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Chapter 46

Impression Materials
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Produced in the United States of America
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Introduction
Impression materials are used to obtain an
impression of teeth and/or the surrounding oral
tissues.

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Definition of Impressions
Impressions are negative reproductions of
dental structures.

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Classification of Impressions
Preliminary impressions
Taken either by the dentist or an
expanded-function dental assistant.
Used to make a reproduction of the teeth
and surrounding tissues.
Used to make (1) diagnostic models, (2)
custom trays, (3) provisional coverage, (4)
orthodontic appliances, and
(5) pretreatment and post-treatment
records.

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Classification of Impressions- contd


Final impressions
Taken by the dentist.
Used to make the most accurate
reproduction of the teeth and surrounding
tissues.
Used to make indirect restorations, partial
or full dentures, and implants.

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Fig. 46-1 Example of a final impression.

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Classification of Impressions- contd


Bite registrations
Taken by the dentist or dental assistant.
Make a reproduction of the occlusal
relationship between the maxillary and
mandibular teeth.
Provide an accurate registration of the
patients centric relationship between the
maxillary and mandibular arches.

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Fig. 46-2 Example of a bite registration.

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Impression Trays
Must be sufficiently rigid to:
Carry the impression material into the oral
cavity.
Hold the material in close proximity to the
teeth.
Avoid breaking during removal.
Prevent warping of the completed
impression.

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Characteristics of Impression Trays


Quadrant tray

Covers one half of the arch.


Section tray
Covers the anterior portion of the arch.
Full arch tray
Covers the entire arch.
Perforated tray
Holes in the tray create a mechanical lock to hold the
material in place.
Smooth tray
Interior of the tray is painted or sprayed with an
adhesive to hold the impression material.

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Table 46-1 Types of Stock Trays

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Tray Selection Criteria


Feel comfortable to the patient.
Extends slightly beyond the facial surfaces of the

teeth.
Extends approximately 2 to 3 mm beyond the
third molar, retromolar, or tuberosity area of the
arch.
Is sufficiently deep to allow 2 to 3 mm of
material between the tray and incisal or occlusal
edges of the teeth.

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Fig. 46-3 Examples of quadrant, section, and fullarch impression trays.

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Tray Adhesives
VPS adhesives (blue)

For polyvinyl siloxane and polyether


impression materials.
Rubber Base Adhesive (brown)
Used with rubber base impression materials.
Silicone Adhesive (orangish-pink)
Used with silicone impression materials.

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Hydrocolloid Impression Materials


Hydro means water.
Colloid means gelatin substance.
Material used to obtain preliminary and final
impressions.

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Irreversible Hydrocolloid
Material that cannot return to a solution state

after it becomes a gel.


Alginate is the irreversible hydrocolloid most
widely used for preliminary impressions.

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Makeup of Alginate
Potassium alginate

Comes from seaweed; is also used in foods


such as ice cream as a thickening agent.
Calcium sulfate
Reacts with the potassium alginate to form
the gel.
Trisodium phosphate
Added to slow down the reaction time for
mixing.

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Makeup of Alginate- contd


Diatomaceous earth

A filler that adds bulk to the material.


Zinc oxide
Adds bulk to the material.
Potassium titanium fluoride
Added so as not to interfere with the setting
and surface strength.

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Physical Phases of Alginate


The first phase is a sol (as in solution). In

the sol phase, the material is in a liquid or


semiliquid form.
The second phase is a gel. In the gel phase,
the material is semisolid, similar to a gelatin
dessert.

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Packaging and Storing of Alginate


Containers about the size of a coffee can are

the most commonly used form of packaging.


Premeasured packages are more expensive,
but save time by eliminating the need for
measurement of the powder.
Shelf life of alginate is approximately 1 year.

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Fig. 46-7 Examples of packaging for alginate.

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Causes for Distortion and Dimensional


Change of Alginate
If an alginate impression is stored in water or in

a very wet paper towel, the alginate will absorb


additional water and expand. This condition is
called imbibition.
If an alginate impression remains in the open
air, moisture will evaporate from the material,
causing it to shrink and distort. This condition is
called syneresis.

