By: Frank J. Milnar, DDS, AAACD
This article originally appeared in Inside Dentistry.
In part 2 of this blog, Dr. Milnar discusses how he was able to take an accurate impression when his 34-year-old patient experienced excessive bleeding during the procedure. Read Part 1.
After the excessive bleeding had mostly been controlled, the impression was taken using NoCord VPS (Figure 4 through Figure 9). Before and after the impression, the preparation was disinfected with Consepsis® (Ultradent). The preparation may be desensitized using Glu/Sense™ Dentin Desensitizer (Centrix), a glutaraldehyde gel in a syringe with a unique sponge tip.
The impression was sent to the laboratory to fabricate the final EZR Zirconia Crown (Valley Dental Arts). The pre-restorative impression was fabricated using Access Blue and the impression taken at the start was used to make the temporary crown using Access Crown Ultra (Centrix). The provisional crown was cemented with Bifix Temporary dual cure (Voco).
After crown fabrication, the temporary crown and residual cement were removed. The tooth was rinsed with Concepsis, and the fit and occlusion of the crown were verified. The crown was cemented with AbsoLute™ (Centrix) dual-cure permanent cement (Figure 10 and Figure 11).
"A trifecta for impression material with NoCord VPS"
The challenge facing dentists every day is to take quality impressions, which requires a trifecta of circumstances—sulcus expansion, hemostasis, and impression accuracy. Approximately 95% of impressions sent to dental laboratories are VPS and more than 80% of prosthetic cases are single units.3 NoCord VPS is the next generation of impression materials that allows the dentist to save time with fewer steps and excellent results.
By: Frank J. Milnar, DDS, AAACD
This article originally appeared in Inside Dentistry.
Taking impressions is a critical step in creating quality restorations. Pressure, astringency, and time are the key elements needed to create the proper environment for taking a good impression. There are well over 40+ brands of impression materials offered by nearly 30 different companies—most are very similar.1 It can be overwhelming and confusing to understand and select the right material types and properties for your clinical use.2
NoCord VPS Impressioning System (Centrix, www.CentrixNoCordVPS.com) is the first material that is truly different. The newest impression material in the market, NoCord VPS brings all three critical areas into play. It is an impressioning system that retracts the tissue, stops bleeding, and takes an accurate impression all in one step. It is able to do this because it incorporates the astringent within the NoCord™ Wash Material (Centrix) and combines it with NoCord™ MegaBody® Tray Material (Centrix) to help create the force (pressure) for retraction and hemostasis. The purpose of this article is to introduce a new class of impression material that takes advantage of these properties, while maintaining the accuracy and stability benefits of a vinyl polysiloxane.
Here is a typical case that one may run into during an average day in the dental office.
A 34-year-old patient presented with decay and discoloration from ferrous contamination under an all ceramic e.max crown (Ivoclar Vivadent) on No. 14 (Figure 1). The patient was given a local anesthetic using Anutra's buffered anesthetic system. Before removing the crown, an Access Blue® (Centrix) quick set impression was made in order to make a temporary restoration. The crown was removed by sectioning it in half using an 850-814-ML diamond (Diatech). After the sectioned crown was removed, the tooth was re-prepared by removing the decay and stain using an 850-814-ML diamond and H32.31.012 diamond (Brasseler USA). The defects in the tooth were filled with the core paste and were finally finished with a final modified chamfer using 850-814.10ML (Diatech).
As a result of extensive subgingival decay on the distal, there was excessive bleeding (Figure 2). Centrix NoCord VPS was indicated as our final impression. NoCord Wash Material can be used by itself where there is minimal bleeding because of its astringent property. Simply wash and dry the preparation before using NoCord VPS to achieve an accurate impression with gingival retraction. In instances such as this, it may be necessary to control excessive bleeding by using additional hemostatic methods such as GingiTrac™ (Centrix) (Figure 3).
