Perfection and Time
A dentist told the following story about his first week in dental school. “My first week in dental school was a real eye opener. We had an exercise in which they handed out a small block of blue wax, a little red book on dental anatomy, a Boley gauge, and some instruments. We were given the assignment to carve a lower left second bicuspid with specific measurements shape and dimensions as dictated by the book.
Halfway through the period, the professor came to my station, measured my carving, scrutinized it, then proceeded to break it in half and set it back down on the bench! Then, much to my chagrin, he called everyone around me to come and see. He said that my carving had a lot of flaws. The measurements were off two tenths of a millimeter in certain areas, the height of contour and cusp tip placements were wrong. Then he said something that stuck with me, not only through dental school but throughout my entire career as well. He said that there were two things they wanted us to learn. First, that by the end of our dental school training, we would all be perfectionists. Everything we did would be “perfect” and that we owed it to our patients to perfect, whether it was impressions, crown margins, fillings or anything else we did. Second, was time management. We would always be fighting the clock. We would owe it to our patients to strive to always be on time.
These lessons apply especially to impressions whether digitally scanned or with conventional impressions. The accuracy and perfection we all strive to achieve, begin and end with the “perfect impression”.
Defining the "Perfect Impression":
What exactly constitutes the elusive "perfect impression"? While perfection may seem an unattainable ideal, a closer examination reveals key characteristics that define this pinnacle of achievement:
- Meticulous incorporation of anatomical landmarks specific to the target area of the impression.
- Absence of imperfections such as bubbles, pulls, tears, or inaccuracies that compromise the fit and integrity of the impression.
- Precise delineation of borders, particularly critical for dentures and partial dentures, ensuring optimal fit and retention.
- Stability and accuracy of materials utilized, including the selection of appropriate impression trays tailored to individual patient needs.
Achieving Precision: Anatomy, Technique, and Materials:
Procedures necessitating impressions demand a delicate balance between precision and adaptability. Custom-made impression trays and meticulous border molding play pivotal roles in capturing passive impressions essential for accurate replication of anatomical structures. While digital scans offer convenience, traditional Adjust-a-Trays™ have emerged as preferred alternatives, offering superior fit and outcomes, especially for procedures reliant on passive impressions. Using a putty and wash impression technique with Adjust-a-Tray™ allows the operator to bypass the traditional two step procedure using the custom tray and border molding which decreases costs and improves productivity.
Navigating Challenges: Bubbles, Tears, and Inadequacies:
The pursuit of perfection is not without obstacles. Trapped air, saliva, or blood can introduce bubbles that compromise impression integrity, while tears result from improper handling or inadequate material characteristics. Addressing these challenges promptly is paramount, as flawed impressions not only impede treatment outcomes but also tarnish professional reputations and erode patient trust.
Borders Matter: Retention, Fit, and Patient Satisfaction:
The significance of proper border definition cannot be overstated, particularly in procedures reliant on passive impressions. Failure to capture accurate borders can lead to discomfort, compromised retention, and patient dissatisfaction. Digital impressions, while advantageous in many scenarios, may fall short in capturing critical border details essential for optimal outcomes. Adjust-a-Tray™ comes with extra length, eliminating the need to add wax to the posterior of the tray to achieve the same length. With just a snap, the unwanted portion of the tray can be removed along pre-established breakpoints, giving the patient the comfort he desires and the dentist the accuracy he needs. They are also adjustable from small, medium, large and extra-large and exhibit greater width in each of these settings than regular impression trays, allowing for better fit, especially for edentulous mouths where the arch becomes narrower on the upper arch and wider on the lower arch as bone is lost. The length and width of Adjust-a-Trays™ therefore provide more accurate impressions where other trays are deficient.
Stability Matters: Choosing the Right Tools for the Job:
The stability of impression materials and trays is crucial in maintaining accuracy and consistency. Environmental factors, mixing ratios, and material characteristics must be meticulously considered to mitigate distortions and inaccuracies. Conventional impressions, facilitated by Adjust-a-Trays™, often yield superior results, especially in complex cases where precision is paramount.
Embracing Wisdom: The Role of Experience in Technique Selection:
While digital impressions offer undeniable benefits, discernment is required in determining the most suitable technique for each clinical scenario. Situations involving sub-gingival margins, extensive restorations, or implant cases may necessitate the precision afforded by conventional impressions. Ultimately, the dentist's experience and expertise guide the selection of the optimal approach for each patient's unique needs.
Conclusion:
In the realm of dentistry, the pursuit of perfection is a perpetual journey, marked by the relentless pursuit of excellence and the mastery of time. The "perfect impression" epitomizes this quest, embodying precision, stability, and meticulous attention to detail. By embracing tradition while embracing technological advancements, dental professionals uphold the highest standards of care, ensuring superior outcomes and enduring patient satisfaction. As for conventional impressions, most will agree that the Adjust-a-Tray™ impression trays offer exceptional fit for the “perfect impression”. Our reputation and integrity as dentists depend on accuracy, striving for perfection and proper time management which can ultimately affect our bottom line.