Impression Materials

Dr. Mohamed Abdel Aziz

Lecturer of fixed prosthodontics

Presented by

IMPRESSION
Definition :
An impression is a negative imprint of the prepared teeth or tooth and their relation to the surrounding structures.

An acceptable impression for cast restoration should meet the following requirements:
1-It must be exact record of all the aspects of the prepared tooth and sufficient unprepared tooth structure immediately adjacent to margins, to allow the dentist and the technician to be certain of the location and configuration of the finish line. 2-Other teeth and tissue surrounding the abutment tooth must be accurately reproduced to permit proper articulation of the cast and contouring of the restoration. 3-It must be free from air bubbles especially in the finish line area.

The Ideal Impression Material Must Meet The Following Requirements:

1- Easy to mix and handle. 2- Suitable working time. 3- Suitable setting time. 4- Compatible with die and stone materials. 5- Not toxic or allergic to the patient. 6- Dimensionally stable on setting.

7-Accurate to record the fine details of the prepared tooth 8-Has acceptable odor and taste. 9-Adequate strength. 10-Adequate shelf life. 11-Economic. 12-Ready to disinfected without loss of accuracy. 13- Fluid or plastic when inserted into the mouth.

Classification of the Impression Materials:

Impression materials are classified to their setting behavior into:

Non elastic Impression Materials Plasters Impression compound

Zinc oxide and eugenol

Some waxes

Elastic Impression Materials

Hydrocolloids

Reversible Irreversible

Elastomeric
Classified according their chemistry

Polysulfide Condensation silicone Polyether Addition silicone

Non elastic impression material

Uses of non elastic imp. Materials in FPD: Non elastic imp. Materials are hard, they lock into undercuts therefore they are not suitable as final imp. For FPD (fixed partial denture) but they have other uses: (a) Plaster: Presentation: powder mixed with water to form a smooth paste Advantages: - Accurate can record fine details. - Easily assembled when fractured. Uses: as an accurate template for soldering

(B) Impression Compound:

Presentation: CAKES OR SHEET FORM: used as preliminary impression for complete dentures. BROWN STICKS: used for single copper band impression GREEN STICKS: used as above and modifications for special trays Advantages: does not need gingival retraction as the copper band causes tissue displacement.

(c) Zinc oxide and eugenol:

Presentation: both the base and accelerator are in the form of paste Uses: in bite registration in conjunction with a bite registration frame.

(d) waxes:
- Blue inlay wax: used for wax pattern construction. - sticky wax: used for soldering. - molding wax: used as a bite registration material.

Elastic impression materials:

I- Hydrocolloids
They are suspension of small solid particles dispersed in liquid (dispersion) when the dispersion medium is water it is called hydro colloids (aqueous impression material). The conversion from sol to gel can be achieved through:- Chang in temperature reversible change - Chemical reaction irreversible change

(A)Reversible hydrocolloid: (Agar-agar)

It is a polysaccharide constituting 8-15% by weight agar; dental agar is composed of several agar species extracted from seaweeds. The remaining constituent is 80% water

Presentation:
It is presented in the form of a semi-solid gel packaged in polyethylene. heavy consistency for, tray material light consistency for syringe material.

It needs special conditioning equipment. This conditioning unit is composed of 3 compartments:

1)

The liquefying bath: where the material is placed in boiling water (100c) for. 10 minutes, reuse of the material needs a longer immersion time (12 min. ) The storage bath: where the material is stored at (63-66c) until needed it can be stored for up to 5 days.

2)

3)

The tempering bath: where the material for a suitable temperature for the mouth (45c)
this is done several minutes before the patient appointment.

Advantages of agar impression:

1- very accurate impression material. 2- Hydrophilic gives best results in presence of saliva. 3- Long working time. 4- Low material cost. 5- No custom tray is required. 6- No mixing required

Disadvantages:
1- Needs special equipments. 2- Needs special type of double-walled trays with water . Circulating tube in it. (water cooled tray) 3-Low stability due to synersis and imbibition. 4- Low tear resistance. 5- Difficult to disinfect.

Precaution: Should be poured immediately for best results.

B- Irreversible hydrocolloid material (Alginate)

It is the most widely used impression material. Its source is a brown seaweed (algae) named algin, it is marketed as powder and liquid. On mixing them a chemical reaction result, which is an irreversible process, so the material can only be used once. In fixed prosthodontics work it is used for primary impression to make the study casts

Advantages: 1- Easily manipulated & mixed. 2- It has suitable setting time. 3- Hydrophilic i.e. can be used in contact with saliva. 4- Low cost Disadvantages: 1- Has low tear strength. 2- Not accurate i.e. incapable to produce the fine details. 3- Dimensionally unstable due to synersis and imbibition. Precaution: should be poured immediately.

