The "Message in a Bottle Mailbag" is a monthly feature of the e-newsletter, Pearls for Your Practice: The Product Navigator. Each month, Editorial Director Joshua Austin, DDS, FAGD, answers reader-submitted questions to help you navigate your dental product decisions (and more!). This month, he discusses using a stump shade guide for preparations that are more than one shade, offers some tips for making the transition to digital impressions, and shares his current favorite TV shows.
QUESTION: Joe from Orange County, California, wrote: I am curious about the Natural Die Material Shade Guide from Ivoclar Vivadent. A lot of times, preparations aren't all the same shade. What’s the best way to handle that?
ANSWER:
Great question, Joe. You are right. There are often times that you will need to use more than one shade tab to communicate with your ceramist, especially for anteriors that have had past trauma. Here's what I recommend: After the impression has been taken, I am ready to take the stump shade photos for my ceramist. I pick the closest stump shade tab (or tabs) for the case. When it comes time to take the photographs, put in cheek retractors or an Ivoclar OptraGate and hold the shade tab so the edge is pressed against the incisal edge of the prep. Take the photo, making sure that the stump shade tab is in the same plane of the prep and that the entire prep and stump shade tab are visible (including the printed text of the shade tab). Take one photo for each stump shade you see.
This is how I do it, based on what my ceramist has asked me to do. Yours may want something different. Talk to your ceramist to find out what will work best; your ceramist will be happy you asked, and great esthetic results will be easier and more predictable!
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QUESTION:
Nathan from Minneapolis, Minnesota, wrote: I just got into the digital impression scanning game. Do you have any tips to make the transition easier?
ANSWER:
Good for you, Nathan. You are going to love it. The learning curve can be somewhat steep, depending on what system you have, but regardless of the brand, you will be happy with the results. The most important thing to have through this transition is patience. At first, impressions will take longer, and you will struggle. That's just how it is. Remember that it took you a long time to master the art of getting a polyvinyl siloxane (PVS) impression too. Just like when you learn anything else, practice makes perfect. I scanned stone models I had laying around the office, and that made me much faster.
As far as preparations go, make sure your margins are clear and readable. More than ever, tissue retraction is important. You need to be able to see your margins to be able to scan them. A thick second cord, packed shallowly, can help to laterally displace the tissue so you can capture the margins more easily. I use hemostatic retraction paste for a few minutes instead of the second cord, and it works very well for me.
I recommend always marking the margins in the software. That information is vital for your laboratory to provide you with the best restorations possible. Marking your margins also forces you to inspect your preparations at high magnification, which will improve your preps going forward. Seeing my preps at 20x magnification on the big touch-screen monitor shows me every single flaw, rough edge, and bur mark. This has made me better over the past few years. I think it's a huge advantage of digital impressions. Good luck with your journey!
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ANSWER:
Thanks for the question, Cheryl! I love TV, and there are several shows I really enjoy. I just wrapped up The People vs OJ Simpson and loved every single minute of it. I was in high school during the trial, and I have a lot of memories of it that the show brought back to me. Game of Thrones has started up again, and I am excited to find out what really happened to Jon Snow. It's such an amazing show—one of the few that I keep up with in real time as they air. I also like The Americans on FX. It's a great drama about Soviet spies in the United States in the '80s during the Cold War. It’s action-packed, and the performances by the leads are outstanding. If you haven’t ever seen it, check out the pilot on the FXNow app or on iTunes. I think you will dig the mix of history and action!
