by Deborah Dopson-Hartley, RDH
Do you still have those same fond memories I have from hygiene school of taking multiple alginate impressions on each other until we got it right? Even though my graduation was more than 29 years ago (1976), I can still remember it as if it was yesterday — quite possibly because taking alginate impressions has not changed much since then.
"Mixing the Mess," as we called it then, was agonizing for me. There were so many variables to go wrong, such as wondering if I had mixed the proper ratio of alginate to water and hoping the water temperature was accurate. Then impatiently waiting what seemed like forever till it set, hoping it had set completely before removal. Then having to pour the alginate immediately before the impression could distort and cause dimensional change, only to find out after it set, left such distaste for me that I haven't taken an alginate impression since my graduation.
That is until last year when my dentist, Dr. Diane Wright, brought home from an advanced hands-on dental conference she attended a new alginate alternative impression material for the assistants to use called StatusBlue® from Zenith Dental. The assistants raved about it because it was convenient, time efficient and so easy to use that even I, an RDH, could handle it. They were right.
No more hand fatigue from hand mixing because StatusBlue comes in automixed cartridges for their MixStar system and their convenient hand held guns so there is no "Mixing the Mess" or bowls and spatulas to clean.
StatusBlue is an innovative A-silicone alginate substitute formula that captures great impression detail, sets quickly and provides complete dimensional stability. It is a stable 100 percent dust-free impression material that is stable in any working environment so we no longer get that annoying white alginate powder everywhere, including our dark colored uniforms.
Where alginate impressions can only be poured once, this alginate substitute impressions can be poured again and again, reused indefinitely for up to three months, all from the original impression. We can now use one impression, the same impression for today's diagnostic study models and tomorrow's cosmetic wax-ups, bite splints, orthotics and snore appliances, sports guards, whitening trays and making or remaking temporaries. Its smooth surface allows exact models, minimizing the effort to trim, for example, while producing temporaries.
Whereas the automix MixStar lives a in central area in our office we stored the hand held guns and cartridges in each room for such opportune times as the patient saying "yes."
Keeping the StatusBlue guns in the hygiene rooms increased my worth and profits to our practice by allowing me the simplicity and ease for taking impressions immediately while storing for pouring it up later.
For me, as a hygienist, the biggest obstacle that this alginate replacement impression material overcame was the working time from mix, to set to removal with little guesswork. You have 1:15 minutes working time before it needs be seated in the mouth. The manufacturer's recommended time in the mouth is: 1:45 minutes before removal and can be poured up to 30 minutes later. Impressions do not have to be kept wet wrapped with a paper towel as alginate does, so moisture distortion doesn't occur. And unlike alginate, StatusBlue impressions can be totally submerged in water with no swelling or distortion. StatusBlue impressions can be disinfected with any standard disinfections solution before sending them to the lab and for storage.
Upon completion I now have an accurate no-hassle impression that can be kept for up to three months for further and repeated uses.
Technique for Preliminary Impression using StatusBlue®
To be used as the matrix for creating a Luxatemp® provisional restoration.
1) Evaluate the area to be impressed
2) Considerations when selecting an impression tray:
• If there is more than one unit in the quadrant, a triple tray is recommended to use. This will give you the opposing, resulting in less occlusal adjustments on the provisional.
• If there is a bridge being done, a full arch impression is ideal.
• Should you discover the tray would fit if it were wider, heat it with a torch and flex it outward to be modified appropriately
3) Load the StatusBlue(r) auto mix cartridge into dispensing gun or MixStar(r).
4) Attach mixing tip to auto mix cartridge and gun
5) When using a cartridge for the first time, express a "pea" size amount of the StatusBlue material from the cartridge onto the tray cover to monitor the setting time.
6) Taking an impression of the site: You will have 1 minute and 15 seconds to complete this step.
7) Load the impression tray with StatusBlue, starting at the posterior loading forward.
• To take a full arch StatusBlue impression, start at the posterior, crossing over the palatal area to the opposite side; make sure the tray is filled harmoniously and to the top ridges of the impression tray.
8) Firmly seat the impression tray unilaterally in patient's mouth. Setting time in patient's mouth is 1 minute 45 seconds.
• On the maxillary, pull the patients lip and cheek out and down, rolling them over the tray to get the border of the vestibule.
• On the mandible, have patient lift the tongue up and move side to side while pulling the lip and cheek out and down, rolling them over the tray to get the border of the vestibule.
9) Remove impression from patient's mouth and evaluate distortions, pulls or tears.
• StatusBlue does not have to be poured immediately because it does not distort!
It is important to remember that this is a preliminary impression. It is made prior to any tooth preparation.
Deborah Dopson-Hartley, RDH, is widely known for being the most profitable hygienist in the country. She is the master of her chosen profession in that she continually writes about it, teaches with the intense, high-wrought emotion that compels to action, and enthusiastically continues to practice her skills on a daily basis For more information please contact her at [email protected] or (813) 985-5516.