II -Elastrometric Impression materials

II -Elastrometric Impression materials

These are elastic impression materials called non aqueous elastic impression material to be distinguished from the hydrocolloids which are aqueous materials. They are synthetic rubber. They offered potential solutions to the two main problems associated with hydrocolloids:

poor tear resistance and poor dimensional stability.

Accuracy = ability to replicate the surface details. Dimensional Stability = ability to retain its
absolute dimensional size over time.

Tear Resistance = ability to resist tearing in thin

sections (such as through the feather-edged material within the gingival sulcus.

Classification:
According to chemistry

- polysulfide. - condensation silicone. - addition silicone. - Polyether.

According to viscosity: - very high (putty). - High. (heavy body) - medium (regular). - low (light). - very low (extra light)

POLYSULFIDE
Polysulfide is an elastomer that is also known as mercaptan, or simply as rubber base. The impression material is packaged in two tubes: a base and an accelerator. Composition: -The base contains a liquid polysulfide polymer mixed with an inert filler. - The accelerator, which is usually lead peroxide mixed with small amounts of sulfur and acts as an oxidation initiator.

Material properties
1-Reaction:
Condensation Polymerization with water by product. This polymerization is exothermic and is affected significantly by moisture and temperature. -High humidity and temperature dramatically reduce its working time , which may be so short -The polymerization begins before it is inserted in the mouth, resulting in severe distortion.

2- Dimensional stability:
Polysulfide rubber base possesses much greater dimensional stability than does hydrocolloid. However, There is a slight contraction of polysulfide during polymerization.
This effects can be minimized by A- a custom impression tray to reduce the bulk of the material. B- impression should be poured within approximately 1 hour of removal from the mouth or less.

3-Tear strength:
The high tear resistance, and enhanced elastic properties of polysulfide facilitate impression making in sulcular areas and pinholes.

4-Setting time:
Polysulfide impression has long setting time in the mouth (about 10 min).

5- Odor:
Polysulfide impression has unpleasant sulfide odor.

6- Stain clothes:
polysulfide materials are polymerized with the aid of lead peroxides, which explains this material's typical brown color. The un polymerized product is sticky and should be handled carefully, because it stains clothing permanently.

7-Hydrophobic material
- Special care must be taken to insure that there is no moisture on the preparation when the impression is made. - Thin layers of moisture that becomes incorporated during the injecting process can cause voids in the impression.

Advantages
1- Good tear resistance. 2-Good flow. 3-High flexibility. 4- Good detail production. 5-Long working time. 6- Low cost.

Disadvantages
1- Long setting time.
2-Pouring within one hour.

3-Unpleasant odor.
4-Need custom tray.

5-Stain clothes.

Condensation Silicone
Condensation Silicone impression materials utilize 1- A heavy-body "putty" relined with 2- A thin light body "wash."

Material properties
-The condensation silicones overcame several disadvantages associated with polysulfide.

1-Reaction ;
- Condensation -reaction because of the nature of their polymerization reaction with alcohol byproduct.

2- Dimensional stability.
-The evaporation of this alcohol is responsible for shrinkage of the material and resultant poor dimensional stability. -Dimensional stability is less than that of polysulfide but greater than that of reversible hydrocolloid

3- Odor ;
-Odorless material

4- Setting time
relatively short setting time in the mouth (about 6 to 8 minutes).

5- Condensation Silicone is less affected by high

operating room temperatures and humidity.

6- Pouring
should be poured within one hour to avoid dimensional instability.

7- Condensation Silicone is extremely hydrophobic for this reason, the prepared teeth and gingival sulci must be completely free of moisture to make possible a defect-free impression. -Pouring without trapping air bubbles is also more difficult than with other impression materials. 8- Condensation Silicone is used with a stock impression tray , no need of special tray

POLYETHER
Material properties

1-Reaction ;
- Addition polymerization reaction. - No volatile by-product is formed, which results in excellent dimensional stability. - polymerization shrinkage is unusually low with room temperature .

2- Dimensional stability.
-High dimensional stability . accurate casts can be produced when the material is poured more than a day after the impression has been made.

