Digital impression, CAD/CAM,

Thermoplastic materials
Name: - Fatma Saeed Hassan Kasem
ID:- 201917414
Removable Prosthodontics 12/9/22 CAD/CAM
 Digital impression, CAD/CAM,
Thermoplastic materials

Abstract
The technologies that have made the use of 3D digital scanners an
integral part of many industries for decades have been improved
and refined for application to dentistry. Since the introduction of
the first dental impression Ing digital scanner in the 1980’s,
development engineers at a number of companies have enhanced
the technologies and created in-office scanners that are
increasingly user-friendly and are used to produce precisely fitting
dental restorations. These systems are capable of capturing 3D
virtual images of tooth preparations from which restorations may
be directly fabricated (CAD/CAM systems) or which can be used to
create accurate master models on which the restorations can be
made in a dental laboratory (dedicated impression scanning
systems). The use of these products is rapidly increasing around
the world and presents a paradigm shift in the way in which dental
impressions are made. Several of the leading 3D dental digital
scanning systems are presented and discussed in this article.
The Concept of Impression Making
The most critical step in the process of fabricating precisely fitting
fixed or removable dental prostheses is the capture of an accurate
impression of prepared or unprepared teeth, dental implants,
edentulous ridges, or intraoral landmarks or defects. Unless a wax
or resin pattern is made directly on the teeth, on the edentulous
ridges, or in the defects, which is a time-consuming and generally
impractical effort, the dentist or auxiliary must achieve an exact
duplication of the site so that a laboratory technician, usually at a
remote location, can create the restoration on a precise replica of
the target site.
Traditionally, the paradigm for transferring the necessary
information from the patient’s oral cavity to the technician’s
laboratory bench has been to obtain an accurate negative of the
target site, from which the technician is able to fabricate an
accurate gypsum positive duplicating the original intraoral
situation. The advent of highly innovative and accurate impression
Ing systems based on new technologies has created a paradigm
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shift in the concept for impression making. These systems are
poised to revolutionize the way in which dental professionals
already are and will continue making impressions for indirect
restorative dentistry.

From Bites to Bytes: A Brief History of Impressioning in

Dentistry
Impression making for restorative dentistry is a relatively recent
concept in the millennia-old history of restorative dentistry. The
earliest physical proof or record of prosthetic treatment to replace
missing teeth goes back to Etruscan times, approximately 700 bc,
in which teeth were carved from ivory and bone and affixed to
adjacent teeth with gold wires. It was not until 1856, when Dr.
Charles Stent perfected an impression material for use in the
fabrication of the device that bears his name for the correction of
oral deformities, that documentation exists of the use of an
impression material other than beeswax or plaster of Paris, which
had inherent problems, respectively, of distortion or difficulty of
use, for creating an oral prosthesis.1
The first use of an elastomeric material for capturing impressions
of tooth preparations, as well as other oral and dental conditions,
was not until 1937, when Sears introduced agar as an impression
material for crown preparations.2 In the mere 71 years that elastic
impression materials have been in use, numerous formulations
have been developed, all of which have exhibited particular
shortcomings in the goal of obtaining precise reproduction of the
oral structures.
The reversible hydrocolloid agar and the irreversible hydrocolloid
alginate exhibit poor dimensional stability because of the imbibition
or loss of water, respectively, when sitting in wet or dry conditions,
as well as in having low tear resistance. The Japanese embargo
on the sale of agar to the United States during World War II
spurred research into the development of alternative elastomeric
impression materials. The polysulfide rubber impression material
introduced in the late 1950s, originally developed to seal gaps
between sectional concrete structures,3 overcame some of the
problems of the hydrocolloids. Nevertheless, polysulfide rubber
was messy, possessed objectionable taste and odor, had long
setting times intraorally, and underwent dimensional change after
the impression was removed from the mouth, as a result of
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continued polymerization with the evaporation of water and
shrinkage toward the impression tray, leading to dies that were
wider and shorter than the teeth being impressed.4 This problem
was overcome somewhat by the use of custom trays that allowed
for 4 mm of uniform space for the material and by pouring up the
impression within 48 hours.3
The introduction in 1965 of the polyether material Impregum™ by
ESPE, GmbH as the first elastomeric impression material
specifically developed for use in dentistry afforded the profession a
material with relatively fast setting time, excellent flowability,
outstanding detail reproduction, adequate tear strength, high
hydrophilicity, and low shrinkage. The material is still in use today
in several formulations, although it exhibits problems with
objectionable odor and taste, high elastic modulus (stiffness) often
leading to difficulty in removing impressions from the mouth, and
the requirement to pour up models within 48 hours because of
absorption of water in very humid conditions, which can lead to
impression distortion.4
Condensation cure silicone impression materials subsequently
were developed, but these also suffered from problems with
dimensional accuracy. The creation of addition silicone vinyl
polysiloxane impression materials solved the issues of dimensional
inaccuracy, poor taste and odor, and high modulus of elasticity,
and offered excellent tear strength, superior flowabilty, and lack of
distortion even if models were not poured quickly. The biggest
drawback of the polysiloxane impression materials, however, is
that they are hydrophobic, which can lead to the inability to capture
fine detail if problems with hemostasis and/or moisture control
occur during impression making.
In addition to the many problems inherent in the accuracy of the
elastomeric materials themselves, further distortions can occur by
mistakes made in the mixing of the materials or in the impression-
making technique, the use of nonrigid impression trays,5 the
transfer of the impression to the dental laboratory (often subjecting
the impressions to variable temperatures in everything from
delivery vehicles to post office sorting rooms to the holds of cargo
jets), the need for humidity control in the dental laboratory to
assure accuracy in the setting of the gypsum model materials, etc.
Newer technologies that allow for the use of digital scanners for
impression making are indeed a welcome development. Digital
impression making does not require patients to sit for as long as 7

