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3CREDITS
CE written for
dentists,
dental hygienists,
and assistants.
SUPPLEMENT TO
PENNWELL PUBLICATIONS
EARN
3CREDITS
CE This educational activity was made possible through
an unrestricted educational grant by Ultradent.
Fixed restorative dentistry requires an impression of the teeth and area to be restored Known Benefits and Limitations of the Data:
The information presented in this educational activity
for the laboratory to fabricate the desired restorations. Traditional impressions are is derived from the data and information contained
still utilized the majority of the time to capture the needed information. Selection in reference section. The research data is extensive
and provides direct benefit to the patient and
of the correct viscosity will vary depending on what prosthesis is to be fabricated, improvements in oral health.
which tray is being used and whether the preparations are on natural teeth or Registration: The cost of this CE course is $59.00 for
implants. Problems can arise during impression taking that can compromise the 3 CE credits.
ability of the lab to fabricate the restoration or affect the accuracy and fit of the Cancellation/Refund Policy: Any participant who is
not 100% satisfied with this course can request a full
finished prosthesis. Identifying impression problems is part of the process, but how refund by contacting PennWell in writing.
to manage these to improve the quality and accuracy of our impressions is critical
to fixed prosthetics.
INTRODUCTION
Impression fabrication is a critical and technique-sensitive step in the Figure 2
fabrication of fixed prosthetics. It can also be a frustrating stage during
treatment, both to the clinician and laboratory technician. Potential
complications need to be identified and corrected prior to sending the
impression to the lab for fabrication of the prosthetics. This article will
address some common difficulties, what factors may cause impression
errors, and present methods to correct and avoid complications related
to impression capture.
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DENTAL ACADEMY OF CONTINUING EDUCATION
set impression with scissors will prevent the interproximal and between viscosities. The lower the viscosity the more likely it may tear in the
material from preventing full reinsertion of the impres- sulcus due to the thinness expressed subgingivally. The deeper the sulcus, the
sion intraorally. Additionally, new wash material should thinner the wash material and the higher the potential for it to tear when removed
be placed in all the tooth areas on the side of the impres- intraorally. Additionally, removal of the impression prior to complete setting of the
sion before reseating the previously set impression. Place- wash material may also cause marginal tearing.3 Elastic recovery of the wash mate-
ment of wash material only at the prepared teeth may rial is also critical to impression accuracy. The material may not tear upon removal
result in a "stepped" impression and lead to a restoration intraorally, but if it does not return to its pre-removal shape, the resulting impres-
that is not accurate related to the occlusion. sion will not be accurate and the prosthesis will not fit the teeth.
While the cause of large, internal, ill-defined areas in Should an impression need to be retaken due to sulcular material tearing, any
these preparations is usually fluid accumulation, air en- remnants of the original impression material must be removed from the sulcus.
trapment may also be a factor in narrow, deep inlay prepa- Additional tissue retraction may be indicated to widen the sulcus to facilitate
rations. These errors may be avoided by thorough flushing thicker sulcular impression material. Switching to a more viscous wash material
and drying of the preparation prior to impression taking. may further prevent development of another tear. Syringable hemostatic materi-
Placing an intraoral impression tip into the deepest part als (ViscoStat® Clear, Ultradent, South Jordan, UT; Quick-Stat Free, Vista Dental
of the preparation floor and extruding a light body VPS Products, Racine, WI) can be used to limit the amount of fluid evident in the
material to backfill the preparation, making sure to keep treatment area, and the patient can be instructed to occlude into a cotton cap
the tip in the material as its expressed, will force air out for several minutes, thereby physically pushing the tissue away from the tooth
of the preparation decreasing entrapment potential. and forcing the hemostatic deeper into the tissues.5, 6
If an air bubble remains on the cast after the impression
is poured, a corresponding void will be created in the DRAGS AND PULLS
prosthetic material. This should not interfere with seating A common complication encountered when using high viscousity impression ma-
of the restoration and will be filled with the luting agent. terials (i.e., putty or heavy body materials) are drags and pulls. A drag results when
These spots can often prevent complete seating when long, rounded depressions that resemble the cuspal edges of the teeth are left in the
removed from the cast prior to restoration fabrication as impression material upon insertion of the tray (Figure 5). Whereas, a pull (also referred
alteration of the casts surface may not match what is to as a fold) results when the material creates a fold in the material, usually at the
present intraorally on the preparation. Identification of gingival aspect (Figure 6). These deformities can both result from:
premature internal contacts can be performed with paint • Teeth rebounding off the tray and sliding into position.