Impregum L DuoSoft Quick

3- Pouring
-Accurate casts can be produced when the material is poured more than a day after the impression has been made. -Polyether is stable only if stored dry, because it will absorb moisture and undergo significant dimensional change.

4- Setting time
Short setting time in the mouth (about 5 minutes) which is less than half the time required for polysulfide.

5- Stiffness of the Material

-The stiffness of the set material causes problems when separating a stone cast from the impression. -Thin and single tooth, is liable to break unless the practitioner uses great care. -Custom made tray is used to minimize the bulk of the material to make it easier to remove the impression from the mouth and the cast.

6-Odor ;
-Odorless material

Advantages:
1-Hydrophilic in nature so it has -Better flow in contact with soft tissues. -Better reproduction of the soft tissue and finish line. -accurate casts

2- Easy handling and mixing.

3- Excellent dimensional stability. 4- Multiple castes can be obtained. 5-High accuracy. 6-Short setting time. 7-Automix is available.

Disadvantages:
1-Short working time. 2-Stable in dry condition . Absorb moisture resulting in dimensional change.

3- Stiff material cause problem during separation from the cast and patient mouth.
4- Low tear resistance. 5- Bitter taste

ADDITION SILICONE
Also known as (poly-vinyl siloxane) Addition silicone is generally used as a two-viscosity system, although monophase formulations are also available.

Material properties
1-Reaction
- Addition polymerization reaction. has much greater dimensional stability. -The set material is less rigid than polyether but stiffer than polysulfide.

2- Dimensional stability
-Has greater dimensional stability due to absence of byproducts.

3-Setting time
Relatively short ,can be controlled by changing the base catalyst ratio.

4-Pouring
-Accurate casts can be produced when the material is poured more than a day after the impression has been made. -Pouring should be delayed with some of the earlier products because the porosity of the cast surface caused by hydrogen gas from the impression material. -Modification of the formula by the addition of palladium to absorb the hydrogen has minimized this problem..

5-Stiffness of the Material

-Relatively rigid, difficult to remove from the mouth or sever undercut. - Fracture of the die may occur when separating a stone cast from the impression

6-Odor ;
-Odorless tasteless and clean material.

-Polymerization retardation of some brands of impression material, in combination with some brands of gloves can be observed resulted from sulfur derivatives in the latex. -This can even occur indirectly, when the impression material comes in contact with an object, such as a tooth, that has been touched by a glove, and not with the glove itself. -Also can result from contact with other latex items, such as a rubber dam or even from retraction cord. -This problem can be avoided by using (non-Latex) poly-vinyl or poly-Nitrile gloves or over-gloves during the handling of the impression material.

Advantages :
1. -High accuracy. 2. -High dimensional stability.

3. -Pouring can be delayed.

4. -Multiple cast can be obtained. 5. -Dos not stain cloth.

6. -Short setting time.

7. -May be used with stock or custom tray. 8. -Can be silver or copper plated. 9. -Automix is available.

Disadvantages:
1. -Expensive.

2. -Short working time.

3. -Poor wetting. 4. -Hydrophobic so it is important to dry the field. 5. -Some materials released hydrogen 6. -Setting is affected by some brand of latex gloves due to sulfur inhibition.

Comparison of Properties

Working time

longest to shortest

agar > polysulfide > silicones > alginate = polyether

Setting time

shortest to longest

alginate < polyether < agar < silicones < polysulfide

OBrien Dental Materials & their Selection 1997

Comparison of Properties

Stiffness

most to least

polyether > addition silicone > condensation silicone > polysulfide = hydrocolloids

Tear strength

greatest to least

polysulfide > addition silicone > polyether > condensation silicone >> hydrocolloids

OBrien Dental Materials & their Selection 1997

Comparison of Properties

Cost

lowest to highest

alginate < agar = polysulfide <condensation silicone < addition silicone < polyether

Dimensional stability

best to worst

addition silicone > polyether > polysulfide > condensation silicone > hydrocolloid
Phillips 1996

OBrien Dental Materials & their Selection 1997

Comparison of Properties

Wettability

best to worst

hydrocolloids > polyether > hydrophilic addition silicone > polysulfide > hydrophobic addition silicone = condensation silicone

Castability

best to worst

hydrocolloids > hydrophilic addition silicone > polyether > polysulfide > hydrophobic addition silicone = condensation silicone
OBrien Dental Materials & their Selection 1997

IMPRESSION TECHNIQUE

I- Single mix impression technique:

-This technique need custom made tray painted with adhesive . -The material is supplied as a medium viscosity type. -Equal length of base and catalyst are mixed thoroughly.

