Evaluation of Effect of Tray Space on the Accuracy of Condensation Silicone, Addition Silicone and Polyether Impression Materials: An In Vitro Study

Optimal thickness of impression materials in the custom tray in order to get the most accurate impression. To investigate the effect of different tray spacer thickness on the accuracy and the dimensional stability of impressions made from monophasic condensation silicone, addition silicone and polyether impression materials. Three different types of elastomeric monophasic impression materials were used for making the impression of a master die with tray having tray spacer thickness of 2, 4 and 6 mm. Each type of impression was poured in die stone after 1 h. Each cast was analyzed by a travelling microscope and compared with the master die. The data was tabulated and subjected to statistical evaluation. The results of the study indicated that the impressions made from 2 to 4 mm spaced trays produced more accurate stone casts when compared to 6 mm spaced tray. No statistical significant differences were observed between the accuracy and dimensional stability of the three materials tested. Minimum changes were observed when the cast was poured after 1 h and the tray space was 2 mm for all the materials tested. It is therefore advisable not to exceed tray space of 2 mm.     

Accuracy of open tray implant impressions: an in vitro comparison of stock versus custom trays

STATEMENT OF PROBLEM: The accuracy of an implant fixture-level impression is affected by the type of impression tray used. PURPOSE: The purpose of this in vitro study was to investigate the accuracy of open tray implant impressions comparing polycarbonate stock impression trays and rigid custom-made impression trays to make implant fixture-level impressions. MATERIAL AND METHODS: Gold cylinder pairs, splinted by gold bars (reference frameworks) were constructed on an aluminum typodont. Polyether impressions were made of 2 pairs of Br?nemark 3.75-mm diameter fixtures mounted in an aluminium typodont, with 3 stock impression trays, 3 close-fit custom trays, and 3 spaced custom impression trays, by use of an open tray technique. The casts produced were assessed for accuracy by attaching the reference frameworks with alternate single screws and measuring the vertical fit discrepancy of these reference frameworks to the analogs within the working cast using a traveling microscope. Comparison of gap dimensions by tray type was performed with a nonparametric Kruskal-Wallis analysis of variance (ANOVA) followed by pair-wise Mann-Whitney U tests. To adjust for multiple comparisons in the post-ANOVA contrasts (P<.02). Comparison of gap dimensions between anterior and posterior regions were performed with Mann-Whitney U tests (P <.05). RESULTS: The results showed that the mean fit accuracy, as measured by vertical fit discrepancy, of casts from the stock trays (23 +/- 20 microm) were statistically significantly less (P<.001) than the spaced custom trays (12 +/- 10 microm) or close fit custom trays (11 +/- 10 microm). The difference in median gap size for analogs with a 20-mm separation was 10 microm. CONCLUSION: Within the limits of this in vitro study, rigid custom trays produced significantly more accurate impressions than the polycarbonate stock trays. The stock trays used in this study could not produce accurate impressions consistently. For analogs with a 20-mm separation, there was a difference in medians of 10 microm in accuracy between the stock and custom trays.     

Dimensional stability of autopolymerizing acrylic resin impression trays

A study was undertaken to determine the optimal interval between fabrication of an autopolymerizing acrylic resin custom impression tray and making a final impression. Twenty mandibular arch-shaped trays, 10 each of Fastray and Formatray resin, were evaluated for dimensional change. Both materials behaved similarly. Cross-arch contraction of the borders of buccal flanges and unilateral expansion of the borders of buccal-to-lingual flanges were observed. These changes indicate distortion. Linear dimensional changes occurred throughout 6 hours, which suggests that any impression made in a methyl methacrylate acrylic resin custom impression tray should be poured as soon as is conveniently possible. Significant linear dimensional changes were observed for only 40 minutes from the initiation of tray fabrication. This study concludes that while an aged tray is preferred, it is acceptable to make an impression in an autopolymerizing resin custom impression tray after 40 minutes.     

