Impression Materials in Fixed Prosthodontics: Influence of Choice on Clinical Procedure

The purpose of this article is to review impression materials used for fabricating fixed restorations in dentistry. Their compositions, properties, advantages, and disadvantages are presented and compared. How these properties influence clinical decisions is also described. This review helps the clinician choose which material is more suitable for a specific case. A broad search of the published literature was performed using Medline to identify pertinent current articles. Textbooks, the Internet, and manufacturers’ literature were also used to supplement this information. It is limited to impression materials used in fixed prosthodontics. The review gives basic knowledge of ideal impression material properties and discusses traditional and, primarily, more recently developed products, such as polyethers, poly(vinyl siloxane), polysulfides, and condensation silicone materials. Clear advantages and disadvantages for these impression materials are provided along with the role that compositional variations have on the outcome of the impression. This should enable clinicians and technicians to easily identify the important physical properties of each type of impression material and their primary clinical indications.     

A historical review of hydrocolloids and an investigation of the dimensional accuracy of the new alginates for crown and bridge impressions when using stock trays

Reversible hydrocolloids have been used since 1937 and irreversible hydrocolloids since 1947 for the making of impressions for fixed prostheses; the impression techniques were similar to today's. The dimensional accuracy of reproduction of the irreversible hydrocolloids has been proved since 1947. In this paper the dimensional accuracy of three new alginates, Algi -X ( Algiflex Super, Howmedica Alginate), Ardent Alginate, Ultrafine and a combination material, Colloid 80/ Algiace ( Dentloid / Algiace ) were compared to two agar hydrocolloids and an addition silicone, when different stock trays were used as in the dental clinic. In most clinical situations the new alginates used in metal stock trays are as accurate as the "old" impression materials. The combination material is less accurate when many abutment preparations are to be reproduced. Whether perforated or nonperforated metal stock trays are used with the alginates is of no consequence to the accuracy. Alginates used in disposable plastic trays may cause severe inaccuracy. In narrow spaces with severe unblocked undercuts some of the alginates may be inferior to the other impression materials in this study.     

Effects of implant angulation, material selection, and impression technique on impression accuracy: a preliminary laboratory stu

The aim of this preliminary laboratory study was to evaluate the effects of 5- and 25-degree implant angulations in simulated clinical casts on an impression's accuracy when using different impression materials and tray selections. A convenience sample of each implant angulation group was selected for both open and closed trays in combination with one polyether and two polyvinyl siloxane impression materials. The influence of material and technique appeared to be significant for both 5- and 25-degree angulations (P < .05), and increased angulation tended to decrease impression accuracy. The open-tray technique was more accurate with highly nonaxially oriented implants for the small sample size investigated.     

Pressure Produced on the Residual Maxillary Alveolar Ridge by Different Impression Materials and Tray Design: An In Vivo Study

Increased ridge resorption may occur due to inappropriate pressure applied during final impression making phase of complete denture fabrication. This study was done to evaluate the pressure applied on the residual ridge while making impressions with two tray designs (with and without spacer) using, zinc oxide eugenol and light body polyvinyl siloxane impression material. Five edentulous subjects were randomly selected. For each of the five subjects four maxillary final impressions were made and were labelled as, Group A-Impression made with tray without spacer using zinc oxide eugenol impression, Group B-Impression made with tray with spacer using zinc oxide eugenol impression material, Group C-Impression made with tray without spacer using light body polyvinyl siloxane impression material, Group D-Impression made with tray with spacer using light body polyvinyl siloxane impression material. During the impression procedure a closed hydraulic system was used to remotely measure the pressures produced in three areas. The pressure produced were calibrated according to the micro strain record. Statistical comparisons of readings were done using t test and ANOVA. The acquired data revealed that ZOE produced an average pressures value of 26.534 and 72.05 microstrain, while light body PVS produced 11.430 and 37.584 microstrain value with and without spacer respectively. Significantly high values were recorded on the vault of the palate when using trays without spacer. The use of light body polyvinyl siloxane and zinc oxide eugenol impression material showed insignificant difference. Within the limitations of this study, tray design has a significantly effected on the pressures produced, while the impression materials does not have any significant difference.     