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Alginate Settings
Normal set alginate

Working time of 2 minutes and a setting time of up to


41/2 minutes after mixing.
Fast set alginate
Working time of 11/4 minutes and a setting time of 1
to 2 minutes.
Working time
The time allowed for mixing the alginate, loading the
tray, and positioning the tray in the patient's mouth.
Setting time
The time required for the chemical action to be
completed.

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Altering the Setting Times of Alginate


Cooler water can increase the setting time if

additional time is needed for the procedure.


Warmer water can reduce or shorten the
setting time of the procedure.

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Water-to-Powder Ratio
An adult mandibular impression generally

requires two scoops of powder and two


measures of water.
An adult maxillary impression generally
requires three scoops of powder and three
measures of water.

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Fig. 46-8 Scoop and water measure for alginate.

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Taking an Alginate Impression


Explain the procedure to the patient:
The material will feel cold, there is no
unpleasant taste, and the material will set
quickly.
Breathe deeply through your nose to help
you relax and be more comfortable.
Use hand signals to communicate any
discomfort.

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An Acceptable Alginate Impression


The impression tray is centered over the central and

lateral incisors.
There is a complete "peripheral roll," which includes all of
the vestibular areas.
The tray is not "overseated," which would result in
exposure of areas of the impression tray.
The impression is free from tears or voids.
There is sharp anatomic detail of all teeth and soft
tissues.
The retromolar area, lingual frenum, tongue space, and
mylohyoid ridge are reproduced in the mandibular
impression.
The hard palate and tuberosities are recorded in the
maxillary impression.

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Fig. 46-12 An alginate impression.

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Reversible Hydrocolloid
An impression material that changes its

physical state from a sol to a gel and then


back to a sol.

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Chemical Makeup of Reversible


Hydrocolloid
85% water
13% agar

Agar is an organic substance derived from


seaweed.
Additional chemical modifiers are added to
aid in the handling characteristics.

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Conditioning Bath for Reversible


Hydrocolloid
Three Compartments

The first bath is for liquefying the semisolid


material. A special water bath called a
hydrocolloid conditioner at 212 F liquefies the
material. After liquefying, the preset thermostat
cools the temperature to 150 F automatically.
The second bath becomes a storage bath that
cools the material, readying it for the impression.
At this temperature, the tubes are waiting for use.
A third bath is kept at 110 F/44 C for
tempering the material after it has been placed
in the tray.

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Types of Reversible Hydrocolloid


Tray material

Packaged in plastic tubes. Each tube has


enough material to fill a full arch, watercooled tray.
Syringe material
Packaged in plastic or glass cartridges that
fit a syringe or in preloaded syringe or
preformed sticks that refill special
hydrocolloid inlay syringes.

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Application of Reversible Hydrocolloid


Impression Material
1. A stock water-cooled tray is selected, making sure
2.
3.

4.
5.

6.

that the tray does not impinge on any of the teeth


or soft tissue.
Plastic stops are placed in the tray.
Tubing is connected to the tray and to the water
outlet for drainage.
The material is liquefied and moved to the storage
bath.
The light-bodied material is placed in the syringe,
and heavy-bodied material is placed in the tray.
The light-bodied material is expressed around the
prepared tooth, and the dentist seats the tray.

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Elastomeric Impression Materials


A material that is used when an extremely
accurate impression is essential. The term
elastomeric means having elastic or
rubberlike qualities.

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Characteristics or Elastomeric
Impression Materials
Base

Packaged as a paste in a tube, as a


cartridge, or as putty in a jar.
Catalyst
Also known as the accelerator, is packaged
as a paste in a tube, as a cartridge, or as a
liquid in a bottle with a dropper top.

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Forms of Elastomeric Materials


Light-bodied
Also referred to as syringe type, or wash
type. This material is used because of its
ability to flow in and about the details of the
prepared tooth. A special syringe, or
extruder, is used to place the light-bodied
material on and immediately around the
prepared teeth.

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Forms of Elastomeric Materials- contd


Regular and heavy-bodied
Often referred to as tray-type materials, they
are much thicker. As the names imply, they
are used to fill the tray. Their stiffness helps
to force the light-bodied material into close
contact with the prepared teeth and
surrounding tissues to ensure a more
accurate impression of the details of a
preparation.

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Basic Impression Technique


1. The material selected depends upon the dentists preference

2.
3.
4.

5.
6.

7.

and the type of impression required for the procedure.


