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This is a patient with a missing tooth who will be treated with a combination of bridge and partial denture. The 4 anterior teeth prepared at the previous visit will act as bridge abutments for replacement of tooth 22

  • The provisional crowns have been removed and any remaining traces of temporary cement are cleaned off with an ultrasound scaler Minor bleeding at the gingival margin is a common occurrence during this process, and must be treated before the impression is taken. A product based on ferric sulphate should be used for haemostasis.
    This type of product is the most compatible with Apol Classe.
    Bleeding gum tissue is rubbed with the special tip while the product is applied. Haemostasis occurs in less than a minute. The mouth should then be washed copiously to remove any residual blood clots and any trace of the product.
  • Once bleeding has definitely stopped, retraction chords are placed in the sulcus below the cervical margin. The aim is to open up the sulcus temporarily. The cord should remain visible along the whole length of the preparation.
    A short length of cord should be left accessible on the palatal aspect to facilitate removal before taking the impression. Cords sometimes have an annoying tendency to lift. Replacing the provisional crown on the preparation will keep the cords in the sulcus for as long as required.
    When it is time to take the impression the chords are removed carefully, revealing the cervical margin of the preparations.
  • Apol Classe is injected using a syringe, starting in the sulcus, and the preparations are partially covered with the material, leaving the tip of the syringe in the bulk to avoid trapping air bubbles. The loaded impression tray is then seated on the arch and kept in place until the material has set completely. Withdrawal of the impression tray is an important stage:
    The tray should be withdrawn along the presumed axis of the preparations, avoiding any tilting movement. Compressed air should be directed under the impression tray to break the vacuum and allow the tray to be gently removed.
    A triple syringe is often inadequate for this purpose. The pressure obtained from a turbine connection will be more effective.
  • Once the impression has been withdrawn the quality is checked, ensuring that the cervical margins have been reproduced accurately. A clear and sharp plaster model will enable the prosthodontist to identify the margins of the preparations easily and accurately.
    The key to success with crowns and bridges lies almost entirely with the accuracy of reproduction of the cervical margins.
    When the bridge comes back from the laboratory it will be tried in to check that it fits perfectly. It will then be cemented before the crown or bridge is fabricated.

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Apol, Dental Product Manufacturer, 597 rue René Cassin - 39 300 Champagnole - France. With kind participation of "laboratoire Actuel Dental" from Evreux (F)