A User Report by Dr. Christian Niemeyer
Ever since I have been working as a dentist, my objective has not only been to achieve solid treatment results. I have rather been aiming to work on a contemporary and modern level. It is crucial that I can rely on reproducible, safe, and precise workflows and ensure the highest level of safety and quality for my patients as well as for myself. The opportunities of digital dentistry have always been fascinating to me. Thus, I joined an entirely digitalized practice after my graduation in 2019, in which I steadily got familiar with the use of CEREC, 3D printing, etc.
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Fig. 1: Preparation, showing initial bleeding |
Within the first months however, it quickly became obvious that digital technologies alone cannot accomplish miracles. When it comes to impressions, subgingival preparation margins represent an especially major challenge. Blood, sulcus fluid, and insufficient tissue retraction can significantly affect the scans and finally determine the success or failure of a treatment (Fig. 1). It is impossible to correct blurry scans, indistinct preparation margins, or poorly fitting crowns simply by using a software or specific technology. To resolve these problems, it is indispensable to establish a consistent tissue management protocol.
Bearing that in mind, I actively started searching for a suitable solution. I tested various materials and techniques, including conventional retraction cords, double-cord techniques, hemostatic pastes, electrosurgery, and lasers. In retrospect some methods worked better than others. The turning point occurred during an exchange in an established Facebook CAD-/CAM-group, in which different clinical cases and experiences were shared, along with discussions about materials and techniques. These insights helped me to optimize my treatment concept continuously. Finally, I became aware of a small but very helpful product: ViscoStat Clear TM (Ultradent Products).
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Fig. 2: After the application of ViscoStat Clear |
ViscoStat Clear is a hemostatic agent, based on an active ingredient of 25% aluminum chloride in a viscous, transparent solution. It features an extremely easy application and handling. ViscoStat Clear is applied directly from the syringe and brushed into the sulcus with a small brush at the end of the tip (Fig. 2). It acts quickly, requires basically no exposure time, and I can rinse it off immediately after having brushed it into the sulcus. The aluminum chloride is an astringent material and stops bleeding by reducing the vascular permeability (mostly acting on the collagen fibers within the capillaries’ endothelium). Besides all these, the best feature is ViscoStat Clear’s immediate effect (Fig. 3 - 5). Bleedings are reliably stopped, sulcus fluid is reduced, and the result is an extremely dry working field. What more could you wish for as a dentist?
Fig. 3, 4 & 5: Hemostatic process and clearly visible preparation margin
I have been working in my own practice since 2022. It is self-explanatory that I take decisions and adapt my treatment protocols according to the specific circumstances and requirements of each case. However, I permanently rely on a basic tool, which is undoubtedly ViscoStat Clear. I love using this hemostatic agent even in cases without visible bleedings to eliminate residual moisture and thus ensure the scan quality.
For deep subgingival preparation margins or short crowns, I do not only use ViscoStat Clear, but additionally retraction cords. My goal is always to create clearly visible preparation margins, reproducible restorations, and predictable outcomes. According to my experience, Teflon cords have proven to be especially effective (Fig. 6 & 7). They are dimensionally stable, as they do not absorb moisture. Moreover, they remain reliably in place on the preparation margin and rarely reactivate bleedings.
Fig. 6 & 7: Sulcus with Teflon cord
Regardless of the applied type of cord, ViscoStat Clear convinces me repeatedly due to its quick and effective action, the clean working field it creates, and the fact that it can be removed residue-free without leaving any discoloration on hard or soft tissues.
The advantages for me as a dentist are significant. There is less need for time-consuming revisions or frustrating repetitive impression-takings. The treatment times are noticeably shorter. I appreciate ViscoStat Clear primarily for the safety it provides both to me and my patients. This workflow stability becomes particularly evident in cases in which several teeth are prepared simultaneously. The hemostasis is consistently maintained throughout the entire treatment process, eliminating the need for corrections.
Digital impressions are a central part of my daily work. They offer precision, efficiency, and reproducible results, given the circumstances and conditions are appropriate. From my experience, it proved to be pivotal to shift from the mere hope for a dry working field and successful outcomes to the implementation of a controlled, reliable treatment protocol, resulting in perfect scans (Fig. 8–10).
Fig. 8-10: Reliable treatment protocol, showing clearly visible preparation margins and perfect scans
Thanks to ViscoStat Clear, this became easy and uncomplicated. That’s why ViscoStat Clear is an essential product in my practice. It embodies reliability, a seamless workflow, and total control of every preparation detail. Especially in the field of digital dentistry, ViscoStat Clear consistently enables me to ensure high quality restorations.
Dr. Christian Niemeyer