Evaluation of Polycaprolaitone Custom Tray Material

Custom impression trays are necessary for accurate impressions in fixed prosthodontics when using polysulfide impression materials. These custom impression trays are needed to provide for a uniform thickness of impression material to minimize distortion. Custom impression trays have historically been made from acrylic resin. New materials have been developed as alternatives to acrylic resin, and this study evaluates one product currently available that is composed of polycaprolaitone. This study evaluates the modulus of elasticity of polycaprolaitone as compared with acrylic resin, and also evaluates the amount of permanent deformation of the new material when placed under a load. The elastic modulus of polycaprolaitone was tested using three-point bending of specimens placed in a universal mechanical test system. The elastic modulus of the new material was found to be significantly lower than that of acrylic resin. The next test evaluated the amount of permanent deformation of the polycaprolaitone material when specimens approximating the shape and size of custom impression trays were placed under a load. These trays were placed in a universal mechanical test system and differing loads were placed on them. Results showed that although the trays deformed at relatively low loads, all deformation was fully recovered within a clinically insignificant period of time (less than 30 seconds). From these experiments it was concluded that although the polycaprolaitone material has a lower modulus of elasticity and will deform under relatively low loads, the material recovers completely, and thus the deformation would not interfere with the clinical performance of polycaprolaitone as a custom tray material.     

Pressure Generated on a Simulated Mandibular Oral Analog by Impression Materials in Custom Trays of Different Design

PURPOSE: The purpose was to measure the pressure exerted under a simulated mandibular edentulous impression at different locations using commonly used impression materials and four impression tray configurations. MATERIALS AND METHODS: This study was performed using an oral analog that simulated an edentulous mandibular arch. Three pressure transducers were embedded in the oral analog-one pressure transducer in the anterior ridge area, and the other two in the right and left buccal shelves. Four configurations of custom trays were fabricated: trays with no relief, with and without holes; and trays with relief, with and without holes. The impression materials tested were light body polysulfide, light body vinyl polysiloxane, medium body vinyl polysiloxane, and irreversible hydrocolloid. The custom tray and the oral analog were mounted using a reline jig, and a Satec universal testing machine was used to apply a constant pressure of 1 kg/cm(2) over a period of 5 minutes on the loaded custom tray. Eighty impressions for the 16 groups (n = 5) were made, and pressures were recorded every 10 seconds. Factorial ANOVA and Tukey Multiple Comparison Test were used to analyze the results (p < 0.05). RESULTS: A significant difference was found in the pressure produced using different impression materials. Irreversible hydrocolloid and medium body vinyl polysiloxane produced significantly higher pressure than light body polysulfide and light body vinyl polysiloxane impression materials. The presence of holes and/or relief significantly altered the magnitude of pressure produced by irreversible hydrocolloid and medium body vinyl polysiloxane but not light body polysulfide and light body vinyl polysiloxane. CONCLUSION: All impression materials produced pressure during simulated mandibular edentulous impression making. For making mandibular edentulous impressions, low-viscosity impression materials-light body polysulfide and light body vinyl polysiloxane-are recommended. Tray modification was not important in changing the amount of pressure produced for the low-viscosity impression materials.     

A review of contemporary impression materials and techniques

The contemporary restorative dentist has a host of impression materials available for making impressions in fixed prosthodontics,implant dentistry, and operative dentistry. With proper material selection and manipulation, accurate impressions can be obtained for fabrication of tooth- and implant-supported restorations. This article outlines the ideal properties of impression materials and explains the importance of critical manipulative variables. Available impression materials are analyzed relative to these variables, and several "specialized" impression techniques are described. Special attention is paid to polyvinyl siloxane impression materials because they have become the most widely used impression material in restorative dentistry.     

Working Times and Dimensional Accuracy of the One-Step Putty/Wash Impression Technique

PURPOSE: Using the one-step polyvinyl siloxane impression technique, this study compared the effect of putty material working time on the dimensional accuracy of recovered improved stone casts. MATERIALS AND METHODS: An acrylic resin master cast was fabricated with embedded reference points to enable both horizontal and vertical measurements. Four commercially available polyvinyl siloxane impression putties with light body washes were evaluated: 1) Extrude (Kerr), 2) Cutter (Coltere), 3) Express (3M), and 4) Reprosil (Caulk). Each putty was mixed by hand for 30 seconds, placed in a plastic stock tray, and seated on the master cast at 0, 30, 60, 90, and 120 seconds after mixing (N = 100, n = 5). The impressions were poured in improved stone, and vertical and horizontal measurements were made to 0.001 mm between reference points on recovered casts using an optical traveling microscope. ANOVA (p < or = .05) was used to compare vertical and horizontal measurements to master cast dimensions. RESULTS: No statistically significant difference was found among casts for all materials and time periods tested. When horizontal measurement ranges were evaluated, Extrude casts exhibited the widest range of measurement, especially when the trays were seated at 90 and 120 seconds. When vertical measurement ranges were evaluated, Express casts at 120 seconds exhibited the widest range. CONCLUSIONS: A high range of variability in vertical and horizontal dimensions occurred at the later time periods, especially for Extrude and Express casts. As a result of rapid polymerization and poor flow properties of putty materials, the impression tray should be seated within 60 seconds after putty mixing to reduce dimensional variability of recovered casts.     