on occlusion indicator liquids (e.g., Accufilm IV, Parkell • Impression material beyond its working time (no longer in its most fluid state)
Inc, Farmingdale, NY; Arti-Spot Bausch, Nashua, NH). The • Failure of the impression material to adapt to the teeth.
laboratory can block out around these tiny internal bubbles • Exceeding working time of the material prior to intraoral insertion.
prior to fabrication to decrease chairside time. • Insertion of the tray in one motion.
Drags and pulls can be avoided by using a less viscous material either syringed
MARGINAL TEARS around the teeth or placed over the more viscous material in the tray prior to insertion.
Marginal tears usually occur when a wash (syringable) Correction of a pull in the impression can be accomplished by removal of the inter-
material with insufficient tear strength is used (Figure 4). proximal impression material so the impression can be reinserted without interference.
Tear strength will vary from manufacturer to manufacturer A wash impression material (light or extra-light) should be placed over the entire
4 www.DentalAcademyOfCE.com
DENTAL ACADEMY OF CONTINUING EDUCATION
impression, and the depressions should be filled where the teeth are. The impression
can then be reinserting intraorally. Drags, on the other hand often are not correctable
by adding additional material, as they may have caused distortion of the tray. Avoiding
contact between the tray and the teeth will help avoid these deformations.
TRAY SELECTION
Tray selection is important to capture the needed area without distortion and
provide the needed details.7, 8 The tray, either a dual arch tray (also known as a triple
tray) or stock single arch tray, should be large enough encompass all the teeth
without contacting the soft tissue (Figure 7). The completed impression should Figure 11
not demonstrate any show through of the tray. Full arch trays are available in small,
medium and large and arch shape varies by manufacturer with some trays round
in shape and others more square. When using stock full arch trays it is important
to select a tray that is long enough to capture the entire arch from the hamular
notches or retromolar pads to the most anterior aspect of the buccal vestibule. A
tray that is too narrow may prevent adequate seating of the tray leading to missing
of needed arch detail (Figure 8). Metal trays may be bent to widen them in the
posterior, but modifications to the anterior of the tray can be difficult. Plastic stock
trays are easier to modify. An alcohol torch may be used to heat the plastic tray and SEPARATION FROM THE TRAY
the flanges readapted to fit the specific patient. Separation of the impression material from the tray may
Dual-arch trays also are available in different widths that can accommodate not be obvious until the restoration is returned and tried
different width arch sections. It is best to have a variety of these trays to accom- in (Figure 11). This deformation may be overlooked when
modate each patients arch size and shape. Show-through of the tray in the impression using trays with slots and holes to lock the impression
indicates that the tray used was either positioned improperly or the tray was too material and can occur with VPS, polyethers and even
small. (Figure 9) With dual-arch trays contact with the tray by soft tissue may cause alginate. The heavier the viscosity of the impression mate-
distortion of the resulting impression and a restoration that does not fit the prepared rial the higher the potential for the material not to lock
tooth. When using quadrant or dual arch trays, it is important to capture at least into the retention areas of the tray. Tray adhesive should
one full tooth (or the equivalent space) both mesial and distal to the tooth to be be used with all impressions to help eliminate impression
restored. Failure to provide this in the impression may make it difficult for the labo- separation from the tray creating a chemical bond between
ratory to properly mount the casts and achieve an accurate occlusion (Figure 10). the tray and impression material.9 Additional holes for
mechanical retention may be placed with a lab bur in stock
Figure 7 Figure 8 trays if needed. Each impression material’s chemistry is
different so it is advised that the clinician use the tray
adhesive from the same manufacturer as their impression
material to ensure chemical compatibility between the
adhesive and impression material. Following application
of the adhesive to the tray, allow the adhesive to dry prior
to applying the impression material. The adhesive can be
applied at the beginning of the appointment and will then
be dry and ready when it is time to take the impression.
