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Innovative Crown & Bridge Technique --
The H&H Impression Technique

Continued

Self-Test

  1. What are the three key physical properties of impression materials that are most influential in the clinical performance of the material?

    1. resistance to fluid absorption, tasteless, odorless
    2. viscosity, durometer hardness, resistance to fluid absorption
    3. durometer hardness, working time, and setting time
    4. none of the above


  2. Which of the following present clinical challenges that hinder accurate impressions of subgingival margins when using conventional impression taking techniques?

    1. maintaining a dry field
    2. retraction cord placement and associated difficulties
    3. electrosurgery complications
    4. gingival hemorrhaging after subgingival margin preparation
    5. all of the above


  3. Low or medium durometer impression materials typically exhibit a Shore A Durometer Hardness of?

    1. 10-20
    2. 60-70
    3. 40-50
    4. less than 80


  4. High durometer impression materials typically exhibit a Shore A Durometer Hardness of?

    1. greater than 85
    2. 60-70
    3. 85-95
    4. 75-85

  5. When using the H&H Impression Technique, which of the following physical properties of the impression material is most critical in eliminating the need for the gingival retraction cord?

    1. Dimensional stability
    2. Durometer Hardness
    3. Working time
    4. Viscosity


  6. During impression tray try-in for the H&H Technique, the patient is instructed to open and close several times with the empty impression tray in place. The purpose of this is to?

    1. direct the patient into maximum intercuspation
    2. allow the patient to feel comfortable with the procedure
    3. confirm that the patient can occlude without impinging on the tray
    4. all of the above


  7. When using the H&H Technique the high- and low-durometer impression materials must both exhibit?

    1. hydrophobic properties
    2. thixotropic properties
    3. hydrophilic properties
    4. a and b
    5. b and c


  8. The thixotropic property of impression materials is described as the ability of the material to?

    1. stay where it is put without slumping
    2. flow under applied pressure
    3. a
    4. a and b


  9. Hemostatic agents that contain sulfur are contraindicated when using vinyl polysiloxane impression materials since they interfere with the impression material's?

    1. durometer hardness
    2. shelf life
    3. water sorption
    4. setting time


  10. When considering use of a hemostatic agent for patients who have a history of cardiovascular problems, it is prudent to avoid using hemostatic agents that contain?

    1. sulfur
    2. epinephrine
    3. a and b
    4. none of the above


  11. The letters in the H&H Impression Technique stand for 1.) Hardness 2.) Hydraulic, 3.) Hydrophilic, 4.) Hydrophobic?

    1. 2 and 1
    2. 3 and 4
    3. 2 and 4
    4. 1 and 3


  12. The hydraulic forces generated during the H&H Impression Technique are necessary to?

    1. place the occluding teeth in maximum intercuspation
    2. propel the low durometer material subgingivally
    3. maintain patient comfort
    4. all of the above


  13. It is necessary to know the durometer hardness of the vinyl polysiloxane material used for the H&H Technique to determine if the material?

    1. qualifies for use as a first or second step material
    2. repels fluids
    3. is tasteless or odorless
    4. none of the above


  14. When using the H&H Impression Technique, the impression is not removed from the mouth until?

    1. the low durometer material is applied and set
    2. the high durometer material is applied and set
    3. all of the above
    4. none of the above


  15. A dual arch tray is used in the H&H Technique to capture an impression of the?

    1. prepared teeth, adjacent teeth and opposing arch
    2. prepared teeth and opposing arch
    3. prepared teeth and adjacent teeth
    4. maxillary and mandibular arch


  16. The hydraulic effect generated in the H&H Technique is created by the?

    1. force of the patient occluding into the impression material
    2. rigid, plaster-like set of the first step material
    3. a and b


  17. The rigid plaster-like set of the first step material used in the H&H Technique is able to sustain the hydraulic force of occlusion without

    1. resistance
    2. fluid absorption
    3. slumping
    4. rebound


  18. In which instances would use of the H&H Technique be contraindicated?

    1. teeth exhibiting mobility
    2. presence of mandibular or maxillary tori
    3. severely malpositioned teeth
    4. all of the above


  19. When using the H&H Impression Technique, the hydraulics of the method and the hydrophobic qualities of the materials eliminate the need for?