-An impression syringe is used to drive the material in the sulcus and the preparation.

-The other part is loaded in the custom made tray to be seated in the patient mouth over the injected material.

-Part of the mix is injected around the prepared teeth after removal of retraction cord and gentle drying with compressed air. -Then the custom made tray is seated in the patient mouth over the injected material.

II- Double mix impression technique: (One step)

-This technique , two different viscosity the material is used . Heavy and medium or heavy and low. custom or with adhesive or stock tray is required

-Medium or low viscosity mix is injected by a syringe around the prepared teeth after removal of retraction cord and gentle drying with compressed air.

-The heavy viscosity is mixed and loaded on the tray and seated on the patient s mouth over the injected material.

III- Double mix impression technique: (two step) (Putty and wash technique)
-This technique used a stock tray. A putty or heavy body impression is made on the stock tray to produce putty tray similar to the acrylic resin custom tray. -Over which a wash of low viscosity material is applied to record. The fine detail of the prepared teeth, adjacent teeth and oral structure. better than the double mix technique because 1-The set putty or the heavy body material force the wash material to record the preparation details . 2- Eliminate the step of custom made tray construction so save time.

-A space for wash material should be created either by:

1-taking it from the patient mouth before the preparation 2-- covering the material by polyethylene strip as spacer for the wash material. 3-selective relief of the set heavy body impression using sharp scalpel.

Steps:
1-Before preparation select a stock tray that fit the arch. The putty material is mixed by clean hand by kneading it using squeezing motion until the material become streak free. 2-Roll it in the form of rod, put it inside the tray and insert it in the patient mouth and keep it under light pressure.

3-After setting remove from the mouth remove the excess and undercut using scalpel.

4-After preparation and tissue retraction cord the light body or wash material is mixed on the glass slab with spatula until the mix is free from streaks of catalyst, loaded some of the mix in a syringe and the rest on the putty impression. 5-The mix is injected by a syringe around the prepared teeth after removal of retraction cord and gentle air drying then seat the tray firmly in place until complete polymerization.

6-Seat the tray slowly until it is firmly in place.

7-The tray should be held in place with no downward pressure for 6 minutes. 8-Pressure exerted on the tray while the wash is polymerizing will produce stresses in the semi-rigid putty lining the impression tray. -When the impression is removed from the mouth, the stresses will relax, resulting in deformation and distortion of the impression. After the material has set, remove the impression as quickly as possible to prevent plastic deformation of the material.

IV- Dual Arch Technique:

Closed mouth technique

-It is called triple tray technique . It is used for making impression for single unit. -The impression is made at maximum intercuspation using high viscosity polyether or additional silicon supported by thin mesh in a frame.

The optical impression technique:

-It depends mainly on the computer for designing and manufacturing all-ceramic inlays onlays crowns at chair side . (CAD CAM ) -After teeth preparation a thin layer of opaque powder is sprayed over the preparation to reflect the light.

A small hand held camera is placed over the preparation to take an optical impression of the prepared teeth

The image of the preparation is transmitted to the computer screen. The design of the restoration is made and the recorded data is transferred to small milling machine to fabricate the restoration from a prefabricated ceramic blocks.

Advantages:
1-The restoration finished in single visit . 2-Coventional impression and laboratory techniques are eliminated

Impression inaccuracies
Visible flaws
related to impression technique which occur commonly include:

Finish line not visible Air bubbles in critical places Voids or drags Unset impression material on surface of impression and cast

Finish line not visible??

Inadequate soft-tissue management

Bleeding from inflamed gingiva displacing impression material

Tendency of the gingival cuff to recoil and displace partially set impression material

Sulcus impression tearing because of inadequate bulk

Retraction cord (plain or impregnated) Two-cord technique Rotary curettage Electrosurgery Laser troughing

Air bubbles in critical places

mixing tray loading syringing tray seating

Polyether and polyvinyl siloxane benefit from their shear thinning behavior

hard to mix through a mixing tip (Silicone and polysulfide elastomers)

Mixing and Delivery Systems

Air bubbles in critical places? Smart syringing

keep the syringe tip in the expressed material during syringing. start syringing from the most difficult area usually the disto-lingual. use a three in one syringe to blow the light body evenly over the preparation

Voids

Poorly adapted tray Inadequate drying of teeth Premature syringing of impression material intraorally prior to seating the tray Salivary contamination of the syringed material.

management

Adequate wetting by impression material Tray must effectively constrain the impression Adequate drying

Unset impression material

Contamination of the impression by ingredients of latex rubber gloves, which poison the choroplatinic acid catalyst of addition silicones Retraction solutions have not been shown to effect impression setting significantly

de Camargo L M, et al. J Prosthet Dent 1993.