2种托盘制取松动基牙模型的精度比较

目的：评价成品托盘和个别托盘使用海藻酸盐印模材料对松动牙取模时模型的精度的影响。方法：用成品托盘和个别托盘对同一松动牙模型取模,各制得20个超硬人造石模型。使用电子游标卡尺测量取得的人造石模型上标各记点间距离,测量精度为0.001mm,将测得数据进行统计分析。结果：采用2种托盘对松动牙取模精度无显著性差异,2种托盘对于松动牙取模精度均已超出临床所允许范围。结论：当使用海藻酸盐作为印模材料时,成品托盘和按照常规方法制作的个别托盘不适于松动牙的取模,及对于松动牙,应尽可能避免使用海藻酸盐印模材料。     

Determining the accuracy of stock and custom tray impression/casts

SUMMARY A study was conducted to evaluate the accuracy of casts made from stock tray and custom tray impressions using polysiloxane impression material. The results indicate that all casts distort but that impressions made from custom trays were more accurate and consistent in reproduction than were stock tray impressions.     

Impression material thickness in stock and custom trays

This study did not examine the accuracy of the resultant impressions. Rather, the impression material thickness in impressions made using both the highly advocated custom acrylic resin tray and in the highly used manufactured stock tray was examined. Comparison between the material thickness at the prepared tooth area revealed a mean difference in material thickness of less than 1 mm. The question of the significance of this difference remains to be answered. If the difference is not significant in the success of the impression and the resultant casting, then there are several advantages in using the manufactured stock tray; the first is economy. The average cost of a custom acrylic full arch impression tray is $3.65, compared with an average cost of slightly over $0.30 for the stock tray. The second advantage is the convenience factor. Making a custom tray requires planning, study models, laboratory time, curing interval, and finishing time. In contrast, the stock tray can be selected, adapted, and used in a single visit for both anticipated and unanticipated situations. If the difference in material thickness is significant, the custom tray is indicated. However, attention to detail in making and inserting the tray in the mouth must be observed to maximize the benefits of the custom tray.     

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. .     

Use of Implant‐Supported Custom Milled Impression Copings to Capture Soft‐Tissue Contours and Incisal Guidance

A technique is presented where a custom milled impression coping is used to replicate the clinically established anterior incisal guidance to the definitive prosthesis when multiple implants are restored in the esthetic zone. A conventional impression is initially made, then the stone cast is scanned, and a digitally designed custom screw‐retained, implant‐supported interim prosthesis is milled from a polymethylmethacrylate (PMMA) billet. This is aimed to digitally design the pontic areas, contour the gingival soft tissue, and establish an anterior incisal guidance. A custom milled impression coping (CMIC) is then fabricated. The CMIC has contours similar to the contours of the interim prosthesis and is fabricated from a PMMA billet. Titanium inserts are placed in the interim prosthesis and the CMIC. The CMIC is inserted intraorally and used for the final impression by using a custom tray and by following the open tray impression protocol. With the proposed technique, the exact contours of the digitally designed and clinically verified interim prosthesis are used to fabricate the definitive restoration.     

Split-tray impression technique for immediate upper dentures

A split-tray impression technique for making an immediate maxillary complete denture was described. With this two-step impression technique, an accurate impression of edentulous regions, with better control of the labial peripheral tissues, can be made. When an irreversible hydrocolloid impression is made in the usual custom tray, the control of borders and thickness is very difficult. With this splittray technique, the borders are more easily controlled.     

Comparison of vertical movement occurring during loading of distal-extension removable partial denture bases made by three impression techniques.

Although the altered-cast impression technique attains stability and controlled tissue support for distal-extension removable partial dentures, the procedure is time-consuming and technique-sensitive. This study clinically compared the vertical displacement of distal-extension removable partial dentures made from different impression techniques. The impressions studied were the altered-cast impression, an impression made from a border-molded custom tray, and a stock tray irreversible hydrocolloid impression that served as a control. A post hoc analysis, using a Tukey Q-test, exhibited significance (p less than 0.01) between the two impression techniques after intraoral loading was performed. Although statistically significant, the 0.19 mm difference between the impression techniques may or may not be clinically relevant. Additional research is required in this area.     