Application times for the single-step/double-mix technique for impression materials in clinical practice

Hydrophilicity of unset impression materials underlies changes occurring during working time. Hence, the clinical application time when impression materials contact oral tissues after mixing may play a critical role in successful impressions. The aim of this study was to analyze the clinical time course of impression taking applying the single-step/double-mix technique. Application times of 86 impressions, comprising 265 prepared teeth and 46 implants, taken by 14 different clinicians at a university dental clinic were analyzed. The mean time from loading the impression tray until its final position in the patient's mouth (total application time) was 51.2 seconds; confidence intervals were 46.9 (lower limit) and 55.5 (upper limit). The number of registered teeth and implants did not influence the duration of impression taking. Related to wettability data, several polyvinyl siloxane impression materials show decreased hydrophilicity with respect to estimated application times. The authors suggest considering clinically relevant application times for impression taking in future in vitro studies on physicochemical characteristics of impression materials.     

Survey of prosthodontic impression procedures for complete dentures in general dental practice in the United Kingdom

STATEMENT OF PROBLEM: Anecdotal evidence suggests impression techniques used in general dental practice may vary from those taught at dental schools. There is little published information on this topic. PURPOSE: This study identifies the materials and methods used by general dental practitioners for recording impressions for the provision of replacement of complete dentures. METHODS: A total of 905 questionnaires were sent to general dental practitioners in the Greater Manchester area to identify current clinical practices. RESULTS: The results revealed that 88% of respondents use only irreversible hydrocolloid for primary impressions. If multiple responses are included, 99% of respondents mentioned irreversible hydrocolloids as an option for primary impressions. In response to the same question for secondary impressions, 94% of respondents mentioned irreversible hydrocolloids as an option. Other material mentioned as an option for secondary impressions included zinc oxide-eugenol (29%) and polyvinyl siloxane (13%). With regard to special trays, 75% of respondents routinely used laboratory constructed special trays to take definitive impressions. Questions on the requisite spacing, perforation, handle design of special trays, and on disinfection showed a diversity of opinion among practitioners. CONCLUSIONS: Although this survey reflected a diverse range of clinical preferences, it is clear that irreversible hydrocolloid dominates the impression market for complete dentures. The use of special trays is normal practice for complete dentures in general dental practice in the United Kingdom.     

A clinical study comparing the three-dimensional accuracy of a working die generated from two dual-arch trays and a complete-arch custom tray

STATEMENT OF PROBLEM: Dual-arch trays are often used by the dentists to make crown impressions of opposing quadrants simultaneously. Metal and plastic trays are available, but little is known about the accuracy of the impressions and resultant working dies. PURPOSE: The purpose of this study was to conduct a clinical trial to compare the accuracy of gypsum working dies made from impressions with metal dual-arch, plastic dual-arch, and complete-arch custom trays. MATERIAL AND METHODS: Eight patients requiring a posterior single tooth implant restoration were selected on the basis of inclusion and exclusion criteria. A customized abutment was measured in 3 dimensions (buccolingual, mesiodistal, and occlusogingival) by use of a measuring microscope. Three polyvinyl siloxane impressions were made of the abutment with a complete-arch custom tray, a plastic, and a metal dual-arch tray. Each impression was poured with type IV improved dental die stone. The diameter (buccolingual and mesiodistal), from gingivoaxial to gingivoaxial point angle, and height (occlusogingival), gingivoaxial to occlusoaxial point angle of the abutment standard was determined by measuring each dimension several times to obtain a mean. These 3 mean values served as the controls and were compared with the same measurements of the gypsum dies generated by the 3 different impression techniques. The patient was asked to rank the 3 impressions in order of overall comfort. A multivariate repeated measures single factor ANOVA was used in the statistical analysis (alpha=.05). When main effects were significant, a pairwise comparison of mean values was conducted with Bonferonni adjustment for multiple comparisons. RESULTS: There were no significant differences in die accuracy among the 3 trays for the mesiodistal (3.507 mm) and occlusogingival (3.584 mm) dimensions of the implant abutment. Dies were smaller than the standard for these 2 dimensions and larger in the buccolingual dimension. There was a significant difference in accuracy between the metal and plastic dual-arch trays. The dies produced from the metal dual-arch tray were 20 microm larger than the abutment standard compared with 3 microm larger for the plastic tray. The occlusogingival dimension of the working dies was 30 to 40 microm shorter than the implant abutment. Seven of the 8 patients ranked the plastic dual-arch impression as the most comfortable and the complete-arch custom tray as the least comfortable. CONCLUSIONS: Within the limitations of this study, the dimensions of working dies from a custom tray impression did not differ significantly from those created with dual arch trays. However, working dies from a plastic dual-arch tray were more accurate buccolingually than those from metal dual-arch trays.     