The dentist prepares the tooth or teeth for the impression.
The light-bodied material is prepared and loaded into the
syringe and transferred to the dentist.
The dentist places the light-bodied material over and around
the prepared teeth and onto the surrounding tissues.
The heavy-bodied material is prepared and loaded into the
tray and transferred to the dentist.
When the impression material has reached final set, the
impression is removed and inspected for accuracy.
The impression is disinfected, placed in a biohazard bag,
labeled, and readied for the laboratory technician.

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Curing Stages of Elastomeric Materials


Initial set

The first stage results in stiffening of the paste


without the appearance of elastic properties. The
material may be manipulated only during this first
stage.
Final set
The second stage begins with the appearance of
elasticity and proceeds through a gradual change to
a solid rubberlike mass. The material must be in
place in the mouth before the elastic properties of
the final set begin to develop.
Final cure
The last stage occurs from 1 to 24 hours.

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Types of Elastomeric Materials

Polysulfide
Polyether
Silicone
Polyvinyl siloxane

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Polysulfide Impression Material


Chemical makeup
Base: Mercaptan polysulfide.
Cross-linking agent: Sulfur and/or lead
peroxide.
Catalysts: Copper hydroxides, zinc peroxide,
organic hydroperoxide.
Fillers: Zinc sulfate, lithopone, or calcium
sulfate dihydrate.

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Manipulation and Technique


Considerations for Polysulfide Material
Dispense pastes at the top of the mixing pad.
Mix pastes with the tip of a spatula to incorporate the

material first.
Transfer the material to the fresh surface of the mixing
pad.
Water, saliva, and blood affect polysulfide material.
Impression should be removed quickly after setting-do not
rock the tray.
Adhesive must be thin and dry before adding the
impression material.
Wait 20 to 30 minutes before pouring the impression for
the stress relaxation to occur in the material.
Be careful of glove powder contamination of the
impression.

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Polyether Impression Material


Chemical makeup

Base: Polyether
Cross-linking agent: Sulfate
Catalysts: Glycol-based plasticizers
Filler: Silica

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Manipulation and Technique


Considerations for Polyether Material
Material is very stiff, which makes it difficult to

remove without rocking.


When removing the impression, break the seal
and rock slightly to prevent tearing.
Water, saliva, and blood affect polyether
material.
Added moisture will increase the impressions
marginal discrepancy.
Increased water absorption occurs if a thinning
agent is used.

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Silicone Impression Material


Chemical makeup
Base: Poly dimethyl siloxane
Cross-linking agent: Alkyl ortho silicate or
organo hydrogen siloxane
Catalyst: Organo tin compounds
Filler: Silica

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Manipulation and Technique


Considerations for Silicone Material
The material has a limited shelf life.
The tray requires a special tray adhesive.
No syneresis or imbibition but does respond with

shrinkage over time.


The material is more flexible, so there is more
chance for distortion during removal.
Wait 20 to 30 minutes before pouring of models
for stress relaxation to occur.

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Polyvinyl Siloxane Impression Material


Chemical makeup
Base: Silicone polym
Catalyst: Chloroplatinic acid
Filler: Silica

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Manipulation and Technique Considerations


for Polyvinyl Siloxane Material
For dimensional stability, this is the best

impression material.
Pouring of the model can be delayed up to 7 to
10 days.
Stiffness of the material makes removal of the
tray difficult.
Material dispensed using auto-mixing unit and
mixing tips.

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Occlusal Registration
An accurate registration of the normal

centric relationship of the maxillary and


mandibular arches. Also commonly referred
to as the bite registration.

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Types of Occlusal Registration


Wax bite
Useful when the diagnostic casts are
trimmed.
The most common technique is to use a
softened baseplate wax.

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Fig. 46-27 Wax bite registration.

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Types of Occlusal Registration- contd


Polysiloxane bite registration paste:

Supplied both as a paste system and also as


cartridges.
The material is fast setting.
There is no resistance to biting forces.
There is no odor or taste for the patient.
It gains dimensional stability over time.
It is convenient to use.

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Types of Occlusal Registration- contd


Zinc oxide-eugenol (ZOE) bite registration

paste
ZOE paste has little to no resistance to bite
closure and is a fast-setting material.
Material is supplied in a paste system and
dispensed onto a paper pad, mixed, and
placed onto a gauze tray for the patient to
bite into.

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