May 2019 DSM Insider 32 - Page 4

PATRICK TESSIER, MBA ® SOMETIMES THE SIMPLEST ACCUTHERM I n July 1975, the US and the USSR conducted a joint space flight called the “Apollo-Soyuz Test Project”. It involved the docking of an Apollo Command module and the Soviet Soyuz 19 capsule. The story that emerged from that fateful day when the astronauts met illustrates our desire to overcome every challenge with a technical solution. Even when a simple solution is right in front of us... The two astronauts were tasked with many things but recording all the activities with detailed notes was a requirement of both sides. The American had come prepared to show off our American ingenuity and superiority. He pulled out a paper notebook and what looked like a standard issue government ball point pen and started to take notes. But this was not any ordinary pen. He explained that the US had spent years developing this writing instrument that would be able to work in the zero gravity conditions of space. No small achievement. As he smiled, he asked what the Soviet had brought to overcome this highly technical problem. The Soviet pulled out his paper notebook SOLUTION IS THE BEST! and his writing instrument. A pencil. Sometimes the simple solution is the best. Pierre Fauchard published the first medical literature dealing with dentistry in 1728, establishing a new medical specialty. Soon after the first prosthetic teeth were made of various techniques and materials, most famously illustrated by George Washington’s wooden dentures. At that point in the history of dentistry, the most vexing problem was exposed. The difficulty of obtaining an accurate impression and model work to build good fitting restorations. For the first 100 years of dentistry, we primarily used beeswax and plaster of Paris to obtain the impression. Prior to WWII, a fantastic new material was developed called Alginate. Since the 1950s, new rubber-based, silicone-based and in recent times polyvinylsiloxane materials have been used. Each material superior to the previous. In that last 10 years, digital scanning devices have been successfully used to record the most detailed impressions. But even with the most accurate PVS impressions or digital scans, dentists and labs still struggle with the number one issue – Fit. How can fit still be an issue with the high-tech solutions available today? Turns out the devil is in the details and our details are measured in microns. Analog impressions require following a precise procedure to properly cure the material. Pulls and distortions are typical issues. Add in a gagging patient with lots of saliva and the task becomes more difficult.