Impression inaccuracies

Invisible impression flaws,

resulting in an apparently good fit of the restoration on the die but a poor fit on the tooth, may also occur because of: Tray and impression recoil Detachment of impression from tray Permanent deformation

Tray and impression Recoil

Considerable force to seat the putty impression
Impression Tray Impression

outward flexion of the tray wall

stresses

On tray removal, tray walls rebound

Impression

Dies and castings which are undersized buccolingually.

management

Rigid trays Spacing

Influence of tray material

Metal and rigid plastic stock trays give greater accuracy in the putty/wash silicone twin mix impression technique compared with flexible plastic ones.

Carrotte PV et al, J Prosthet Dent. 2008

Influence of tray material

Stock plastic tray generally produce casts with lower accuracy than custom-made trays of acrylic resin and the thermoplastic material.

Gordon GE et al, J Prosthet Dent. 2003

Authors demonstrated that plastic stock trays are convenient but whilst unreliable with putty-wash, they can produce accurate results with a combination of heavy and light bodied addition silicones in a single step technique.
Wassell R Wand Ibbetson R,J Prosthet Dent 1991. Abuasi H. Accuracy of polyvinyl siloxane impressions. [PhD]. University of Newcastle upon Tyne, 1993. Abuasi H A, Wassell R W.. Eur J Prosthodont Restor Dent 1994

Wassel et al, state that special trays are only needed for heavy light bodied addition silicone impressions where stock trays are a poor fit.
British dental journal, 2002. British dental journal, 2002.

Management of Distortion During Tray Removal

If the stress is applied quickly, then all the energy is stored elastically and the material will not undergo plastic deformation.

Strain rate sensitive elastomers

Impression Tray
Impression

Fast removal VERY FAST (SNAP)

Slow removal

However, some time is required for complete elastic recovery.

Distortion Time Related to Setting Reaction

Once the impression is clinically set (which corresponds to about 50% or greater reaction conversion), the impression tray can be removed with a SNAP.
Continue to react, shrink and distort after removal

REACTION CONVERSION (%)

100

VPS

P Eth

PS, C Silicone

log TIME (minutes)

Balancing out the effect of time for elastic recovery and potential problems with continued shrinkage.

Stick to the rule of waiting 20-30 minutes before pouring.

Detachment of impression from tray

proper use of adhesive and having a tray with adequate perforations allow time for the adhesives solvent to evaporate and for adequate bond strength to develop. Where a special tray is made it is important that the wax spacer does not come into contact with the tray acrylic; contamination will reduce the strength of the adhesive bond.

CLASSIFICATION According to the impression mixing methods

Hand mixing Auto mixing

Machine mixing

Auto mix Technique

-Impression material (Addition silicon) in prepackaged cartridges with a disposable mixing tip attached. The cartridge is inserted in a gun-like device, and the base and catalyst are extruded into the mixing tip, where mixing occurs as they progress to the end of the tip. -The homogeneously incorporated material can be directly placed on the prepared tooth and impression tray.

Advantage:
1-Elimination of hand mixing 2- Fewer voids in the impression 3-Proper ratio 4-Reduced mixing time 5-Less contamination

Machine Mixing Technique

An alternative method for improving polyether and addition silicon impression mixing is to use a machine mixer. This system is convenient and produces void-free impressions.

EVALUATION of IMPRESSION
1. The impression material been properly mixed. An impression that contains visible streaks of base or catalyst material should be rejected. Impression material should be firmly attached to the tray and not separated from the tray No voids, folds in the preparation margin These should have been avoided by careful technique.

2. 3.

4. NO part of tray is shown through the impression .

5. No interproximal tearing of the impression.

Disinfection
Disinfection is an essential step for preventing

cross-infection for laboratory personnel. After being removed from the patient's mouth, the impression is immediately 1-Rinsed with tap water 2- Dried with an air syringe. 3-Suitable chemicals should be used, such as Glutaraldehyde solutions (2% )or Iodophor or Chlorine compound (1:10 dilution) or Ethanol sprays and stored in plastic bag.

The recommended procedures for the impression material

THANKS