January 3, 2011
From Dental Tribune……….
By Kevin Kim………… I evaluate about 40 cases per day. Five of those 40 cases may have inadequate impressions. In the morning, with my coffee in hand, I can easily spot them without even sifting through the work tickets. They’re demarcated with a square yellow paper with a big red stamp that says “Kevin” and a handwritten note that reads “Please evaluate impression and call doctor.”
A technician has asked me to consult with the doctor because he feels that this case might result in a remake. After checking the impression and evaluating the model, nine out of 10 times he’s right.
We’ve all heard the term, “Garbage in … Garbage out.” Meaning, if you send me a bad impression, you’re going to receive a bad crown. There’s no sugar coating that statement, but in real life,it’s true. As a technician,the next time you see a bad impression, take a step back and ask yourself:
So before all that time and work goes wasted into fabricating this restoration, it’s my duty to save us all the future headache and just make the phone call. I’ve found if you simply ask for a new impression, the doctor will send a new one uncontested. However, there will be instances where the doctor cannot take a new impression due to time constraints (i.e., a wedding or a vacation).
When I see impressions that look like the outcome will be compromised, I make a mental note, but I have them poured up anyway. This will show the doctor we at least made a conscious attempt at pouring up his impression. The resulting model will reveal where the discrepancy is. At this point, I’ll give the doctor one of four options:
The technicians in our lab often ask me how I approach my doctors without offending them for a new impression. It’s actually quite simple.
In the instance where a doctor gives you a problematic impression, don’t blame him … Help him. Show that you are genuinely concerned about his patient and his practice by giving him recommendations and solutions. Here are a few important suggestions I convey to my client that help him understand why this impression went awry:
In closing, I would urge doctors to double-check your impressions before dismissing the patient and certainly before boxing up the case and sending it to your lab. A word to the wise, as my plaster manager (Steve Tapie) always says, “Time spent on the impression is time saved when you’re chairside.”
On the other hand, we, as lab technicians, should inspect the impression closely upon receipt and before pouring up the model. If the doctor sends us a perfect impression, there’s no reason we can’t fabricate a perfect restoration.
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