By Dr. Kelly Brummett
Getting ready for a crown case can be stressful. However, if you approach the appointment with options, there can be a decrease in potential stress that will allow the flow of technical and creative skill to flow abundantly. What I am talking about is bringing the options of both digital and analog impression techniques, along with possibilities, to your crown prep appointment. I have often heard in my lifelong learning, that you “should” have everything figured out before you sit down to prep the tooth. Well, I propose that we can think about what we would like to include in our plan while being prepared for the times that the plan doesn’t proceed as expected! While I love taking digital impressions with my Itero, I also like to be prepared for the times that an analog impression may be more beneficial to the final fabrication of the crown.
One example is when you are prepping a tooth for a crown, and due to caries, you must prep below the gingiva to establish a solid foundation for final cementation of the future restoration. For these cases, I often choose to do an analog impression over a digital impression. I find that the physical compression of the tissue with an analog heavy body impression material (Honigum Pro, DMG America), along with the light body’s ability to thin under load, captures the margin with as much accuracy as possible. To obtain the same results with digital scanning, I often have to throw the kitchen sink at the gingiva; placing retraction cords to compress the tissue away from the crown margin to reveal all aspects of the prep, or utilizing hemadent, retraction paste, surperoxyl, or laser preparation to obtain the accuracy I am looking for. I am confident I save time and decrease obscurities and irritation to the tissue with using an analog impression with quality materials.
The bottom line is that we are all required to use our thought process and available resources to adequately prepare and capture the tooth preparation. This is vital in communicating clearly to the lab for the best results of the final restoration. As we are moving into a digital world, there are still instances where new technology is not yet providing all the solutions that traditional techniques still offer. Being prepared and having the best options available when we prepare for our restoration procedures will help improve and assure the outcome and experience, we are seeking for in our patient care.