Monday, July 10, 2017

The quality of fixed prosthodontic impressions: An assessment of crown and bridge impressions received at commercial laboratories.

J Am Dent Assoc. 2017 Jun 7. pii: S0002-8177(17)30406-3. doi: 10.1016/j.adaj.2017.04.038. [Epub ahead of print]

Abstract

BACKGROUND:

The authors evaluated and quantified clinically detectable errors commonly seen in impressions sent to commercial laboratories and determined possible relationships between finish line errors and other factors involved.

METHODS:

The authors visited 3 large and 1 small commercial dental laboratories over a 12-month period. Three calibrated examiners evaluated the impressions. The examiners evaluated all impressions for errors by using ×2.5 magnification loupes under ambient room lighting without the aid of additional illumination.

RESULTS:

The authors evaluated 1,157 impressions; 86% of the examined impressions had at least 1 detectable error, and 55% of the noted errors were critical errors pertaining to the finish line. The largest single error categories evaluated were tissue over the finish line (49.09%), lack of unprepared stops in dual-arch impressions (25.63%), pressure of the tray on the soft tissue (25.06%), and void at the finish line (24.38%). The factors blood on the impression (odds ratio, 2.31; P < .001) and tray type (odds ratio, 1.68; P < .001) were associated significantly with finish line errors.

CONCLUSIONS:

Marginal discrepancies made up the largest category of error noted in impressions evaluated. The authors noted an increase in errors at the finish line with dual-arch impression techniques and in the presence of blood.

PRACTICAL IMPLICATIONS:

Dentists have ethical, moral, and legal obligations bestowed on them by the profession and need to evaluate critically the work they send to laboratories. The authors strongly recommend an improvement in technique and reviewing of all impressions and working casts.

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