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DENTAL ACADEMY OF CONTINUING EDUCATION
(Figures 12a). Use of a medium body (monophase) VPS as DUAL ARCH TRAYS
the main tray material will allow the tray to distort when it Dual arch trays work well for fixed prosthetic applications as long as the patient
contacts soft tissue or tooth and an elongated cast tooth has holding occlusal contacts in the section of the arch to be restored. As previously
results as the tray springs back. (Figure 12b) Proper selection indicated, it’s important that at least one tooth mesial and distal to the prepared
of a tray that does not contact the teeth and is rigid enough tooth be captured in the impression. Dual arch trays are available as posterior
to resist distortion is critical. When using dual-arch trays, it quadrant, anterior arch, ¾ arch, and full arch versions.
is advisable to use a rigid setting VPS material (e.g., a heavy When the tray is inserted and the patient occludes, it is important that maximum
body or tray material) as the bulk of the impression to provide intercuspation be observed on the adjacent side (Figure 14). When using anterior dual
a stable impression.10 Two-phase impressions can be used arch trays it is often difficult to determine if the patient has occluded fully, so a separate
to create a custom format using the dual-arch tray. The bite should be provided to the laboratory in a very rigid VPS material designed for
preliminary impression creates a rigid base that will provide occlusal records. It is recommended that the lab be instructed to use the separate bite
hydraulic pressure to force the wash material in and around record provided to mount the case and avoid hand articulating the casts or using the
the preparations. Trimming the interproximal material from dual-arch impression to determine occlusion. Wax bites should not be used as they
the preliminary impression will aid in seating the wash are unstable in transport to the lab due to changes in temperature during shipping.
impression fully when the wash phase is performed. Posterior and ¾ quadrant trays have a plastic distal loop on the tray to stabilize the
tray at insertion. It is critical that the patient not occlude on this loop as this will lead
Figure 12a Figure 12b to distortion of the tray and resulting spring back when the tray is removed (Figure 15).
Figure 14
INADEQUATE SYRINGE MATERIAL Upon dual arch tray impression removal, the clinician should be able to see
A “stepped” impression may result when using a two-phase contacts through the material to the trays mesh where the teeth are intercuspated
impression technique and insufficient wash material has been (Figure 16). Holding the tray up to the light should reveal illumination at these
placed (Figure 13). The result will be restorations that require contact points. An impression that was improperly occluded will show lack of oc-
excessive occlusal adjustments. This can be avoided by filling clusal shine through and thicker material between the arches. If there is any chance
the entire set tray material where the teeth depressions are that the laboratory cannot verify the occlusion, a separate bite should be taken
with wash material, to provide a uniform impression. with an appropriate VPS material and included with the case.