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minutes with a tray of often foul-tasting and malodorous “goop” in
their mouths, requiring that they open uncomfortably wide, often
gagging. Further, these devices help calm dentists’ anxieties about
economic and time considerations when deciding to remake
inadequate impressions.
Advances in computerization, optics, miniaturization, and laser
technologies have enabled the capture of dental impressions.
Three-dimensional (3D) digitizing scanners have been in use in
dentistry for more than 20 years and continue to be developed and
improved for obtaining virtual impressions. The stressful, yet
critical task of obtaining accurate impressions has undergone a
paradigm shift.
The computer-aided design/computer-aided manufacture
(CAD/CAM) dental systems that are currently available are able to
feed data obtained from accurate digital scans of teeth directly into
milling systems capable of carving restorations out of ceramic or
composite resin blocks without the need for a physical replica of
the prepared, adjacent, and opposing teeth. With the development
of newer high-strength and esthetic ceramic restorative materials,
such as zirconia, laboratory techniques have been developed in
which master models poured from elastic impressions are digitally
scanned to create stereolithic models on which the restorations are
made. Even with such high-tech improvements, it is evident that
such second-generation models are not as accurate as stereolithic
models made directly from data obtained from 3D digital scans of
the teeth provided by dedicated 3D scanners designed for
impression making. This article outlines the features of two
CAD/CAM systems and two dedicated 3D impressioning digital
scanners that have been gaining in popularity in this emergent field
of technology.

CAD/CAM Systems
CAD/CAM technology has been in use for a half century. It
originated in the 1950s with numerically controlled machines
feeding numbers on paper tape into controllers wired to motors
positioning work on machine tools. It advanced in the 1960s with
the creation of early computer software that enabled the design of
products in the aircraft and automotive industries. The introduction
of CAD/CAM concepts into dental applications was the brainchild
of Dr. Francois Duret in his thesis written at the Université Claude
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Bernard, Faculté d’Odontologie in Lyon, France in 1973, entitled
“Empreinte Optique” (Optical Impression). He developed a
CAD/CAM device, obtained a patent for it in 1984,6 and brought it
to the Chicago Midwinter Meeting in 1989. There, he fabricated a
crown in 4 hours as attendees watched. In the meantime, in 1980,
a Swiss dentist, Dr. Werner Mörmann and an electrical engineer,
Marco Brandestini developed the concept for what was to be
introduced in 1987 by Sirona Dental Systems LLC (Charlotte, NC)
as the first commercially viable CAD/CAM system for the
fabrication of dental restorations—CEREC®.

