IMPRESSION MATERIALS

Dr. Kais George 18/10/2012

IMPRESSION: Definition. : a dental impression is a negative replica of the tissues of the oral cavity.
CLASSIFICATION OF IMPRESSION MATERIALS. I) Based on mode of setting & elasticity a) Rigid i) Reversible (thermoplastic) E.g. impression compound [primary impression] ii) Irreversible [final impression] E.g. Zoe impression paste Impression plaster. b) elastic i) Hydrocolloids a) Irreversible E.g. Alginate [primary impression] ii) Elastomeric impression materials E.g. Polysulfides Polyether Addition silicones Condensation silicones II) Based on type of impression & area of use A) Dentulous i) Primary E.g. alginate ii) Secondary E.g. zoe B) Edentulous i) Primary E.g. Impression compound Impression plaster Alginate
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ii) Secondary e.g. ZOE impression paste Elastomers for CD III) based on their use in dentistry A) edentulous For complete denture prosthesis e.g. Impression compound zoe impression paste alginate Elastomers B) dentulous i) Fixed Partial Denture ii) Removable PD E.g. Alginate Elastomers IV) based on the amount of pressure applied i) Mucocompressive [functional] e.g. Impression compound ii) mucostatic e.g. Impression plaster V) based on the manipulation A) hand mixing i) kneading [] e.g. Impression compound wet kneading putty consistency Elastomers ii) circular motion (with glass slab & spatula) eg.zoe impression paste polysulfide iii) vigorous mixing e.g. Alginate (figure of 8 motions) B) mechanical mixing VI) based on the tray used for impression A) stock tray i) types of tray rim locked perforated e.g. Alginate Elastomers

ii) based on type of perforation a) perforated e.g. Alginate Elastomers b) non perforated e.g. Impression compound B) special tray i) resin. e.g. Zoe impression paste IDEAL REQIUREMENTS OF IMPRESSION MATERIAL 1. have a pleasant taste & odor 2. not contain toxic or irritant constituents. 3. adequate shelf life for requirements of storage & distribution. 4. economically commensurate with the results obtained. 5. easy to use with the minimum of equipment. 6. setting characteristics that meet clinical requirements. 7. satisfactory consistency texture. 8. readily wets oral tissues 9. elastic properties with freedom from permanent deformation after strain. 10. adequate strength so it will not break or tear on removal from the mouth. 11. dimensional stability over temp. & humidity ranges normally found in clinical & lab. Procedures for a period long enough to permit the production of a cast

or die. 12. compatibility with cast & die materials. 13.accuracy in clinical use.
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14. readily disinfected without loss of accuracy. 15.no release of gas or other by products during the setting of the impression on cast & die materials.

IMPRESSION COMPOUND It is a rigid, reversible impression material which sets by physical change. Classification: Acc to ADA sp. No.3: Type I: low fusing compound green stick compound. medium fusing compound impression compound. Type II: high fusing compound tray compound. Supplied as: 1. as sticks, cakes, & cones. 2. colors green, brown, red. Applications: Type I: For making primary impressions. For individual tooth impression For peripheral tracing or border moulding. To check undercuts in inlay preparation. Type II: To make a special tray. Requirements of an ideal impression compound: 1. harden at or little above mouth temp. 2. be plastic at a temp. not injurious or harmful to oral tissues. 3. not containing irritating or toxic ingredients. 4. harden uniformly when cooled without distortion. 5. have a consistency when softened which will allow it to reproduce fine details. 6. be cohesive but not adhesive. 7. not undergo permanent deformation or fracture while withdrawing the impression from the mouth. 8. be dimensionally stable after removal from mouth & during storage. 9. exhibit a smooth glossy surface after flaming.
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10.withstand trimming with sharp knife without flaking or chipping after hardening. Composition Rosin Copal resin Carbuna wax Stearic acid Talc Coloring agent Properties: Thermal properties i) thermal conductivity: has low thermal conductivity. Significance: during softening of the material , the outside will soften first & inside last. So to ensure uniform softening the material should be kept immersed for a long time in water bath. the layer adjacent to the mouth tissue swill remain soft. Therefore Its imp to cool the compound thoroughly before removing the impression. ii) Coefficient of linear expansion. (CTE) high CTE , 0.3% acceptable. iii) Flow high fusing compounds < 2% at 37 .C & < 70-85 % at 45.C low fusing compounds - < 3% at 37 C & < 80-85% at 45 C impression compound to be manipulated at least 8 .C for adequate flow. iv) Glass transition temp it is the temp. at which the material loses its hardness or brittleness on heating or forms a rigid mass. App. 39.C Material removed from the mouth after glass transition temp. is reached. v) Fusion Temp. its the temp. at which the impression compound becomes plastic. Its 43.5.C vi) Dimensional stability. Poor dimensional stability. 30 30 10 5 25 app.