6 www.DentalAcademyOfCE.com
DENTAL ACADEMY OF CONTINUING EDUCATION
Figure 17
Figure 18
SURFACE CONTAMINATION
A less common problem, unset im-
pression material on the surface of
the set tray material may present. This
typically presents as an unset tacky
layer (Figure 17). Exposure to air in- INADEQUATE IMPRESSION MATERIAL MIXING
hibited methacrylates (e.g., compos- Once the impression material is combined, it should be
ites, adhesives, core build-up materi- uniform in color with no streaking. Streaking is more com-
als, bis-acryl temporary crown and mon with hand mixed putty materials than with cartridge
bridge materials) may leave a greasy coat on the prepared tooth that inhibits the materials (Figure 18). When hand mixing putty, the material
material’s ability to set correctly. When using two-step impressions, failure of the should be kneaded quickly to keep within the working time
wash material to adhere to the tray material may occur when the preliminary and yield a uniform color when completed. But, may also
impression is utilized to fabricate the temporary prosthesis. Wiping down both the occur if the automix cartridge is not bled prior to attaching
tooth and preliminary impression with alcohol to remove the greasy air-inhibited the mixing syringe, allowing one component to extrude
layer can prevent these issues. out of the cartridge first. Standard operating procedure
Hemostatic agents may transfer sulfur to critical areas of the impression and cause should be to bleed the cartridge right before a new automix
inhibition of the setting reaction of the marginal VPS material. These include retrac- tip is placed to ensure both base and catalyst are equally
tion cords and solutions containing ferric sulfate or aluminum chloride; glove contact flowing to avoid mixing issues. It is also recommended
of the prepared teeth or surrounding tissues; rolling retraction cord in gloved fingers; that the practitioner use the wash and tray material from
or the use of a rubber dam. Rinsing the area with mouthwash or water after rubber the same manufacturer to ensure that chemically the two
dam removal and thoroughly drying can avoid this problem. Latex contamination of materials are designed to work together. Mixing materials
the putty can occur when mixing by hand. This may be avoided by washing gloved from different companies may lead to separation of the
hands to remove any residual powder and surface sulfides. Powder-free, nitrile or vinyl wash material from the tray VPS decreasing the impressions
gloves are alternatives to prevent putty contamination. It is advised that following accuracy when the lab pours the model.
use of a hemostatic agent to control gingival hemorrhage, the preparation be vigor-
ously washed with the air/water syringe to clean any residual hemostatic and debris CAST DISCREPANCIES
from the tooth. Should any gingival oozing begin, additional hemostatic is burnished Large bubbles on the cast will correspond to a defect in
into the gingiva to arrest the hemorrhaging. If no bleeding is noted the prep is air dried the impression material and should be identified before
and impressioning can begin. This will avoid sulcular bleeding that will lead to having dismissing the patient so that a new impression or a wash
to retake the impression and the impression is only begun when your assured all in the defective impression can be taken to correct the
hemorrhage in the sulcus has been controlled. problem (Figure 19). These bubbles invariably are caused
When a small area of unset material is noted in the final impression, but the re-
mainder of the material has set properly. This may be the result of a failure to bleed
the cartridge prior to expressing material from the auto mix tip. All new cartridges
should be “bled” prior to use. It is a wise practice to express a small amount of base
and catalyst prior to placement of an automix tip each time to ensure that both
materials are flowing from the cartridge and have not set at the end of the
cartridge. Figure 19
Disinfection of the completed impression can be performed either prior to sending
the impression to the laboratory or at the laboratory. Immersion of the impression in
common disinfecting solutions (i.e. phenols and gluteraldehydes) used for periods of
time up to 60 minutes have not shown clinically significant distortion or surface al-
teration of the impression material.11, 12 Although, overnight immersion is not recom-
mended as this may result in a decrease in accuracy of the final cast.13
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DENTAL ACADEMY OF CONTINUING EDUCATION
Figure 20 Figure 22
8 www.DentalAcademyOfCE.com
DENTAL ACADEMY OF CONTINUING EDUCATION
Figure 23
8. Thongthammachat S, Moore BK, Barco MT 2nd, Hovijitra S, Brown DT,
Andres CJ.: Dimensional accuracy of dental casts: influence of tray
material, impression material, and time. J Prosthodont. 2002
Jun;11(2):98-108.
9. Giordano R 2nd.: Issues in handling impression materials. Gen Dent.
2000 Nov-Dec;48(6):646-8.
10. Ceyhan JA, Johnson GH, Lepe X.: The effect of tray selection,
viscosity of impression material, and sequence of pour on the
accuracy of dies made from dual-arch impressions. J Prosthet Dent.