Dimensional stability of elastomeric impression materials in custom-made and stock trays

Elastomeric impression materials for fixed prosthodontics are considered most stable when they have an even thickness of 2 to 4 mm. To obtain this, a custom-made impression tray is recommended. The purpose of the present study was to compare the stability of impressions made in custom trays and trays made of chromium-plated brass. The impression materials chosen were polyether and silicone.Two master models of the upper jaw were made of metal. The canines and first molars represented abutment teeth with flat occlusal surfaces. An engraved cross on each surface made it possible to measure in a microscope the distances between the abutment teeth on the models and in the impressions. The accuracy of the method was within ±8 μm. Twelve standardized impressions were made with each impression material in the two types of trays. The distances between the abutment teeth were measured immediately on removal of the impression, and after 1 and 24 hours. Although ample amount of impression material (2 to 9 mm) was allowed, the linear dimensional stability of the impressions made in stock trays was not inferior to the stability of impressions made in custom-made trays.     

Effect of polyvinyl siloxane impression material on the polymerization of composite resin

Statement of problem

Polyvinyl siloxane impression material has been widely used as a lingual matrix for rebuilding missing tooth structure with composite resin. The composite resin is light polymerized in contact with the polyvinyl siloxane impression material. However, polyvinyl siloxane impression material has been shown to interact with other dental materials.

Vinyl polysiloxane impression material in removable prosthodontics. Part 1: edentulous impressions

Recent advances in impression materials and stock edentulous impression trays have resulted in simplified approaches to impression making in removable prosthodontics. Once considered an absolute necessity, it is now possible to avoid the need for custom impression trays. In an effort to achieve reliable master casts in a single appointment, new and innovative procedures are now available. This article, the first in a 3-part series, will review historical information, basic concepts, materials considerations, and philosophic approaches to impression making in complete-denture therapy. A modem technique using readily available impression materials will be described and illustrated so readers can consider the benefits of incorporation into their daily management of edentulous patients.     

Thiol-ene functionalized siloxanes for use as elastomeric dental impression materials

Objectives

Thiol- and allyl-functionalized siloxane oligomers are synthesized and evaluated for use as a radical-mediated, rapid set elastomeric dental impression material. Thiol-ene siloxane formulations are crosslinked using a redox-initiated polymerization scheme, and the mechanical properties of the thiol-ene network are manipulated through the incorporation of varying degrees of plasticizer and kaolin filler. Formulations with medium and light body consistencies are further evaluated for their ability to accurately replicate features on both the gross and microscopic levels. We hypothesize that thiol-ene functionalized siloxane systems will exhibit faster setting times and greater detail reproduction than commercially available polyvinylsiloxane (PVS) materials of comparable consistencies.

Methods

Thiol-ene functionalized siloxane mixtures formulated with varying levels of redox initiators, plasticizer, and kaolin filler are made and evaluated for their polymerization speed (FTIR), consistency (ISO4823.9.2), and surface energy (goniometer). Feature replication is evaluated quantitatively by SEM. The T_g, storage modulus, and creep behavior are determined by DMA.

Results

Increasing redox initiation rate increases the polymerization rate but at high levels also limits working time. Combining 0.86 wt% oxidizing agent with up to 5 wt% plasticizer gave a working time of 3 min and a setting time of 2 min. The selected medium and light body thiol-ene formulations also achieved greater qualitative detail reproduction than the commercial material and reproduced micrometer patterns with 98% accuracy.