 To prevent distortion pour the cast within 1 hr. vii) surface detail reproduction less because of high viscosity & low flow. Manipulation Sticks Small amt. softened over flame Cakes Softened in a thermostatically controlled water bath. Precautions: o prolonged immersion in a water bath is not indicated o overheating In water makes the compound sticky & difficult to handle. o avoid incorporating water while kneading. Advantages: 1. cheap 2. reusable 3. does not produce irritation to the patient 4. impression can be remodified & resoftned again till an accurate impression is obtained. 5. Disadvantages: 1. difficult to record details accurately. 2. Soft tissues are compressed due to pressure applied while taking the impression. 3. Distortion. 4. Difficult to remove undercuts. 5. Does not have an pleasant taste. 6. Can be uncomfortable in patients because of the rigidity. ZINC OXIDE EUGENOL PASTE Introduction Produce a rigid impression. High degree of accuracy & good surface reproduction of details. Is irreversible, sets by chemical change.

Classification: ADA specification No. 16 Type I or hard Type II or soft Available as In paste form in 2 tubes Base paste (white) Accelerator/ reactor/catalyst paste (red) Composition: Base Paste: Zinc oxide Olive oil /linseed oil 87 % 13% 12% 50% 20% 5%

Accelerator paste: Oil of cloves Gum or polymerized rosin Filler (silica type) : Lanolin 3% Resinous balsam 10% Accelerator solution Setting Reaction : ZnO + H2O Zn (OH)2 Zn (OH)2 + 2HE ZnE2+ 2 H2O

Manipulation: Dispense equal length of the 2 pastes. Variation in length alters setting time. Paper pad is used as a mixing slab & a stiff stainless steel spatula with an 8-10 cm blade should be used. Mixing is done for 30-40 sec. until no color streaks in the mix & a uniform consistency is obtained. Setting time: Type I Type II Initial setting time 3-6 min. 3-6 min final setting time 10 min. 15 min.

Factors controlling setting time: Decreasing setting time: Small amt. of zinc acetate Accelerators Small drop of water mixed in the paste containing eugenol Increasing the mixing time. Increasing accelerator paste while mixing. Increasing setting time: Cooling the spatula & mixing slab Addition of inert oils & waxes during mixing to reduce hardness like: olive oil. Increasing base paste while mixing. Properties: i) consistency & flow thick consistency compress the tissues. ii) dimensional stability quite satisfactory, less than 0.1 % shrinkage occurs during hardening. iii) reproduction of details good. Biologic considerations: Some patients experience burning sensation in the mouth due to eugenol & can also cause tissue irritation. This maybe overcome by using a non eugenol paste. Uses: 1. 2. 3. 4. 5. 6. 7. cementing & insulating medium temporary filling root canal filling material surgical pack in periodontal surgical procedures. bite registration pastes temporary relining material for dentures. impression material for edentulous patients.

Advantages:
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1. 2. 3. 4. 5.

Good dimensional stability good detail reproduction impression surface can be modified by adding in deficient areas easy to manipulate long working time, so border moulding can be done while relining dentures.