CEREC
The CEREC® 3 system (Figure 1), an acronym for Chairside
Economical Restoration of Esthetic Ceramics was a bold effort to
combine a 3D digital scanner (Figure 2) with a milling unit to create
dental restorations from commercially available blocks of ceramic
material in a single appointment. One-appointment direct dental
restorations eliminated the need for multiple visits, as well as for
temporization and all of its inherent problems. The CEREC
system uses computer-assisted technologies, including 3D
digitization, the storage of the data as a digital model, and
proprietary CEREC3D software that proposes a restoration
shape based on biogeneric comparisons to adjacent and opposing
teeth, and then enables the dentist to modify the design of the
restoration. After this is accomplished, the data is transmitted to a
milling machine, the latest version of which, CEREC inLab® MC
XL, is capable of milling a crown in as little as 4 minutes from a
block of ceramic or composite material. The most current version
of the CEREC 3 acquisition unit is integrated into a total
chair/systems unit, the CEREC Chairline (Figure 3).
With this system, the impressioning process necessitates
achieving adequate visualization of the margins of the tooth
preparation by proper tissue retraction or troughing and
hemostasis. The entire area being impressed needs to be coated
completely with a layer of biocompatible titanium dioxide powder to
enable the camera to register all of the tissues. This is true not
only for digital scanning, but also for conventional elastomeric
impressions as well.
Several image views then are made from an occlusal orientation

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assuring capture of the tooth or teeth being restored, as well as of
the adjacent and opposing teeth. Next, the preparation is shown
on a touch screen that enables the dentist to view the prepared
tooth from every angle and to focus on magnified areas of the
preparation. The “die” is “cut” on the virtual model, and the finish
line is delineated by the dentist directly on the image of the die on
the monitor screen. Then, the CAD biogeneric proposal of an
idealized restoration is presented by the system, and the dentist is
given the opportunity to make adjustments to the proposed design
using a number of simple and intuitive on-screen tools (Figure 4).
After the dentist is satisfied with the proposed restoration, he or
she mounts a block of homogeneous ceramic or composite
material of the desired shade in the milling unit and proceeds with
fabrication of the physical restoration. The use of color-coded tools
during the design stage of the process to determine the degree of
interproximal contact helps to assure finished restorations that
require minimal, if any, adjustments before cementation.

E4D Dentist
D4D Technologies LLC (Dallas, TX), an acronym for Dream,
Design, Develop, Deliver, introduced the E4D Dentist™ CAD/CAM
system in early 2008, after an extended period of beta-testing and
fine-tuning to assure a quality product. It consists of a cart
containing the design center (computer and monitor) and laser
scanner (Figure 5), a separate milling unit, and a job server and
router for communication. The scanner, termed the IntraOral
Digitizer, has a shorter vertical profile than that of the CEREC
system, so the patient is not required to open as wide for posterior
scans.
Of significance, the E4D Dentist does not require the use of a
reflecting agent, such as titanium dioxide powder, to enable the
capture of fine detail on the target site. Other CAD/CAM systems
create a digital “gypsum” model on which the restoration is made.
While the E4D Dentist can create such models when the scanner
is used on either actual gypsum models or elastomeric
impressions, it creates a more accurate and informative model
when scanning is done with the IntraOral Digitizer (Figure 6).
The ICEverything™ (ICE) feature of the system’s DentaLogic™
software takes actual pictures of the teeth and gingiva before

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treatment and after tooth preparation, as well as an occlusal
registration. As successive pictures are taken, they are wrapped
around the 3D model to create the ICE model. The 3D ICE view
makes margin detection simpler to achieve (Figure 7). The touch
screen monitor enables the dentist to view the preparation from
various angles to assure its accuracy.
The design system of the E4D Dentist is capable of autodetecting
and marking the finish line on the preparation. After the dentist
approves this landmark, the software uses its Autogenesis™
feature to propose a restoration, chosen from its anatomical
libraries, for the tooth to be restored (Figure 8). As with the
CEREC system, the operator is provided with a number of highly
intuitive tools to modify the restoration proposal. After the final
restoration is approved, the design center transmits the data to the
milling machine. Using blocks of ceramic or composite mounted in
the milling machine, and with the aid of rotary diamond instruments
that can replace themselves when worn or damaged, the dentist
can fabricate the physical restoration.