    1. hemostatic agents
    2. retraction cord
    3. electrosurgery
    4. a and b
    5. all of the above


  20. When using the H&H Technique, it is necessary to use a hydrophobic impression material to?

    1. allow fluids to be absorbed
    2. allow the impression to float in disinfectant solutions
    3. resist absorption of fluids in the prepared field
    4. avoid the use of retraction cord


  21. A dual arch impression tray insures an accurate reproduction of the patient's bite because?

    1. both the maxillary and mandibular arches are reproduced
    2. the patient's maximum intercuspation can be checked on the opposing side of the restoration
    3. the patient can feel when their teeth come together
    4. use of a dual arch tray does not interfere with the patient's occlusion


  22. The key procedural difference between conventional impression techniques and the H&H Technique is?

    1. the impression tray is a dual arch tray
    2. the impression tray is stabilized on the arch opposing the prepared tooth while the second step material is placed in the impression of the prepared tooth
    3. vinyl polysiloxane impression materials are used for the first and second step materials
    4. the impression tray is stabilized on the arch opposing the prepared tooth while the second step material is placed around the prepared tooth


  23. When using the H&H Technique the first step impression is not removed from the mouth until the second or final impression is complete. This makes is easier for the patient to?

    1. relocate maximum intercuspation during the second, or final impression
    2. displace the lower durometer impression material during the second or final impression
    3. create a stronger occlusal force
    4. none of the above


  24. Vinyl polysiloxane materials are the impression material of choice for the H&H Technique because they are?

    1. tasteless
    2. exhibit good dimensional stability
    3. odorless
    4. all of the above


  25. Which of the following could present a problem when selecting a dual arch impression tray for the H&H Impression Technique, and may contraindicate use of the H&H Technique?

    1. edentulous areas on the opposing arch
    2. the presence of maxillary or mandibular tori
    3. spatial discrepancy between the maxillary and mandibular arch
    4. none of the above


  26. The hydraulic force created during the H&H Technique, along with the hydrophobic properties of the materials?

    1. propels the low durometer material into the sulcus
    2. pushes fluids out of the subgingival margin area
    3. does not allow absorption of fluids
    4. all of the above


  27. For the majority of clinical situations, the most commonly used working time for the high durometer material used in the H&H Technique is?

    1. 90 seconds
    2. 30 seconds
    3. 2 minutes
    4. 4 minutes


  28. Due to the small amount of low durometer material used in the final impression step of the H&H technique, the most commonly used working time for the low durometer material is?

    1. 90 seconds
    2. 30 seconds
    3. 2 minutes
    4. a and b


  29. The H&H Technique increases patient comfort with impression taking by?

    1. eliminating the need for retraction cord
    2. reducing the number of times the impression tray is placed in the mouth
    3. saving time
    4. all of the above


  30. Best results are achieved with the H&H Technique when the final impression is evaluated and shows the high durometer material showing through the low durometer material on the coronal portion of the prepared tooth. This is evidence that?

    1. small amount of low durometer material was dispensed in the coronal half of the impression of the prepared tooth
    2. the clinician ran out of low durometer impression material during the procedure
    3. the patient gained maximum intercuspation and the impression was completely seated.
    4. a and c

Innovative Crown & Bridge Technique -- The H&H Impression Technique is available as a continuing education course from

The Academy Of Dental Therapeutics And Stomatology
P .O. Box 241337
Mayfield Heights, Ohio 44124
(888) 463-3323

Dr. Jeffrey Hoos

Dr. Hoos has been in private practice for 20 years, with an emphasis on implant, cosmetic, and restorative dentistry. He received his DMD in 1978 from Tufts University in Boston, Massachusetts and is a Fellow in the Academy of General Dentistry and the Academy of Implantology. Questions or comments can be directed to Dr. Hoos at (203) 378-9500, fax (203) 397-3632, or e-mail at jchdmd@bettersmile.com.

PerfectIM Systems

Perfectim® 30-Second Blue Velvet®

VPS impression material that produces a rigid, plaster-like set to yield a quick and precise bite template for bite registration or first-step impressions. Can be used for a three-function tray technique, for a pick up transfer copings and castings, bite recordings, edentulous impressions, and for a putty substitute in the putty wash technique and implant impressions. Thixotropic consistency eliminates material from running or dripping to prevent patient gagging. 30-second work time / 60-second set time.

Perfectim® 30-Second Flexi-Velvet®

Captures the soft-tissue detail needed in second-step impressions without distortion. Quick, 30-second work time / 60-second set time ensures maximum patient comfort.





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