Indirect and Direct Restorative Protocols - Caulk

››“The B4 Surface Optimizer helps me
work faster by adapting each surface
and readying the tissues for precise
impression capture.”
David Parker, DDS
Private practice, Smithtown, NY.
Figure 3. The cord is removed immediately prior to taking the impression,
with caution exercised to avoid tearing the cord or damaging the
soft tissues, which will cause sulcular bleeding and obscure marginal
detail in the resulting impression.
Figure 4. Use of the B4 ® Pre-impression Surface Optimizer (DENTSPLY
Caulk, Milford, DE) coats the hard and soft tissue surfaces to allow
the syringed wash material to pass more easily over and around the
surfaces to be impressed.
Table. Achieving Predictable Tissue Retraction: Treatment Rationale
Method Rationale Considerations
Cords
n Enhanced degree of mechanical displacement
n Available with or without a hemostatic agent
n Available in a variety of types and thicknessesto
accommodate a range of procedures
n Care must be taken to avoid soft tissue trauma
n Often requires the use of local anesthesia
n The ability to absorb hemostatic agents must
be taken into account during cord selection
Pastes
n Completely atraumatic to soft tissue
n Local anesthesia is not required
n Expeditious application may be advantageous
in multi-abutment situations
n Vigorous rinsing is required for removal
n Does not work well in narrow or shallow sulci
n Does not provide the same degree of displacement
as the cord technique
Insertion and removal of the retraction
cord should be performed
with great care to avoid inflicting
trauma to the soft tissue and ensure
optimal patient comfort (Figure 3).
Use of a pre-impression surface optimizer
(B4®, DENTSPLY Caulk,
Milford, DE) will further ensure
predictable marginal accuracy and
precise data capture by coating the
hard and soft tissues and allowing
the wash material to better flow over
and around them for improved accuracy
(Figure 4).
The highly wettable Aquasil Ultra
Smart Wetting® Impression Material
(DENTSPLY Caulk, Milford, DE) is designed
to aid the clinician in maintaining
adequate moisture control during
the process. When using this hydrophilic
material, the preparation area should be
moist, but pooled liquid should first be
removed with an evacuator to avoid the
creation of an excessively moist field.
When conducted accordingly, an impression
material can thus flow subgingivally
and capture the details of the tooth
and ensure proper integration with the
periodontal tissues. In fixed prosthodontic
care, where the smallest subtleties have
a considerable impact on the outcome of
treatment, proper tissue management
and tissue retraction are critical. n
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