Dedicated Impression Scanning Systems

Dedicated 3D digital dental impression scanners eliminate several
time-consuming steps in the dental office, including tray selection,
dispensing and setting of materials, disinfection, and shipment of
impressions to the laboratory. In addition, the laboratory saves
time by not having to pour base and pin models, cut and trim dies,
or articulate casts. With these systems, the final restorations are
produced in the laboratory, but they are fabricated on models
created from the data in the digital scans, as opposed to gypsum
models made from physical impressions. Patient comfort,
treatment acceptance, and education are added benefits. Digital
scans can be stored on computer hard drives indefinitely, whereas
conventional models, which may chip or break, must be stored
physically, which often requires extra space in the dental office.

iTero
The iTero™ digital impression system (Cadent, Carlstadt, NJ) was
introduced in early 2007, following 5 years of intensive research
and beta testing. Based on the theory of “parallel confocal,” the

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iTero scanner emits a beam of light through a small hole, and any
surface within a certain distance will reflect the light back toward
the wand. The iTero device projects 100,000 beams of red light,
and within one third of a second, the reflected light is converted
into digital data. There is no need for the use of a reflecting agent,
such as titanium dioxide powder, as the laser is able to reflect off
all oral structures.
The iTero system includes a computer, monitor, mouse, integrated
keyboard, foot pedal, and scanning wand organized on a well-
designed mobile cart (Figure 9). Disinfection consists of replacing
the disposable sleeve on the handheld scanner (Figure 10). The
end of the scanner that enters the mouth has the tallest vertical
profile of the systems reviewed in this article (Figure 11), and thus
requires wider mouth opening by the patient.
Voice prompts guide the dentist in taking a series of scans of the
patient’s teeth and occlusal registration. The images are captured
on the monitor by stepping on the foot pedal. The image on the
screen is similar to a viewfinder on a camera, which allows the
dentist to position the camera correctly while looking at the screen.
As this is not a continuous scan and no powdering is necessary,
the dentist may remove the scanner from the mouth to dry or rinse
fluids as necessary.7 Individual images may be retaken to ensure
capture of adequate detail. If the preparation must be modified, the
quadrant needs to be rescanned after all adjustments are
complete.8
After all scans (at least 21) are completed, the dentist steps on the
foot pedal and, within a few minutes, the digital model is displayed
on the monitor (Figure 12). Using a wireless mouse, the dentist
can rotate the model on the screen to confirm that the preparations
are satisfactory before temporizing the teeth and sending the
scans to the laboratory. Voice prompts again are very helpful in
assuring that such necessities as proper occlusal tooth reduction
for the intended crown type have been achieved.
All patient data and laboratory prescriptions are input into the
computer before the scanning procedure. Digital data are sent
wirelessly to Cadent, where the digital impression is refined and a
hard plastic model is milled. Cadent then returns the model to the
local dental laboratory, which completes the final restoration.9