A modified edentulous maxillary custom tray to help prevent gagging

The gag reflex can be a normal, healthy defense mechanism to prevent foreign objects from entering the trachea. During certain dental procedures, however, gagging can greatly complicate the final result, especially during the maxillary complete denture final impression. A modification can be made to the maxillary custom acrylic resin tray to aid in securing a clinically acceptable elastomeric final impression. This modification involves forming a vacuum chamber at the posterior extent of the custom tray to which a saliva ejector tip is embedded. When the saliva ejector is connected to the low-volume evacuation hose, the chamber will trap any excess impression material that might extrude from the posterior border of the loaded tray. This results in a reduced chance of eliciting the patient's gag reflex.     

Fabricating a custom tray for an impression of multiple abutment teeth by using an open-source software program

Although intraoral scanners have gained in popularity, the traditional impression technique with a custom tray is still useful, particularly when making a definitive impression of multiple abutment teeth. A custom tray can be fabricated with a dental software program, avoiding the disadvantages of the manual laboratory procedures. However, additional module purchasing is necessary. This article presents a digital workflow for designing a custom tray by using an open-source software program.     

Linear dimensional accuracy of a polyvinyl siloxane of varying viscosities using different impression techniques

Abstract Aim: The present study is an in vitro study to evaluate the linear dimensional accuracy of commercially available polyvinyl siloxanes of varying viscosities using different impression techniques. Methods: Different impression techniques used were: (a) putty wash, with a two‐step technique with polyethylene spacer, using a stock tray; (b) putty wash, with a one‐step technique, using a stock tray; (c) single‐mix technique, utilizing medium viscosity in a custom tray; and (d) multiple‐mix technique, utilizing a heavy‐ and low‐viscosity combination in a custom tray. For each technique, 10 impressions were made of a metallic maxillary dentulous master model. Results: The result of this study dictates that a heavy‐ and low‐viscosity combination, double‐mix technique in a custom tray produced an accurate result in all dimensions, followed by the single‐mix technique, utilizing medium viscosity in a custom tray, and the putty wash two‐step technique with polyethylene spacer, using a stock tray. Group 2 putty wash, one‐step, simultaneous technique produced the least accurate result in all dimensions. Conclusion: The putty wash two‐step techniques were found to be as accurate as the multiple‐mix technique, utilizing a heavy‐ and low‐viscosity combination in a custom tray, and the single‐mix technique, utilizing medium viscosity in a custom tray. Making custom trays is time consuming and costly.     

Accuracy of complete dental arch impressions and stone casts using a three-dimensional measurement system. Effects on accuracy of rubber impression materials and trays

The purpose of this study was to investigate and compare the accuracy of complete dental arch impressions and stone casts made with two kinds of impression materials (addition-type silicone and polysulfide rubber) and trays (custom tray and modified custom tray). In addition, the effect of the quantity of stone was examined. Impressions were made from a metallic model of a simplified maxillary dentition. Impressions and stone casts were measured respectively with a three-dimensional measuring microscope. The results were as follows: 1. Distortions of impressions were so small that the reproducibilities of impressions were superior three-dimensionally. These kinds of impressions and trays did not influence the accuracy of impressions. 2. The setting expansion of the stone in the impression occurred in the outward direction and was affected by the kinds of impressions and trays. 3. The arch widths and lengths of the stone casts tended to increase in number. 4. Stone casts made with addition-type silicone impression material and a custom tray were the most accurate because the combination of the impression material and tray effectively suppressed the setting expansion of stone. 5. The accuracy of stone casts could be improved by controlling the quantity of stone.     

An alternative method of fabricating a custom tray for direct implant impressions

Creating accurate impressions for implants is essential for fabricating passive-fitting prostheses. This report describes a modified technique for fabricating a custom impression tray when implants are positioned unfavorably. A simple and accurate method of making an implant impression tray and the benefits of this technique are highlighted in this technical report.     

An effect of tray design and material retention on the linear dimensional changes in polysulfide impressions

One-unit fixed partial dentures, which fit accurately on the laboratory dies made from polysulfide impression materials, often pose a problem in seating completely in the mouth of the patient. Sectioning of the fixed partial denture units allows the individual units to seat accurately in the mouth but requires a soldering procedure. Linear distortion of the mercaptan (polysulfide) rubber base that takes place during setting is a cause of this problem. The distortion is directly related to (1) tray design, (2) area of adhesive placement, and (3) excessive bulk of material on the tray border during impression making. A controlled amount of adhesive and impression material in a new design for a custom tray must be used to minimize this distortion. When these factors are controlled, the resulting impression is unrestricted, and a more accurate working die is obtained. This results in a better fit of one-unit fixed partial dentures in the mouth.     