2003 Aug;90(2):143-9.
11. Rios MP, Morgano SM, Stein RS, Rose L.: Effects of chemical
but it is important to know the working time for that material. The impression disinfectant solutions on the stability and accuracy of the dental
needs to be dispensed into the tray and inserted within that working time. If this impression complex. J Prosthet Dent. 1996 Oct;76(4):356-62.
is exceeded the impression material has started the setting process and may not 12. Oda Y, Matsumoto T, Sumii T.: Evaluation of dimensional stability of
elastomeric impression materials during disinfection. Bull Tokyo
fully seat, plus will not accurately capture the needed details intraorally. As
Dent Coll. 1995 Feb;36(1):1-7.
discussed high tear strength for the wash material with good elastic recovery 13. Lepe X, Johnson GH.: Accuracy of polyether and addition silicone
will allow accurate capture of the marginal details. Hydrophilicity, is also an after long-term immersion disinfection. J Prosthet Dent. 1997
important feature in quality VPS impression materials. Materials that have high Sep;78(3):245-9.
hydrophilicity will adapt to the prepared tooth better especially subgingivally
where fluid may be present. Those that have low hydrophilicity or are hydrophobic
will not adapt to wet surfaces and lead to lower impression quality as a result. AUTHOR PROFILE
Some of the materials that fulfill those qualities include; Thermo Clone VPS
Gregori M. Kurtzman, DDS, MAGD,
(Ultradent), Imprint (3M/ESPE) and Take One (Kerr Dental).
FPFA, FACD, FADI, DICOI, DADIA, Dr.
Kurtzman has completed over 4,500 hours
CONCLUSION of continuing education in the areas of
Complications during the impression process can be perplexing to both the dentist IMPLANT DENTISTRY, COSMETIC DENTISTRY
and laboratory technician. Some of the more common concerns include tearing, voids, AND OTHER DENTAL TOPICS. A graduate of
The AAID / Howard University College of
bubbles, and tray contact. Identifying the problem is only half the solution and under-
Dentistry IMPLANT MAXI COURSE, he has been trained in all aspects
standing why it occurred helps guide the practitioner to correct the issue and prevent of Implant Dentistry. He has achieved FELLOWSHIP in the Academy
future occurrences. This article addressed solutions for correction of some of the most of General Dentistry (AGD), Pierre Fauchard Academy (PFA),
prevalent impression issues that are experienced in clinical practice. By taking the International Congress of oral Implantologists (ICOI), the American
necessary precautions, clinicians can ensure improved accuracy in communication College of Dentists (ACD) and the Academy of Dentistry
International (ADI). Holds MASTERSHIP in the AGD and the Implant
of critical parameters as well as an overall improvement in restorative fit related to
Prosthetic Section of the ICOI. He also has achieved DIPLOMATE
their impressions. Key to these goals are achieving sufficient hemostasis (retraction status in the ICOI and the American Dental Implant Association
cord, retraction pastes or laser) and using a quality impression material so that treat- (ADIA). He is a former Assistant Program Director for a university
ment success is maximized for the doctor, lab and most importantly the patient. based IMPLANT MAXI-COURSE and a former Assistant Clinical
Professor at University of Maryland, Baltimore School of Dental
Surgery in the department of Endodontics, Prosthetics and
REFERENCES:
Operative Dentistry. An International lecturer, he has been
1. Shannon A.: Expanded clinical uses of a novel tissue-retraction material. Compend Contin Educ
recognized annually since 2006 as one of the “TOP DENTAL
Dent. 2002 Jan;23(1 Suppl):3-6
LECTURERS” by Dentistry Today. Dr. Kurtzman has published over
2. Poss S.: An innovative tissue-retraction material. Compend Contin Educ Dent. 2002 Jan;23(1
180 dental articles in national and international dental journals and
Suppl):13-7
is a consultant to multiple dental manufacturers.
