Simplified method for making a soft tissue mask for a working cast

Nopsaran Chaimattayompol, DDSa Tufts University School of Dental Medicine, Boston, Mass.

Soft tissue casts are routinely made from pickup impressions that require an additional patient appointment.1-3 Having soft tissue contours available for the laboratory technician at the wax up stage should improve the contours of the metal substructure. This article describes a procedure that enables the dentist to transfer the soft tissue structure to a working cast without the pickup impression.
aAssistant

PROCEDURE
Polyvinyl siloxane putty-type impression material (Reprosil, Caulk Div, Dentsply Intl Inc, Milford, Del.) is used to index the facial gingival tissue and occlusal and incisal surface of both prepared and unprepared teeth on an untrimmed cast (Fig. 1). Individual dies are trimmed facially and interproximally with additional depth of 3 mm to allow space for soft tissue material. Some undercuts are provided to index and to hold the soft tissue material. The working (pindexed) cast and facial index are lubricated with a thin layer of petroleum jelly. The facial aspect of the prepared teeth are then relined on the index with pink poly siloxane condensation-type material (Gi-Mask, Coltene/Whaledent Inc, Mahwah, N.J.) and seated on the working cast (Figs. 2 and 3). Any excess Gi-Mask material is trimmed away (Fig. 4).

Professor, Department of Restorative Dentistry. J Prosthet Dent 2000;83:117-8.

Fig. 1. Untrimmed working cast. Fig. 3. Place putty index reline with Gi-Mask on pindexed working cast.

Fig. 2. Gi-Mask on putty index.

JANUARY 2000

Fig. 4. Pindexed cast with tissue mask in place ready for metal framework and porcelain application.
THE JOURNAL OF PROSTHETIC DENTISTRY 117

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CHAIMATTAYOMPOL

SUMMARY
The proposed method reduces the need for a pickup impression, limits the number of office visits, and is cost-effective. The gingival tissue mask can be freely removed and replaced during technical procedures. These simulated soft tissues permit better esthetic control in the fabrication of the prosthesis.
REFERENCES
1. Pameijer JH. Soft tissue master cast for esthetic control in crown and bridge procedures. J Esthet Dent 1989;1:47-50. 2. Balshi TJ. Soft tissue working cast. J Prosthet Dent 1977;39:349-51. 3. Martin D. Soft tissue master cast. Int J Periodontics Restorative Dent 1982; 4:35.

Reprint requests to: DR NOPSARAN CHAIMATTAYOMPOL DEPARTMENT OF RESTORATIVE DENTISTRY TUFTS UNIVERSITY SCHOOL OF DENTAL MEDICINE 1 KNEELAND ST BOSTON, MA 02111 FAX: (617)636-6583 E-MAIL: nchai@banet.net Copyright 2000 by The Editorial Council of The Journal of Prosthetic Dentistry. 0022-3913/2000/$12.00 + 0. 10/4/103748

Restoration longevity and analysis of reasons for the placement and replacement of restorations provided by vocational dental practitioners and their trainers in the United Kingdom Burke FJT, Cheung SW, Mjr IA, Wilson NHF. Quintessence Int 1999;30:234-42. Purpose. The purpose of this article was to examine the longevity of restorations in the United Kingdom, report the reasons for placement and replacement of these restorations, and if there were differences in treatment planning decisions made by vocational dental practitioners (VDPs) and their trainers. Since 1993, it has been mandatory that new dental graduates work for 1 year as VDPs in special training practices if they wish to subsequently work under National Health Services Regulations. These dentists work for 4 days clinically and the fifth day is devoted to didactic structured learning. Material and methods. The method of data collection was reported in another article. Eighteen VDP groups participated in this study, 56 were VDPs and 17 were trainers. A form on which both VDPs and trainers recorded the reason for placement or replacement of each restoration and for each replaced restoration, its age, class of restoration, material if known, and the material selected as the replacement. Data was collected on a total of 9031 restorations and this was subject to a computerized statistical package that included basic descriptive statistics, cross-tabulation tables and, when appropriate nonparametric tests, such as the Mann-Whitney U test and Kruskal-Wallis tests. Results. Of the 9031 restorations placed, 53.9% were amalgam, 29.8% were resin composite, and 16.3% were glass-ionomer cement. Reasons for placement and replacement were principally primary dental caries (41.3%), secondary dental caries (21.9%), tooth fracture (6.4%0, marginal fracture or degradation (6.1%), and noncarious defects (5.8%). Of amalgam restorations, most were placed to restore Class II (65.8%) and Class I preparations (29.9%). Of composite restorations, most were placed in Class III (35.5%) and Class V (26.3%). Glass-ionomer cement was used in the majority of cases in Class V cavities (63.5%). Conclusion. Regardless of the material, secondary caries was the most prevalent reason for the replacement of restorations. There was no statistically significant difference in treatment planning decisions between VDPs and their trainers. Statistical analysis indicated that amalgam provided a significantly greater longevity than composite or glass-ionomer restorations. 23 References. RP Renner

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