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Tuesday, July 30, 2013

[ACEsthetics] New Post/Thread Notification: General Dentistry

Hello,

gmoor@windstream.net has just posted in the General Dentistry forum of ACE Dental World under the title of Blu Mousse problems.

This thread is located at http://www.acedentalforum.com/forum/threads/2707-Blu-Mousse-problems

Here is the message that has just been posted:
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---Quote (Originally by Peter)---
Guy, see, here is the problem...you say you are amazed that people have problems with this technique...you can't understand why. But you see...in your post, you mention taking the tray OUT of the mouth and making sure it is dry and clean. I understand the rationale...it's gotta be dry and clean otherwise the wash won't stick. BUT...BUT...both the Morita company on their technique video AND Arun Nayyar in a personal email to me and I believe even Jeff Hoos (in the past) absolutely, 100%, no exceptions EVER, stated that the tray was NEVER to be removed from the mouth and you HAD to HOLD IT against the opposing arch. But now you are saying, "oh, I take it out to get it all clean and dry, and then I make sure it goes exactly back into position." Well no, that's no good. You've VARIED the technique. Taking the tray out and putting in back in after drying it introduces an error. How much of an error? I don't know. You would say ZERO, because you wouldn't tolerate anything less than excellence. One might guess 5%. Many of us are very good, careful, conscientious clinical dentists you know...not just you! Nobody knows. Morita wants you to use THEIR materials to do this technique. Almost no one does! Everybody seems to use Blu Mousse plus their own favorite wash. ANOTHER variable. Now we are talking different types of trays as well. The H & H technique is like old time chicken soup, no two recipes are exactly the same. To me, it is no wonder at all that the results are all over the map. I've had perfect fits and also CRAPPY fits using this technique. WHY? I used the same technique every time. I think the technique is not bad but there is something variable that is causing these problems. Could be the tray twisting under a hard bit...could be how hard the patient is biting...could be the labs are either doing something with these that they should NOT be or vice versa. I dunno. But my results were always an unpleasant guessing game so I had to give up...as many here on the list have done.
Nobody here remembers the "H.I.T" technique...? "Hydrodynamic Impression Technique"? Sort of a cross between an H & H and a conventional impression...where a hole is drilled into the tray after the impression is taken out, it is reinserted and then wash is injected under high pressure to reline the initial impression. What? No one remembers? I guess it DIDN'T CATCH ON because it never worked consistently.
---End Quote---
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Damn Peter you sounded royally pissed at me. Here's the deal, until yesterday, I had never taken an H and H out of the mouth and cleaned both sides. Jeff is doing this on some cases and told me about it. In my humble opinion, it is much harder because you have to place it back into the proper alignment. My C and B room has two air/water syringes. One blows both water and air and the other only air. *Attachment 5636 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5636)Attachment 5637 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5637)Attachment 5638 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5638)
*I'm not trashing anyone else's clinical expertise or ability. I've inserted the FIRST on that I have removed and replaced after cleaning in the mouth. I removed and replaced this one because I needed an accurate opposing. Jeffrey is constantly trying to improve this technique by bringing us better materials and trays. If this technique did not work there would not be a bucketful of trays for the technique out there. Hell, I'm not even telling you to change if what you have is working. But I will tell you I am getting great impressions and saving a fortune on impression materials.
**This impression was going to be a bear to get with margins way under the gingiva and I needed a good opposing so I took it out and cleaned the mess around the prep, seated it back in the mouth with wash on lower with a marked reset spot and wash on the upper. Yes, you have to get the Blue Mousse clean and dry but that has not been a real problem with me. Remember this is my second bout of trying this technique with total failure the first time. My frustrations on my first attempts were tremendous and I finally gave up until I had to start fighting these impressions. THIS impression is the first I've ever taken out of the mouth out of hundreds of impressions since I started using this technique. And yes you can get it clean and dry but I'm not going to start a rock throwing contest with friends over the technique. Do it any way you please. I meant no disparagement on your clinical abilities. I will say this. I use string on these impressions. That, and needing a drying syringe for bonding, are the main reason I have an air only syringe in my crown and bridge room. My partner takes the impression out of the mouth and paints it with adhesive as I was doing for a while because I did not think it would stick. It will stick. I've got a 80 psi air hose in my lab. If you can blow that on the wash and it doesn't budge then it is stuck. H and H has worked consistently producing beautiful restorations from World and Bonadent. Mila calls me when I send her crap. She has not called me. I suggest that everyone use the impression material and technique that works for them and let's not throw cow patties at each other. If it is working for you then do it. I'm having to do 95% less retakes. Look at this impression I had to get. World will take this and reproduce that portion that is root in the restoration and I'll get a great restoration. I radiograph all my crowns on seating as most of you do. The technique seems to not work for so...fine...it says nothing negative about your clinical abilities if it doesn't. What convinced me to go back was when a high end prosthodontist like Arun can use it for full mouth then I damned sure can use it for quarter arches. I'm doing full mouths now. You need a lab that understands it. My local lab is still baffled. I don't use them. World and Bonadent move right along. I did not mean to piss you off Peter. I have never claimed to be superior to anyone on this forum. That was what turned me off when I first came on and I WON'T! Guy *

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