3. Pescatore C.: A predictable gingival retraction system. Compend Contin Educ Dent. 2002 Jan;23(1
Suppl):7-12
4. Kurtzman GM, Agarwal T.: Laser Troughing to Improve Scanning and Impressions. Dent Today. 2017 AUTHOR DISCLOSURE
Jan;36(1):122-5. The author has no affiliations with any company who would have
5. Hondrum SO.: Tear and energy properties of three impression materials. Int J Prosthodont. 1994 a gained interest in the material published in this course. The
Nov-Dec;7(6):517-21. author is not employed by a company that would stand to profit
6. Chai J, Takahashi Y, Lautenschlager EP.: Clinically relevant mechanical properties of elastomeric off the publication of this course. All research is presented in an
impression materials. Int J Prosthodont. 1998 May-Jun;11(3):219-23. unbiased manner.
7. Brosky ME, Pesun IJ, Lowder PD, Delong R, Hodges JS.: Laser digitization of casts to determine the
effect of tray selection and cast formation technique on accuracy. J Prosthet Dent. 2002
Feb;87(2):204-9.
www.DentalAcademyOfCE.com 9
DENTAL ACADEMY OF CONTINUING EDUCATION
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QUESTIONS
1. Primary complaint from labs is? 8. When using a 2-step impression 14. Exceeding the working time of the
a. Inadequate marginal detail technique? impression material can result in?
b. Torn sulcular material a. Trim interproximal material with scissor in a. Drags and folds
c. Voids on the marginal material set tray material before step 2 b. Failure of the wash material and tray
d. All of the above b. Avoid drying the set material in the tray material to adhere to each other
2. Failure to capture the marginal details c. Place wash material over all tooth c. No effect on the final impression
will result in? areas in the set tray material before d. Make removal of the impression intraorally
a. Overhanging restoration margins reinserting more difficult
b. Overextended restorative margins d. A and C 15. To avoid drags and pulls when using
c. Open restorative margins 9. When capturing an occlusal or proximal heavier body tray materials you can?
d. A and C preparation it is advised to? a. Use a 1-step technique
3. Methods to better visualize the a. A. Use a wash material placed into the tray b. Use a 2-step technique
restorative margin to capture with an over the unset tray material c. Syringe wash material around all of the
impression? b. Place an intraoral tip to the bottom of the teeth before inserting the previously set
a. Retraction cord preparation and backfill it to prevent air tray material
b. Retraction pastes entrapment d. Syringe wash material around all of the
c. Laser c. Utilize a 2-step technique teeth before inserting the unset tray
d. All of the above d. Avoid use of a heavy body VPS material
4. Internal bubbles on the impression may 10. Identification of internal premature 16. When using a dual-arch tray?
be due to? contacts on an inlay/onlay restoration a. Use a heavy body VPS in the tray
a. Trapped moisture can be aided by? b. Use a medium body VPS in the tray
b. Trapped food a. Liquid occlusal indicator c. Viscosity of the tray material is not
c. Unset impression material b. Use of articulating film instead of important
d. Poor tooth preparation articulating paper d. All trays are the same
5. Which is problematic in the impression? c. Relief of the entire internal area of the 17. Tray selection is important because?
a. Bubbles on teeth not being restored that do restoration with a bur/diamond a. Patient arches vary and one manufacturers
are not adjacent to the prep d. Relief of the entire preparation with a bur/ tray will not fit all arches of that same
b. Bubbles on the opposing arch diamond size
c. Bubbles at internal line angles 11. Marginal tears of the impression b. Prevent show through of the tray in the
d. Bubbles at the margins material are related to? completed impression
a. Low wash material tear strength c. Not contact soft tissue when inserted that
6. If a bleb is noted related to a bubble on b. Deep margin with narrow sulcus may lead to distoration
the internal line angle of the prep on the c. Premature removal of the impression d. All of the above
cast it is recommended to? intraorally 18. When using full arch trays it is
a. Ignore the bleb as it won’t affect fabrication d. All of the above important to select a tray that is?
