tips and tricks

At one of my private practice jobs the material we use for fixed prosthodontic impressions is PVS putty with a light body wash. I have used this with reasonable success and it takes reasonable impressions as the viscosity of the putty pushes the light body down the tooth, however this can be disadvantageous sometimes as the putty itself fails to flow. Therefore it will be hopeless in capturing an impression of the sulcus if your light body hasn't made it in there. Additionally, if the tissue is quite floppy, it can displace the tissue out of the way but can just as easily push the tissue back onto your preparation undoing the action of your tissue retraction. Ideally you would put a medium/heavy bodied material on top of the light body to act as an intermediary between the two material viscosities. One issue I've been having coming into the summer months is that the putty reaches an early set stage extremely fast where it becomes stiffer and forms cracks and distortions when pr...

Just a friendly reminder to take good care when using a heat out tip to remove gutta percha. At my hospital position, the access to an electronic heatout tip is sporadic so we often have to pull out the bunsen burner and heat out instruments. The instruments are quite clunky and very long and under magnification, the other day I didn't realise that the shank of the instrument was hitting the patient's lip and burning them through the rubber dam.  It is very possible to burn a patient through the dam so take extra care when using a heated instrument, you can put your mirror further from the tooth holding it under the shank of the instrument so it is not possible to contact the dam or soft tissues. Alternatively, if you are getting close to touching something else, the assistant can place a mirror or hold gauze to block the hot tip.

I have had multiple instances of rubber dam clamps getting stuck on the tooth as it is difficult to insert the tips of the forcep back into the  holes when it is time to remove the dam. The problem usually arises when the holes of the rubber dam clamp are angled towards each other which hinders penetration by the rubber dam forcep tips as the angled hole is not the same size as the forcep tip. I commonly see this on when the clamp is overstretched with the bending of the clamp bow changing the angle between the flat sides of the clamp. It is also more common in clamp designs that have the points of the clamp pointing downwards as the flat sides have a preexisting slope to them (Figure 1). Occasionally, teeth that have bulbous crowns and recession will have a clamp that sits more apically on the tooth, the clamp will be closed further and the contour of the tooth crown can hinder access of the forcep tips to the hole. One modification I have seen suggested is to grind back the later...