Disadvantages 1. burning sensation due to eugenol. 2. messy to work with 3. sticks to skin & instruments , difficult to clean. 4. rigid so tends to break off in areas of undercuts. ALGINATE Introduction: Comes from the term algin coined by Scottish chemist. It is an elastic irreversible hydrocolloid because its sets by chemical reaction. Types: Type I fast setting : 1-2 min. Type II normal setting : 2-4.5 min. Available as : 1. bulk powder 2. preweighed packages 3. color changes alginates: violet during mixing, pink when ready to be seated white when set Composition: Ester salts of alginic acid(sodium or potassium or triethanolamine alginate) 15% Calcium sulphate (reactor) 16% Zinc oxide 4% Potassium titanium fluoride 3% Diatomaceous earth 60% Sodium phosphate 2% Coloring & flavoring agents traces Setting reaction:
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2 Na3PO4 + 3 CaSO4 Ca3(PO4)2 + 3Na2SO4 Setting Time: Type I (fast set) : 1-2min Type II (normal) : 2-4.5 min. Control Of gelation time: Under control by manufacturers: o By the amt of retarder added during manufacturing. 1. 2. 3. 4. 5. Under Control of clinicians by altering the W:P ratio by changing the mixing time. by altering the temp. of water increase in temp. decreases gelation time & vice versa. Premature gelation causes distortion in the impression & it is rendered useless. 6. Prolonged gelation time is tedious for both pt. & the dentist. Manipulation : aerate the powder by inverting the can several times. This ensures uniform distribution of the filler before mixing. The top of the can should be taken off carefully to prevent the silica particles from being inhaled. The proper W/P ratio as pacified by the manufacturer should be used measured quantity of water and powder are added in the rubber bowl & mixing is started, with a stirring motion to wet the powder with water. Once its moistened rapid spatulation by swiping or stropping against the side of the bowl is done. A vigorous figure eight motion is used. Mixing time: Working time For fast set alginate 45 sec. 1 min. For normal set alginate Properties: i) taste & odor pleasant ii) flexibility lower w/p ratio results in lower flexibility. 60 sec. 2 min

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iii) elasticity & elastic recovery highly elastic, permanent deformation less if the impression is removed from the mouth quickly. iv) reproduction of the surface detail lower than agar. v) strength

compressive strength : 5000-8000 gm/cm2 tear strength : 350-700 gm/cm2

vi) dimensional stability. Poor

Biologic properties: Silica present in the dust which rises from the can after fluffing alginate powder is a health hazard. Dustless alginate is also present in the market which contain glycol.

Uses: 1. for making primary impression of edentulous patients with undercut ridges. 2. for preliminary impressions for complete dentures. 3. for making impressions for dentulous pts. For construction of study models & temporary removable prosthesis. 4. for making impression for orthodontic study models. 5. used for making impressions for the preparation of mouth protectors for athletes. 6. used as duplicating material. Advantages: 1. ease of mixing & manipulation. 2. no elaborate equipment required. 3. material is elastic & comes out easily from undercuts. 4. economical 5. impression can be removed easily & has pleasant taste & odor, so comfortable for the patient. 6. Disadvantages:
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1. 2. 3. 4. 5.

cant be electroplated. poor tear strength especially in thin sections. dimensional stability is poor. distortion may occur if tray is shifted during setting. cant be refined.

Types of failures: 1. defects: a. improper mixing b. prolonged mixing c. undue gelation d. w/p ratio is too low. 2. tearing: a. inadequate bulk b. moisture contamination c. premature removal from mouth d. prolonged mixing 3. external bubbles: a. undue gelation preventing flow b. air incorporated during mixing 4. irregularly shaped voids: a. moisture 5. rough or chalky stone model: a. inadequate cleaning of the impression b. excess water left in impression c. premature removal of model. 6. distortion: a. impression not poured immediately

IMPRESSION TECHNIQUES
Impression can be classified as : 1. depending on the theories of impression making: a. mucostatic/passive impression. b. Mucocompressive/functional impression c. Selective pressure impression. 2. depending on the technique:

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a. open mouth technique b. closed- mouth technique 3. hand manipulation for functional movements: a. border moulding 4. depending of the type of tray: a. stock tray impression b. custom tray impression 5. depending on the purpose of the impression : a. diagnostic impression b. primary impression c. secondary impression 6. depending on the material used: a. reversible hydrocolloid impression b. irreversible hydrocolloid impression c. modeling plastic impression d. plaster impression e. wax impression f. silicone impression g. Thiokol rubber impression. MUCOSTATIC / PASSIVE IMPRESSION Proposed by Richardson Impression is made with the oral mucous membrane & the jaws in a normal relaxed condition. Border moulding not done. Impression material impression plaster Retention due to interfacial surface tension. Taken with an oversized tray.

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 Denture closely adapted to the denture bearing area but has poor peripheral seal. Therefore these dentures have good stability but poor retention.

MUCOCOMPRESSIVE/ IMPRESSION Given by Carole Jones Records oral tissues in a functional & displaced form. Imp. Material imp. Compound , waxes , soft liners. Dentures dont get displaced due to tissue rebound at rest. During function, the constant pressure exerted onto soft tissues limit the blood circulation leading to residual ridge resorption. SELECTIVE PRESSURE TECHNIQUE Given by Boucher.

Impression made to extend over as much denture bearing area as possible

without interfering with the limiting str. At function at rest. Forces acting on the denture are confined to the stress bearing areas.

Relief is given by using wax in the special tray, which is removed before impression making.

IMPRESSION PROCEDURES.
RECORDING THE PRIMARY IMPRESSION.
TRAY SELECTION Known as stock trays.
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 notch.

Can be metal / plastic, perforated or non perforated. Available in standard sizes. There should be 2-3 mm clearance between the stock tray & Tray should be extend over the tuberosity & the hamular If try too large it will distort the tissue in the borders of If tray is too small then modeling wax should be added The tray material should not react with the impression

the ridge & should have 5-6 mm clearance for impression compound.

the impression & push the tissues away from the bone. along the posterior border of the tray. material & should not distort.

PRIMARY IMPRESSION MAKING IN MAXILLARY ARCH. Objective to obtain a preliminary impression that is slightly overextended along the borders. Imp material with high viscosity preferred

Imp. Compound softened in water bath at 140.F, then kneaded. Using thumb the operator should spread & adapt the material allover the tray so that it app. To the ridge contour.

Kneaded material rolled into a tray & rolled into a ball & placed on the tray.

If alginate used then small amt. of material is placed in the post. Part of the palate & tuberosities before making the imp. Pt. asked to sit upright & open the mouth halfway. Operator should position himself towards the side & rear of the patient. Tray centered over the upper residual ridge by using labial frenum as a centering guide.

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 After proper positioning the tray is seated over the ridge by applying pressure in the first molar region, until it touches the posterior palatal seal. Tray stabilized with a finger placed in its center Borders are refined by asking the pt. to suck down into the tray, move the mandible side to side & then open wide. This record the labial & buccal vestibules & influence of coronoid process on the shape of the buccal vestibules. Once the material has set, the cheeks & upper lip are lifted away from the borders to allow for air entry. Tray is then removed from the mouth in one motion & inspected for any deficiency. Borders of the custom tray can be marked by Marking the peripheral outline on the impression. Outlining the cast Cast is observed & then poured with dental plaster. PRIMARY IMPRESSION MAKING IN MANDIBULAR ARCH Choice of material impression compound / high viscosity alginate. Astringent mouthwash given to reduce the viscosity of the saliva.

Impression material manipulated & loaded into the tray, if alginate used then

small quantity placed on the retromolar pads. Tray should be rotated within the patients mouth in a horizontal plane until it is in the center of the residual ridge. The pt. should be asked to raise the tongue to fit into the tongue space of the impression tray.

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 Tray is seated gently using alternate pressure on the molar regions of either side,. Then passive movements of peripheral musculature is done.

Once the imp. Material sets, the lips & cheek are retracted & the imp. Is removed

in a single snap from the patients mouth. Imp. Should be Checked for any errors like voids etc.

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