http://www.ivoclarvivadent.com/podium/files/accudent_58

Impressions

Accu-Dent Impression System •Irreversible hydrocolloid (hydrophilic) •Two viscosities •Non-slumping •Premeasured sealed packaging •Syringe delivery •Temperature controlled •Unique tray design •Single entry impression system

Accu-Dent Impression System System 1 (edentulous)

System 2 (dentate)

Accu-Dent System 1 Impression System

Accu-Dent System 1 Impression System • System one Accu-gel materials are specially formulated to make impressions of edentulous arches dentate arches • The trays are specifically designed for this purpose • It features a syringe system that facilitates the delivery of impression material into the buccal and labial flange areas

Impressions for the maxillary edentulous arch

Syringe Gel Use the “System 1” side of the measuring vial to proportion the exact amount of water for the syringe gel

The syringe gel mixes quickly and smoothly

Syringe Gel Remove the plunger and back load the syringe

Engage the plunger and press material into the syringe tip

Tray Gel Again use the “System 1� side of the vial to measure the appropriate amount of water for the tray gel

Tray Gel Note that the tray gel appears dry at the start of mixing. Do not add water. In several seconds it will develop into a creamy mix.

Loading the Tray Rub the surface of the loaded tray material with water

Note the tray material is loaded heaviest in the anterior section of the tray

Loading the Tray Apply a small amount of material on the initial loading of the tray. This allows the material to be pressed into the retentive holes of the tray

After all the retentive holes have been engaged add the remaining material to the tray

Making the Impression Begin injecting the material directly into the hamular notch area on one side of the arch

Continue injecting (keeping the tip of the syringe imbedded into the material) up to the labial frenum and stop

Making the Impression

Inject into the hamular notch of the opposite side and continue forward to the labial frenum

Making the Impression Inject some material to anterior hard palate area

Note how the material “attaches (hydrophilic)” to the tissue and does not “drip (non-slumping)”

Taking the Impression Gently seat the tray in the patient’s mouth (do not overseat”

As soon as material extrudes from the back of the tray “stop” seating

Border Molding Gently hold the lower border of the upper lip and pull forward

Have patient slowly open wide

Border Molding

Gently massage the right and left cheeks of the patient

Tray Removal Carefully remove the impression by breaking the seal at the perpheral borders (Do not remove impression by tugging on the handle of the tray) Thoroughly rinse impression of saliva

Tray Removal Disinfect impression using materials and techniques appropriate for irreversible hydrocolloid materials Support the impression using the Accu-dent tray holder (do not lay impression on counter)

Final Impression

Note the accuracy of the peripheral border registrations

Final Impression

In particular note the detailed registration of the hamular notch area

Border molded final maxillary impression

Impressions for the mandibular edentulous arch

The mandibular Accu-dent impression is not a border molded like the maxillary impression

The intent of the mandibular impression is to obtain a “fully extended impression� to facilitate the identification of the anatomical landmarks that will guide the outline of the denture border extensions

Tray Selection (distal rise) Moderately resorbed ridges gradually incline to the ramus

This gradual incline (low distal rise) is reflected in the mandibular trays #25-29

Tray Selection (distal rise) Severely resorbed ridges have a more abrupt incline to the ramus

This high distal rise is reflected in the mandibular trays #20-24

Tray Selection (size) The “tray selection tool� facilitates the proper size selection for the mandibular impression tray Measure approximately where the first molars are located on patients existing denture or on their ridge and select a tray that lines up to the center of the retentive holes of the tray

Making the Impression

The syringe gel material is first injected first over the retromolar pad area and than pulled forward up to the midline area

Making the Impression The opposite retromolar pad is covered and the material is pulled forward to meet the contra-lateral side

Insert the loaded tray asking the patient to place their tongue between the lingual flanges of the tray

Fully extended mandibular impression

Fully extended mandibular impression options

If the anatomy is accurately identified and marked this impression can serve as the final impression

Fully extended mandibular impression options

‌.or this impression can serve as preliminary impression for the fabrication of a custom impression tray

Fully extended mandibular impression options

‌.or this impression can serve to fabricate a interim denture that will be functionally relined several weeks after delivery

Impressions for the partially edentulous arch

Accu-Dent System 2 Impression System

Accu-Dent System 2 Impression System • System two Accu-gel materials are specially formulated to make impressions of dentate arches for partial dentures, crown & bridge opposing casts, occlusal splints, diagnostic casts, etc.

• The trays are specifically designed for this purpose • It features the Pre-Sure tip that attaches to the syringe that virtually guarantees bubble free impressions of tooth surfaces

The “Pre-Sure tip� facilitates the delivery of the Accu-gel material directly to the teeth and surrounding gingiva and virtually guarantees a bubble free impression

The tip is flexible and can be pressed against the teeth and gingiva without discomfort to the patient

The tip provides an excellent vehicle to accurately deliver the syringe gel

Place the Pre-Sure tip firmly against the last tooth in the arch and drag forward while injecting

Turn the syringe at a 45 degree angle in the anterior area and press firmly against the labial surfaces of the teeth

Do the same to the opposite side of the arch

Inject directly onto the lingual surfaces of the anterior teeth

Remove the Pre-Sure tip and inject into the buccal and labial sulcus

Inject some material onto the anterior hard palate area

Final Impression Note the “clarity� of the teeth and surrounding gingiva

Final Impression Note the accuracy and extension of the peripheral borders

System 2 cast preparation Double pour technique

Optional Die Stones • • • • •

Milestone* Resin Rock* Die stone True stone Die keen

Heraeus Whip mix Heraeus Heraeus Heraeus

psi 18,000 11,000 15,000 15,000 18,000

exp .08 .08 .07 .09 .18

*Milestone & Resin Rock are resin reinforced and therefore provides strength in thin areas

Note: Fugi Rock (GC) & Vel Mix (Kerr) are not compatible with Accu-dent

cost 55 45 38 34 54

Always support the cast into the impression holder that comes with the Accu-Dent kit

Wait until the cast appears to be “dry� before inverting

Prepare second mix of stone and invert impression to form the base

These impression were poured using die stone.

Note the “retentive tabs” left on the surface which will mechanically retain the plaster base

The “retentive tabs” will allow the plaster base to be poured later in the day

It is economical to make the second pour in plaster

Also the plaster is much easier to trim

Final Impressions

Note the absence of occlusal and surrounding gingival defects

Final Impressions

Accurate impressions replicate patient’s occlusion