Th 127082

Simultaneous impressions

June 1, 2003
Alfa Triple Tray by Premier. Here is an intriguing new idea — take an upper and lower impression simultaneously while reducing the gag reflex.

Joseph Blaes, DDS

Pearl 1
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Pearl 1: Alfa Triple Tray by Premier. Here is an intriguing new idea — take an upper and lower impression simultaneously while reducing the gag reflex. That's exactly what the new Alfa Triple Tray does. This tray, designed by dentist Dr. Jim DiMarino, revolutionizes full-arch impressions. Dr. DiMarino designed the Alfa to take advantage of the patient's tongue rather than fighting it. The Alfa tray's unique, palate-free design engages the patient's tongue to restrict the posterior flow of the impression material. This keeps the tongue in a much more natural position and actually eliminates gagging.

With this tray, you can mix the alginate and load both the upper and lower at the same time, cutting your chair time in half. You simply place the loaded tray in the mouth and have the patient close into the impression material. This action simultaneously captures upper and lower impressions. Since the patient is biting into the tray, it's unnecessary to hold the tray in place. When the impression material is set, it's easy to remove the tray — simply instruct patients to open their mouths. My patients greatly prefer this method to traditional metal or plastic trays. There are some tricks to placing the loaded tray in the patient's mouth and you can learn these by watching a free tutorial at

This is a great technique for quickly taking impressions for custom-made whitening trays. We can get both impressions at once, pour the impression with a fast-setting stone, and then make custom bleaching trays and deliver them before the patient leaves. In our office, we use the new alginate alternative VPS impression materials like Zenith/DMG's Status Blue and 3M ESPE's Position Penta to make an even easier impression. The Alfa Triple Trays are available in small, medium, and large sizes from your dealer. They are packaged with a trial pack on the outside so you can quickly try the trays without opening the entire package. Another great idea from a dental office! Contact Premier at (888) 670-6100 or visit their Web site at for more information.

Pearl 2: ELECTROtorque plus from KaVo. At the top of my list of products that I cannot practice without is the electric handpiece. This system has tremendously enhanced the way I practice clinical dentistry. The electric handpiece provides a constant torque that allows you to cut teeth precisely and quickly with little effort. Even at slow speeds, the electric hand piece provides the same constant torque that allows easy refinement of preparations.

Pearl 2
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New from KaVo is the ELECTROtorque plus electric handpiece. KaVo has been an innovative leader in electric handpiece design for 25 years. This new system has many great innovations beginning with the new brushless motor. This means little to no maintenance on the motor. With the new motor, KaVo has managed to reduce the noise level of the handpiece even more. The control box houses the digital speed control, allowing speeds of 2,000 to 40,000 rpm. You can also set two programmable speed settings — mine are fast and faster! There is a three-year warranty on the motor, tubing, and control box.

Unlike air-driven systems, which lose speed and torque when you apply the bur to the tooth, ELECTROtorque plus maintains constant torque and speed regardless of the load. The bottom-line result is faster, more precise preparations. The speed-increasing attachment is driven by a gear system that evenly distributes the load on three gears, providing longer life and fewer repairs. This gear system translates into no vibration and quiet operation for you. The ELECTROtorque plus has an outstanding handpiece lighting system that uses glass rod optics. This means that you will have virtually no degradation of light intensity even after thousands of sterilization cycles. KaVo backs this up with a five-year warranty on the glass rod. The system offers interchangeable heads for versatility and special procedures. The ELECTROtorque plus system can be set up with your existing equipment or integrated into a new environment system from KaVo. Either way — you're in for a thrill the first time you prep a tooth. Order from your dealer or visit their Web site at for more information.

Pearl 3: Xeno III self-etch adhesive from DENTSPLY Caulk. From the makers of Prime & Bond® comes a new, single-step, self-etching adhesive for use with light-cured direct restorative materials. Xeno III combines speed of use with great bond strength and no sensitivity. This material has an uncomplicated process that allows etching, priming, and bonding in one easy step — all in about 40 seconds. Xeno III shows bond strengths that are comparable to total-etch technique on enamel and dentin.

Pearl 3
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This new system avoids sensitivity by sealing the dentinal tubules and eliminating the problems of over-drying and over-etching of dentin. There are no separate etching and rinsing steps. You simply dispense equal amounts from bottles A and B and then mix thoroughly. Then, apply this mixture generously to the cavity surfaces. Wait 20 seconds and then uniformly spread the adhesive with a gentle stream of air, then light cure for 10 seconds. It is that simple to use! Order from your dealer, or visit Caulk at for more information.

Pearl 4
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Pearl 4: SeeMORE Retractable system by Discus Dental, Inc. Another example of innovative thinking is a new system for the retraction of lips, cheeks, and that pesky tongue. Discus Dental has just introduced the SeeMORE retraction system. I have used it for about four weeks and it is terrific for seating veneer cases. Most retraction devices either retract the lips or cheeks only and are less ideal than using a rubber dam. Many dentists don't like to hassle with a rubber dam, and Discus Dental has come to their rescue with the new SeeMORE. It utilizes a four-way mechanism that achieves lip and cheek retraction simultaneously for easier clinical access and better vision. Patient response to this new system has been very positive. They are much more comfortable with this system than with anything I have used in the past. While offering isolation comparable to a rubber dam, the system has a regular and small size and is available in two designs: SeeMORE and SeeMORE Plus. The SeeMORE Plus design features an additional tongue cup for controlling the tongue, making it ideal for seating lower anterior cases. The clear color is unobtrusive, which helps to facilitate shade matching and taking images of the cases. This is a great system that will make dentistry more fun in your office! To order, call Discus Dental at 800-422-9448 or visit for more information.

Pearl 5: GINGAGuard from Cosmedent. One of the problems associated with power bleaching or micro abrasion is protecting the gingival tissues from the chemicals used in these treatments. A solution comes from Cosmedent, a company devoted to better aesthetic dentistry. One of the challenges that I have had with other types of gingival protection materials is that they tend to be thin and runny and hard to manage. (My assistants tend to find other things to do when I ask them to apply them.) GINGAGuard is a new resin dam material with a unique chemistry that virtually eliminates this problem.

Pearl 5
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Its excellent consistency facilitates easy application with control and no slumping or running. It does not produce heat upon polymerization, which greatly reduces patient sensitivity. It is easily removed due to its high flexibility and nonstick chemistry. GINGAGuard also is an excellent material to use as a blockout material for undercut areas. Order from Cosmedent or visit them at for more information.

Dr. Blaes has a general practice in the St. Louis area. He is known for his expertise in dental materials and techniques and his innovative systems designs. He writes and lectures on "How To Increase Productivity and Profitability." Dr. Blaes is a member of the American Academy of Dental Practice Administration. He may be reached at [email protected].

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