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Impressions
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Question #1: What are the indications for the closed-bite, quadrant (check-bite) impression technique?

Answer: Since there are many disadvantages use this technique only under ideal conditions: a single unit with full occlusal coverage on first molars or second premolars in an intact arch with good cuspid disclusion. Place gauze between the teeth on the opposite side so there will be adequate impression material thickness across the occlusal surface even though this makes an accurate centric occlusion unlikely.

Question #2: How do you select an addition reaction silicone impression material?

Answer: Since most of these materials are similar, look past features like viscosity and setting time. By far the single most important feature is manufacturer dependability. Quality control, particularly of addition reaction silicone putties, has been a problem and the cost to the dentist and laboratory of a bad batch is very high since these problems are often not discovered until the crown seating appointment.
If quality control is similar, you have to look for other features. The three most important are:
1. Hydrophilic properties. Technically this should result in fewer retakes and provide a better stone pour.
2. Be able to use the material with your normal gloves (usually latex) and retraction chemicals. I hope more manufacturers will provide this feature.
3. Be able to pour at any time to allow flexibility.


Question #3: How important are hydrophilic properties to an impression material? Should I switch if I am happy with my present material?

Answer: If your impressions are good now, they may not be noticeably better if you switch. Clinically the differences between two versions of the same material are hard to detect. However, wetting properties of the hydrophilic materials is significantly improved. This should result in more accurate impressions where moisture cannot be totally controlled and in better gypsum pours.


Question #4: How do I know when a new material is dependable? The sales people always say they have absolutely no problems with any product. Yet I often discover that new materials are not performing up to expectations.

Answer: First reread the instructions and review your technique. New materials often require alterations in use. If this is not the problem then the material should be reevaluated and compare it to others.
A good way to get an unbiased evaluation is by asking colleagues you trust who have used the product for a while. Better yet, form a group of collegues to do clinical product evaluations. Ask your laboratory to assist you.


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