of the restoration 12. Regarding marginal tearing, a. Long enough to capture the entire arch
b. Scrap off the bleb on the cast which viscosity will be stronger in a b. Long enough to capture the teeth being
c. Block out the area on the cast around the deeper sulcus to capture needed treated
bleb if it is small detail? c. Tray contact with soft tissue is not
d. Block out the area on the cast around any
a. Very light body VPS important
size bleb
b. Light body VPS d. Not wider then the arch
7. Large bubbles in the impression at c. Medium body VPS 19. When using a dual-arch posterior tray it
internal line angles may? d. Universal body VPS is important that?
a. Compromise the strength of metal
13. When using a heavier body VPS in the a. Contact with the posterior loop helps
restorations fabricated on the cast
tray you may notice? stabilize the occlusion of the impression
b. Compromise the strength of ceramic
a. Longer setting time b. Upon biting not have contact with the
restorations fabricated on the cast
b. Drags may be noted due to air entrapment posterior loop
c. Not effect the integrity of the restoration
c. Drags may be noted due to the cusps when c. Show through on the occlusal surface not
fabricated
inserted be present
d. May be altered on the cast to remove
d. Lack of adhesion to the wash material d. Contact with the tray be evident to ensure
before restoration fabrication
when doing a 1-step technique an accurate impression
10 www.DentalAcademyOfCE.com
QUESTIONS (CONTINUED)
20. Separation of the impression material 24. When disinfecting an impression you can? 28. When taking an closed tray implant
from the tray can be avoided by? a. Spray with disinfectant and immediately impression?
a. Application of a compatible adhesive to the rinse off a. A medium body VPS is recommended
tray b. Immerse in approved disinfecting solution b. A heavy body VPS is recommended
b. Selection of a tray with adequate retentive for up to 30 minutes c. Any viscosity VPS may be used
elements c. Immerse in approved disinfecting solution d. VPS should not be used as the impression
c. Addition of holes or slots to the stock tray for up to 60 minutes material
before taking the impression d. Immerse in approved disinfecting solution 29. If a tray material VPS is used to capture
d. All of the above overnight a closed tray impression what potential
21. A “stepped” impression may result 25. When taking a VPS impression one problems can occur?
when? should? a. Impression may tear upon removal of the
a. Inadequate wash material is used in a a. Pour the impression immediately impression intraorally
1-step technique b. Wait at least 30 minutes before pouring b. No problems will result using a tray
b. Inadequate wash material is used in a c. Wait at least 60 minutes before pouring material
2-step technique d. Pour the impression before sending to the c. Reinsertion of the coping back into the
c. Working time of the materials has been lab for maximum accuracy of the cast impression extraorally may not be accurate
exceeded 26. Multiple tiny bubbles on the cast that d. A and C
d. Different brands of VPS used together are not in the impression is an indication 30. Use of a heavy body VPS as the tray
22. Unset VPS on the impression surface of? material when taking an open tray
may be a result of? a. Impression did not have adequate time to impression
a. Contact with oxygen inhibited de-gas a. Locks the impression copings accurately in
methacrylates b. Moisture was present on the impression relation to other adjacent implants
b. Contact with blood before it was poured b. Accurately captures the implants rotational
c. Contact with powder-free latex gloves c. Impression was dry before it was poured orientation
d. All of the above d. The impression material is not compatible c. Is more accurate then taking a closed tray
23. Bleeding the automix cartridge is with the stone used to fabricate the cast impression
important to 27. When taking an open tray implant d. All of the above
a. Ensure flow of base and catalyst from the impression?
cartridge a. A medium body VPS is recommended
b. Ensure the material has not expired b. A heavy body VPS is recommended
c. Ensure complete mixing from the c. Any viscosity VPS may be used
automix tip d. VPS should not be used as the impression
d. A and C material
NOTES
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