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Lava C.O.S.
The Lava™ Chairside Oral Scanner (C.O.S.) was born out of the
research of Professor Doug Hart and Dr. János Rohály at the
Massachusetts Institute of Technology. The Lava C.O.S. was
created at Brontes Technologies Inc (Lexington, MA) and was
acquired by 3M ESPE (St. Paul, MN) in October 2006. The product
was launched officially at the Chicago Midwinter Meeting in
February 2008.
The method used for capturing 3D impressions involves active
wavefront sampling (AWS), which enables a 3D-in-Motion
technique. This technique incorporates revolutionary optical
design, image processing algorithms, and real-time model
reconstruction to capture 3D data in a video sequence and model
the data in real time. Other digital impressioning scanners use
triangulation and laser approaches, which rely on the warping of a
laser or light pattern on an object to obtain 3D data. In so doing,
these methods are relatively slow and have the downside of
distortion and optical illusion. By using AWS, however, the LAVA
C.O.S. captures scanned images quickly (approximately twenty 3D
data sets per second, or close to 2,400 data sets per arch) in video
mode and creates a highly accurate virtual on-screen model
instantaneously.10
The Lava C.O.S. unit consists of a mobile cart (Figure 13)
containing a computer, a touch screen monitor, and a scanning
wand (Figure 14), which has a 13.2-mm wide tip and weighs 14 oz
(about the size of a large power toothbrush). The end of the
scanner that enters the mouth is the smallest of the systems
reviewed in this article. The camera at the tip of the wand (Figure
15) contains 192 light-emitting diodes (LEDs) and 22 lenses. There
is no need for a keyboard or mouse, as the monitor displays a
keyboard for all data input. Disinfection involves a simple
wipedown of the monitor with an intermediate-level surface
disinfectant designed for use on nonporous surfaces and
replacement of the plastic sheath on the wand.
Whereas the Cadent iTero does not require any powdering and the
CEREC requires heavy powdering, the Lava C.O.S. requires
only enough powdering to allow the scanner to locate reference
points. Therefore a very light dusting of powder is required, and is
produced using the powdering gun provided with the unit.
Following preparation of the tooth and gingival retraction (if
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necessary), the entire arch is dried thoroughly and lightly dusted
with powder. The dentist begins scanning by pressing either a
button on the scanning wand or the start key on the touch screen
monitor. A pulsing blue light emanates from the wand head as a
black and white video of the teeth appears instantaneously on the
monitor. Starting on the occlusal surface of any posterior tooth,
the dentist guides the wand forward over the occlusal surfaces of
the sextant being scanned, and then rotates the wand so that the
buccal surfaces are captured.
The wand then is moved posteriorly, capturing all the buccal
surfaces with some overlap of the occlusal. After he or she
reaches the most posterior tooth, the dentist begins scanning the
lingual surfaces of all the teeth in the sextant. The “stripe
scanning” is completed when the dentist returns to scanning the
occlusal of the starting tooth, i.e., “closing the loop.” If any sudden
movement occurs, the image automatically pauses and the dentist
can continue by returning to any surface that has been previously
scanned. The software recognizes data that is already in the
computer and resumes scanning without the need for pressing any
buttons. Additionally, the software can distinguish between
surfaces that are intended to be scanned (i.e., teeth and attached
gingiva) and extraneous data (i.e., tongue, cheeks, etc).
As the teeth are scanned, they turn bright white on the monitor,
and any areas that remain in red need to be scanned for more
detail. To help the dentist maintain the wand at a proper distance
from the teeth, a target appears on the monitor to indicate whether
the wand is too close or too far away from the teeth. With the help
of these on-screen guides, the dentist can modify the continuous
scan without pausing, withdrawing the wand, or restarting the
scan.
After scanning the preparation and adjacent teeth, the dentist
pauses the scan and evaluates the result on the monitor. He or
she is able to rotate and magnify the view on the screen, and also
switch from the 3D image to a 2D view of the exact images
captured by the camera during the scan. A third option allows the
dentist to view these images while wearing 3D glasses.
After the dentist confirms that all necessary details were captured
on the scan of the preparation (Figure 16), a quick scan of the rest
of the arch is obtained, which takes approximately 2 minutes. If
there are holes in the scan in areas where data is critical, such as

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cusp tips or contact points, it is not necessary to redo the entire
scan. Rather, the dentist simply scans that specific area and the
software patches the hole. The software uses reference points on
the scanned images to integrate the new data with that of the
previous scans; therefore, it is crucial to have some overlap when
scanning new data.
After the opposing arch is scanned, the patient is instructed to
close into maximal intercuspal position. The buccal surfaces of the
teeth on one side of the mouth are powdered, and a 15-second
scan of the occluding teeth is captured. The maxillary and
mandibular scans then are digitally articulated on the screen.
After all the scans have been reviewed for accuracy, the dentist
uses the touch screen monitor to complete an on-screen
laboratory prescription. The data is sent wirelessly to the
laboratory technician, who then uses customized software to cut
the die and mark the margin digitally. 3M ESPE receives the digital
file where it is ditched virtually, and the data is articulated
seamlessly with the operative, opposing, and bite scans. At the
model manufacturing facility, a stereolithography model is
generated, and is sent to the laboratory (along with a Lava coping
if the restoration is to be a Lava crown), where the technician
creates the final restoration. Despite the name of the system, it is
not dedicated only to the creation of Lava crowns, as all types of
finish lines may be reproduced on the stereolithography dies,
allowing for any type of crown to be manufactured by the dental
laboratory.

