impression tray dual arch
TRANSCRIPT
-
8/7/2019 impression tray dual arch
1/3
2003;134;729-730J Am Dent Assoc
JEFFERY C. HOOS and GARY J. KAPLOWITZtraysProper placement of dual-arch impression
jada.ada.org ( this information is current as of March 3, 2011 ):The following resources related to this article are available online at
http://jada.ada.org/cgi/content/full/134/6/729
found in the online version of this article at:including high-resolution figures, can beUpdated information and services
http://jada.ada.org/cgi/collection/implantsImplants :subject collectionsThis article appears in the following
http://www.ada.org/prof/resources/pubs/jada/permissions.asp
reproduce this article in whole or in part can be found at:of this article or about permission toreprintsInformation about obtaining
2011 American Dental Association. The sponsor and its products are not endorsed by the ADA.
onMarch3,2011
jada.ada.org
D
ownloadedfrom
http://jada.ada.org/cgi/content/full/134/6/729http://www.ada.org/prof/resources/pubs/jada/permissions.asphttp://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://www.ada.org/prof/resources/pubs/jada/permissions.asphttp://jada.ada.org/cgi/content/full/134/6/729 -
8/7/2019 impression tray dual arch
2/3
JADA, Vol. 134, June 2003 729
One of the most fre-quently encountered
problems in makingdual-arch impres-
sions is placing thetray in an improper position,
where it impinges on ananatomical structure and is dis-
torted. This kind of distortionmay affect the accuracy of the
final impression and often canbe recognized when the side wall
of the tray shows through theimpression material. This usu-
ally indicates that the side wallof the tray has been deflected by
an anatomical structure thathas pressed against the side of
the tray, thereby displacing theimpression material. Impres-
sions like these should berejected.
We have developed a tech-nique for ensuring that the
impression tray is placed in theproper position. We have used
this technique in more than2,000 impressions, with few
cases involving possible distor-tion caused by deflection by an
anatomical structure. We pre-sent this technique for use in
any dual-arch impressionprotocol.
PROCEDURE
The dentist should select a dual-
arch impression tray that pas-sively fits the quadrant con-
taining the prepared tooth anddoes not impinge on any
anatomical structure. The trayis best fitted before the clinician
administers local anesthetic sothat the patient can feel the tray
in place. A metal or plastic dual-arch tray of any design will suf-
fice, as long as it fits properly.With the tray in place, have
the patient close down and askhim or her if closing down is
comfortable and easy or if thereare any interferences. Retract
the cheek and note the intercus-pation of the teeth. If the patient
can comfortably close down allthe way and no interferences are
noted, proceed with the impres-sion procedure.
Insert the empty tray into thequadrant containing the pre-
pared tooth. Hold the tray onthe maxillary arch and note the
position of the posterior crossbarof the tray. It must be located
posterior to the distal surface ofthe most posterior tooth in the
arch and should not be in a posi-tion that will interfere with com-
plete seating. Load themandibular side of the tray
directly into the mouth using amixing tip on an impression car-
tridge (Figure 1). Have thepatient close down and then
Proper placement ofdual-arch impression trays
JEFFERY C. HOOS, D.D.S., F.A.G.D.; GARY J. KAPLOWITZ,D.D.S., M.A., M.Ed.
C L I N I C A L D I R E C T I O N S
Do you have a time- or work-saving clinical technique to share with your colleagues? Submit it
to JADAs Clinical Directions department. A Clinical Directions item should be a maximum of twodouble-spaced typed pages and should include no more than one figure or illustration. Submit five
copies of your manuscript and of each illustration to Clinical Directions, JADA, 211 E. ChicagoAve., Chicago, Ill. 60611.
Copyright 2003 American Dental Association. All rights reserved.
onMarch3,2011
jada.ada.org
D
ownloadedfrom
http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/ -
8/7/2019 impression tray dual arch
3/3
730 JADA, Vol. 134, June 2003
open. The tray, loaded on themandibular side, will remain on
the mandibular arch.The dentist should then load
the maxillary side of the tray,
again directly into the patientsmouth using the same mixing
tip and cartridge. Have thepatient bite down all the way
(Figure 2).
CONCLUSION
This technique has the advan-tage of allowing the dentist to
visually inspect the position ofthe crossbar and the walls of the
tray in their final position. Inother dual-arch impression pro-
tocols, when both sides of thetray are loaded, the dentist
cannot adequately visualize thecrossbar or the walls, because
they are covered with impres-sion material. The dentist may
not be able to determine if thetray has been placed into the
proper position until the impres-sion protocol has been com-
pleted. With the technique
described above, however, thedentist can abort the impression
procedure as soon as he or sherecognizes a problem in tray
position.This technique is fast and
simple and can be incorporatedinto any dual-arch impression
technique. s
Dr. Hoos is in private practice in Stratford,Conn.
Dr. Kaplowitz is in private practice inHanover, Pa. Address reprint requests to Dr.Kaplowitz at 3109 Northbrook Road, Balti-more, Md. 21208, e-mail [email protected].
1. Kaplowitz G. Trouble-shooting dual archimpressions. JADA 1996;127:234-40.
2. Kaplowitz G. Trouble-shooting dual archimpressions II. JADA 1997;128:1277-81.
C L I N I C A L D I R E C T I O N S
Figure 1. Impression material is delivered intothe mandibular side of the tray.
Figure 2. Impression material is delivered intothe maxillary side of the tray.
Copyright 2003 American Dental Association. All rights reserved.
onMarch3,2011
jada.ada.org
D
ownloadedfrom
http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/http://jada.ada.org/