
• Post-op hemostasis after laser troughing “Using Traxodent immediately after
• Post-op hemostasis after electrosurgery
electrosurgery is great for stopping any
Traxodent’s strong affinity to aqueous solutions allows the paste to be rinsed
easily and cleanly. There is no residue left behind that can interfere with
residual bleeding and tidying up the
impression materials and adhesives. sulcus cut by the tip.”

Michael N. Mandikos, BDSc, MS, Cert

Pros, FRACDS, FICD (Australia)

Impression Precision Starts

with Tissue Management
Comfort
Patient

Using Traxodent with a retraction cap is considerably more

comfortable for the patient. Packing gingival retraction cord can be
uncomfortable, especially when the gingiva is thin. It can also be
difficult and time-consuming for the practitioner.
Traxodent placement and the use of a compression cap are painless
and require only a few moments to complete. This procedure is not
technique sensitive; just dispense Traxodent around the margin, place
the appropriate size retraction cap over the prepared tooth and have
the patient bite down on the cap. In two to three minutes hemostasis
and retraction is achieved with most patients. Moreover, with this Fig 4. Traxodent with retraction cap.
technique the chance of causing trauma to the soft tissue, junctional
epithelium or connective tissue is significantly reduced.

“Our impressions are clean

and accurate; our patients
are comfortable…”
Nancie J. Johnson, DDS (USA)

Fig 5. Resulting impression.

Figures courtesy of Dean Elledge, DDS, MS, Wichita State University, Advanced
Education General Dentistry.

Impression Precision Starts

with Tissue Management
Impression Techniques
1-Step

INJECT WASH (PUSH, DON'T PULL) • AIR THIN • INJECT WASH • SEAT TRAY WITH HEAVY-BODY MATERIAL
Courtesy of Gregg Helvey, DDS, CDT

ONE STEP
HEAVY AND LIGHT BODY TOGETHER
• most frequently used
• faster – less time consuming
• same results with polyvinyl and polyether
• no error compensation

Impression Precision Starts

with Tissue Management
Impression Techniques
2-Step

•S
 eat tray with heavy-body material, and as it • After setting, remove interproximal material • L oad wash material in the entire impression,
approaches the setting time, start taking it in •R
 emove or place vent holes in area not just the prep
and out to develop relief of the preparation • Seat with force

Courtesy of Gregg Helvey, DDS, CDT

TWO STEP
HEAVY BODY FIRST, THEN LIGHT BODY
• provides error compensation
•m
 ust provide relief (vent holes or remove
some material) or strain develops causing
smaller dies

Impression Precision Starts

with Tissue Management
Impression
Digital

APPLY TRAXODENT WAIT 2 MINUTES AND RINSE RETRACTION CAP OPTION REVIEW MARGIN

Traxodent can be used alone, or as Traxodent can be used with a Make certain you can easily
a replacement to the second cord retraction cap for quick, gentle identify your preparation margins
in the double cord technique hemostasis and retraction in your scan as shown here

See Traxodent
PREDICTABLE, ACCURATE, AND SUCCESSFUL in Action
Traxodent is suitable for all routine daily hemostasis and or retraction needs. The paste is easy to
dispense and will stay put until rinse. The paste rinses clean and will not leave behind a film that
can interfere with downstream procedures.

Impression Precision Starts

with Tissue Management
Company
About the

Premier Dental Products Company is a privately-held business with sales in

over 75 countries. Dental professionals have turned to Premier for over 100
years to improve their daily procedures and practices. A leader in bringing
innovative products to the world-wide market, Premier is dedicated to inspiring
solutions for daily dentistry.

The preceding material was provided by the manufacturer. Statements and opinions are solely those
of the manufacturer and not of the editors, publisher, or the Editorial Board of Inside Dentistry.

T H A N K Y O U T O O U R S P O N S O R : P R E M I E R D E N TA L P R O D U C T S

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with cord or a retraction cap for greater gingival deflection.
The paste will not irritate or discolor surrounding tissue,
providing a positive patient experience. Use Traxodent
and enjoy the benefits of predictable results and accurate
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 ADDITIONAL RESOURCES

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