Learning Curve
All of the 3D digital impressioning systems reviewed in this article
have the potential to produce restorations with improved marginal
fit over that of traditional elastomeric impressions, based on the
fact that the master die is created from digital data obtained from
the tooth preparation itself, rather than from a second- or third-
generation impression or model. The success of the CEREC
system over the past 21 years in convincing many dentists
worldwide to engage in new technologies bodes well for the future
of all of the systems that have been and will continue to be
developed. One of the factors that prevent dentists from “taking off
the blinders” and attempting to introduce new techniques and
instruments into their dental practices is the fear that the learning
Page 11 of 14
curve is too great and that “you can’t teach an old dog new tricks.”
Recent research advanced by Norman Doidge11 shows that
neuroplasticity in the brain exists throughout the human lifespan
and that the cerebral cortex is capable of constantly undergoing
improvements in cognitive functioning. This means that any task
that requires highly focused attention or the mastery of new skills
helps to improve the mind, especially memory. Admittedly, learning
to use any of the digital scanners discussed in this article means
acquiring new skills and mastering new techniques, which will take
some time and patience. The bottom line, however, is that the end
result of developing the ability to use these new technologies will
empower dentists to learn more about the dentistry they perform
and enable them to provide their patients with well-fitting
restorations.

The Economics
The cost of all the systems presented, ranging from just over
$20,000 to well over $100,000, may appear prohibitive for many, if
not most, small dental practices. Nevertheless, when all of the
attendant costs of traditional impression-making are taken into
account, including the frequent need to remake impressions or
even remake restorations as a result of the shortcomings of the
older techniques and materials, and considering the improved
quality of restorations made possible by the newer digital systems,
the 3D digital impressioning systems become more appealing. The
lease programs offered through most CAD/CAM system
manufacturers have brought using this technology into the realm of
profitability for practices producing more than 14 indirect
restorations a month.
Notwithstanding the ethical dilemma of dentists’ providing indirect
ceramic restorations when simpler and less expensive composite
restorations are achievable simply to justify the lease expenses of
an expensive digital system, the use of new and better technology
to improve the quality of dentistry is an advantage that well-
educated patients are becoming increasingly more willing to
accept, even at a higher cost. The technology of 3D digital
impression scanning has advanced to a level at which it can no
longer be ignored. Virtual has become a reality.

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Acknowledgements
The authors would like to thank Michael Dunn and Gabe Foster of
Sirona Dental Systems LLC; Dr. Gary Severance and Lee Culp of
D4D Technologies LLC; Tim Mack and Mike Walsh of Cadent; and
Dr. János Rohály, Brian Keenan, and Tara Mingardi of
3M/ESPE/Brontes Technologies, for their help in providing
information which was critical to the content of this article.

Disclosure
Dr. Birnbaum and Dr. Aaronson use the 3M/ESPE Lava C.O.S.
system for digital impressioning in their practice. Dr. Aaronson is
employed on a part-time basis as a trainer for the 3M/ESPE Lava
C.O.S. system.

ABOUT THE AUTHORS: Nathan S. Birnbaum, DDS, is an

associate clinical professor in prosthodontics and operative
dentistry at Tufts University School of Dental Medicine and
maintains a private practice in Wellesley, Massachusetts. Heidi B.
Aaronson, DMD, maintains a private practice in Wellesley,
Massachusetts.

References
1. Ring ME. How a dentist’s name became a synonym for a
life-saving device: the story of Dr. Charles Stent. J Hist Dent.
2001l;49(2):77-80.
2. Sears AW. Hydrocolloid impression technique for inlays
and fixed bridges. Dent Dig. 1937;43:230-234.
3. Craig RG. Restorative Dental Materials. 10th ed. London:
C.V. Mosby Co.; 1997:281-332.
4. Wassell RW, Barker D, Walls AWG. Crowns and other
extra-coronal restorations: impression materials and technique. Br
Dent J. 2002;192(12):679-690.
5. Cho GC, Chee WW. Distortion of disposable plastic stock
trays when used with putty vinyl polysiloxane impression materials.
J Prosthet Dent. 2004;92(4):354-358.
Page 13 of 14
6. Duret F, Termoz C, inventors. Method of and apparatus
for making a prosthesis, especially a dental prosthesis. US patent
4 663 720. May 5, 1987.
7. Garvey P. The dental assistant’s role in integrating digital
impression technology in the dental practice. Dent Assist.
2007;76(6):12-14.
8. Jacobson B. Taking the headache out of impressions.
Dent Today. 2007;26(9):74-76.
9. Cadent debuts “next generation” iTero digital impression
system. Implant Tribune, US edition. 2007;1(12):14.
10. Dalin J. The future of impressions. Dental Economics
[serial online]. June 2007. Available at:
http://www.dentaleconomics.com/articles/article_display.html?id=2
96261. Accessed Jul 2, 2008.
11. Doidge N. The Brain That Changes Itself. New York,
NY: Penguin Books; 2007:87.

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