TheraCal LC, a light-cured, resin-modified calcium silicate was placed as a liner. It is ideal for direct and indirect pulp capping and as a protective base/liner.
The final steps in making an accurate impression will be addressed in our next blog.
1. Cowie RR. Understanding impression materials and techniques. Dent Today. 2007;26(3):108, 110-111.
2. Brown RL. An elastomeric impression material breakthrough. Dent Today. 2009;28(10):118, 120.
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Taking an impression for indirect procedures can be stressful for both patient and clinician. Now taking accurate impressions has never been easier with Centrix NoCord™ VPS.
On October 25th at 7 PM EST, Dr. Frank J. Milnar DDS, AAACD, a “Top Dentist” practicing in St. Paul, Minnesota, will demonstrate the essentials of getting the details right in impression taking using NoCord VPS. In this webinar, you’ll learn:
- Key factors involved in achieving an ideal impression
- Variables involved in tray and impression material selection
- Techniques and materials available to enhance impression accuracy
This webinar provides a step-by-step approach to achieving accurate impressions with the multiple interrelated steps -- including the chemistry of different impression materials like NoCord VPS, a new impression material designed to ensure clinical success and kudos from patients.
Dr. Milnar is a graduate of the University of Minnesota, School of Dentistry, an accredited member of the American Academy of Cosmetic Dentistry and a Board Examiner for Accreditation. Having published many articles about the direct placement of composites, shade selection and minimally invasive dentistry, he is recognized and highly respected as an expert in his field. Dr. Milnar also serves on a number of editorial review boards for several dental journals. Co-founder of the Minnesota Academy of Cosmetic Dentistry, he has lectured extensively for the U.S. Armed Forces, as well as internationally on these topics.
Register today at http://centrixdentallearning.com.
March 2016, Shelton, CT: Centrix welcomes Debora Bridges to her new role as Sales Manager Special Markets where she will focus primarily on Dental Service Organizations, Dental Schools, Government Facilities and Community Health Organizations. Her goal will be to bring increased market share and to actively promote Centrix products by partnering with members of the dental industry, as well as service organizations, government entities, community health clinics, and corporate clients. In addition to sales, she will be responsible for ongoing training and education within these customer segments, a responsibility she has taken on in previous positions within her extensive career in the dental industry.
Debora most previously worked with dental manufacturer DentalEZ Integrated Solutions where she consistently exceeded her sales goals within specialized account relationships. She has worked as a consultant in marketing and sales of dental products as well as a COO at a dental start-up. She began her career at Syntex Dental Products, where she took on increasingly more demanding requirements within sales and marketing for the company.
Debora graduated with a BS from St. Joseph’s University in Philadelphia. She is multi-disciplined athlete who has pursued excellence in tae kwon do, hapkido and scuba diving. She trains triathletes in swimming and also volunteers for organizations that support athletes with physical challenges.
Debora can be reached at 203.513.0774 or by email at firstname.lastname@example.org. Please contact her to learn how Centrix is making dentistry easier.
October 2015, Shelton, CT: Centrix is pleased to announce a new addition to the Centrix sales team, Lindsay Prager.
Lindsay is a goal-driven sales professional who will be tasked with supporting the Centrix network of preferred distributor partners in AK, CO, ID, MT, ND, NE, OR, SD, UT, WA and WY. Lindsay was previously a National Sales Representative for dental device maker ContacEZ where she grew her target sales channel by 33%.
Prior to direct sales, Lindsay was in customer support at CAESY dental patient education. There she was charged with inside sales lead development for this division of Patterson Dental. Lindsay has consistently demonstrated her ability to take on new challenges and we believe she will be an invaluable resource for our distribution partners in the Northwest US.
Lindsay is a recent magna cum laude graduate of Washington State University in Vancouver, Washington. She is also an active member of her community where she volunteers for a number of non-profits as well as within the public school system.
Lindsay can be reached at 360-608-5113 or by email at email@example.com. Please contact her to learn how Centrix is making dentistry easier.