Significance

Improving detail reproduction and setting speed is a primary focus of dental impression material design and synthesis. Radical-mediated polymerizations, particularly thiol-ene reactions, are recognized for their speed, reduced shrinkage, and ‘click’ nature.     

The effect of temperature changes on the dimensional stability of polyvinyl siloxane and polyether impression materials

Statement of problem. Dental impressions are commonly mailed to remote dental laboratories and can be subjected to extreme temperature changes; however, the effects of these temperature changes on the accuracy of elastomeric impression materials are unknown.Purpose. This study evaluated the dimensional changes of polyether and polyvinyl siloxane impression materials as a function of storage temperature.Material and methods. A total of 144 impressions were made of a stainless steel die similar to ADA Specification No. 19. Half of the impressions were made in perforated custom trays and the other half in solid trays. Measurements of the vertical and horizontal lines on the impressions were made at 10 minutes, 1 hour, 24 hours, and 26 hours, and storage temperatures ranged from 4° C to 40° C.Results. Changes in storage temperature had a statistically significant effect on the dimensional stability of the horizontal and vertical lines. However, overall dimensional changes were extremely small.Conclusions. Storing both impression materials at 4° C for 24 hours and then allowing the impressions to reach room temperature resulted in a slightly expanded impression that partially compensated for the contraction that occurred from polymerization shrinkage. Similar results occurred for polyether material only, when stored at 40° C. (J Prosthet Dent 1998;79:626-31.)     

The effects of disposable and custom-made impression trays on the accuracy of impressions

This study indicates that some non-rigid impression trays, including disposable plastic trays and custom-made acrylic resin trays, may produce unreliable results when used with some medium-bodied elastomers. The study does not question the well-documented clinical accuracy of these elastomers when they are used with rigid trays. Disposable plastic trays are found to be acceptable when used with a combination of reversible and non-reversible hydrocolloid impression materials.     

Dimensional accuracy of dental casts: Influence of tray material, impression material, and time

PURPOSE: This study evaluated the influence on dimensional accuracy of dental casts made with different types of trays and impression materials and poured at different and multiple times. MATERIALS AND METHODS: Two types of stock trays (plastic stock tray, perforated metal stock tray) and 4 types of custom tray materials (autopolymerizing acrylic resin, thermoplastic resin, and 2 types of light-polymerized acrylic resins) were used with 2 types of impression materials (addition polymerizing silicone and polyether), to make impressions of a metal master model. Each tray and impression material was used to make 5 impressions. Casts were made by multiple pourings at 30 minutes, 6 hours, 24 hours, and 30 days after impression making. Using a measuring microscope, 12 distances were calculated based on measurements of 8 reference points. The absolute value of the difference of each measurement was calculated, as was the corresponding measurement on the master model. A Bayesian model using a simple noninformative prior was used to analyze these data. RESULTS: Statistical differences within 6 microm were found only with thermoplastic resin tray material for addition silicone, and for thermoplastic resin tray material and 1 type of light-polymerized acrylic resin for polyether. Neither stock trays nor custom trays contributed to the differences in accuracy of the casts. All deviations in casts made with silicone impression material were within a clinically acceptable range. For the polyether, distortions occurred that were clinically unacceptable. Impressions made from polyether distorted over time. Silicone impression material has dimensional stability up to 30 days. CONCLUSION: Accurate casts can be made with either stock trays or custom trays. An impression made from polyether should be poured only once and within 24 hours after impression making, because of the distortion of the material over time. Silicone impression material has better dimensional stability than polyether. .     

Some mechanical properties including the repair strength of two self-curing acrylic resins

Self-curing acrylic resins have been used mainly in prosthetic dentistry for the construction of custom-built impression trays, occlusion registration bases and for repairing fractured dentures. Their major disadvantages when compared with heat-cured resins are their relatively poor mechanical properties and a high level of residual monomer. Recently, pour-type resins have been introduced for the fabrication of denture bases. The present study was undertaken to examine some of the mechanical properties of these materials and compare the results with those previously reported.     

全口义齿印模技术的发展现状

全口义齿修复前,需通过可塑性印模材料来复制无牙颌牙槽嵴和周围软硬组织的解剖形态,清晰准确的口腔印模不仅为后续技工制作义齿提供了良好的结构基础,而且是保证最终修复体固位、稳定及功能的关键.现有研究表明,除印模材料、印模托盘、印模操作和印模消毒外,印模技术也是无牙颌印模制取精度的重要影响因素之一.近年来,随着各类牙科材料的...