The bond strength of elastomer tray adhesives to thermoplastic and acrylic resin tray materials.

This study evaluated the bond strength of selected impression materials (Permlastic, Express, and Hydrosil) to a thermoplastic custom tray material as a function of drying time of the adhesive after application to a tray material. In addition, bond strengths of a polysulfide impression material to an acrylic resin tray material and to a thermoplastic tray material made directly against wax were evaluated. Bond strengths were obtained directly from values of applied load at failure and important conclusions were drawn.     

Modified custom tray

The use of a custom tray is highly desirable for accurate impression making in situations with multiple abutments. This article describes a modified custom tray fabrication method using autopolymerizing acrylic resin. The custom tray is fabricated by intraoral relining with autopolymerizing resin that is polymerized extraorally. The final impression is obtained during the same session after tray polymerization at 100 degrees C for 5 minutes. Relined areas are refined by trimming excess resin with burs of a known diameter to create a 2-mm clearance for the elastomer. For areas with subgingival finish lines, only 0.5 mm of resin is removed to direct the elastomer into the gingival sulcus. The procedure is time-saving because it reduces the need for a retraction cord and minimizes inaccuracies that would necessitate another impression.     

The accuracy of dual-arch impressions: a pilot study

STATEMENT OF PROBLEM: Dual-arch impression trays often are used for addition silicone final impressions of fixed prosthodontic preparations, but concerns about distortion of the impression are common because such trays lack rigidity. PURPOSE: This in vitro pilot study was designed to determine the accuracy of addition silicone impressions made with custom trays or made with either passive or stressed dual-arch trays. MATERIAL AND METHODS: Complete crown preparations of a mandibular molar, premolar, and incisor were made on a dentoform. These tooth preparations received flat, parallel indexes on the facial and lingual axial walls for accurate and reproducible positioning of a digital caliper. Gypsum dies were produced with an addition silicone impression material in either custom trays or dual-arch trays seated passively or with induced flexure (3 dies per tray group). The facio-lingual dimensions of the dies were measured with a digital caliper accurate to +/-5 microm and compared to the dimensions of the original preparations. Flexure in the latter group was induced by contact of the tray with a simulated torus, made of resin, in the lingual vestibule of the dentoform. Data were analyzed with 2-way analysis of variance and Tukey's multiple comparison test (alpha=.05). RESULTS: Dies fabricated with either the custom or passive dual-arch tray reproduced the facio-lingual dimensions of the preparations within a -27 to +13 microm range. Dies fabricated with the flexed dual-arch tray exhibited greater discrepancy, in the range of -47 to -67 microm relative to the preparations. Tray type was a significant factor (P=.002): the flexed tray group was significantly different than the other 2 groups, which did not differ from each other. CONCLUSION: Within the limitations of this pilot study, dual-arch impressions were comparable in accuracy to impressions made with custom trays. Accuracy was reduced, however, when the trays were flexed during closure of the arches.     

The effect of tray selection on the accuracy of elastomeric impression materials

This study evaluated the accuracy of reproduction of stone casts made from impressions using different tray and impression materials. The tray materials used were an acrylic resin, a thermoplastic, and a plastic. The impression materials used were an additional silicone, a polyether, and a polysulfide. Impressions were made of a stainless steel master die that simulated crown preparations for a fixed partial denture and an acrylic resin model with cross-arch and anteroposterior landmarks in stainless steel that typify clinical intra-arch distances. Impressions of the fixed partial denture simulation were made with all three impression materials and all three tray types. Impressions of the cross-arch and anteroposterior landmarks were made by using all three tray types with only the addition reaction silicone impression material. Impressions were poured at 1 hour with a type IV dental stone. Data were analyzed by using ANOVA with a sample size of five. Results indicated that custom-made trays of acrylic resin and the thermoplastic material performed similarly regarding die accuracy and produced clinically acceptable casts. The stock plastic tray consistently produced casts with greater dimensional change than the two custom trays.