Journal of Oral Rehabilitation 2002 29; 357361

Effect of wash bulk on the accuracy of polyvinyl siloxane

putty-wash impressions
J. NISSAN, M. GROSS, A. SHIFMAN & D. ASSIF

Department of Prosthodontics, The Maurice and Gabriela

Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel

SUMMARY Variations in the bulk of wash in a puttywash impression technique can result in dimensional
changes proportional to the thickness of the wash
material during setting. The purpose of the study
was to determine the amount of wash necessary to
achieve accurate stone models while using a twostep putty-wash impression technique with polyvinyl siloxane (PVS) impression material. A total of
45 impressions were made of a stainless steel master
model, 15 impressions for each wash thickness (1, 2
and 3 mm). The model contained three full-crown
abutment preparations, which were used as the
positive control. Accuracy was assessed by measuring six dimensions (occlusogingival and interabutments) on stone dies poured from impressions of

Introduction
A precise impression is necessary for fabricating an
accurately tting cast restoration. For this purpose,
polyvinyl siloxane (PVS) impression materials are
extremely popular because of their combination of
excellent physical properties, handling characteristics
and dimensional stability (McCabe & Wilson, 1978; Yeh
et al., 1980; Lacy et al., 1981; Craig, 1988; Philips, 1991;
Braden & Elliot, 1996). The putty-wash technique is
commonly used in making impressions with PVS
(Donovan & Chee, 1989; Marshak et al., 1990; Chee &
Donovan, 1992; Nissan et al., 2000). It consists of
polymerizing a low-viscosity elastomer (light-body or
wash) against a high-viscosity elastomer (putty). The
putty, used in a perforated metal stock tray, simulates a
custom-made tray.
Dimensional changes, during setting, proportional to
the thickness of the wash material may occur.
2002 Blackwell Science Ltd

the master model. One-way analysis of variance

(ANOVA ) showed statistically signicant differences
amongst the three wash bulk groups, for all occlusogingival and interabutment measurements (P <
0001). The overall discrepancies of the groups using
wash thickness of 1 and 2 mm were smaller than the
group with 3 mm wash thickness. Therefore, wash
bulks of 1 and 2 mm were most accurate for fabricating stone dies, using PVS impression materials.
This can be achieved by using the temporary crown
to create the desired wash space in the preliminary
putty impression. Wash thickness > 2 mm was
inadequate to obtain accurate stone dies.
KEYWORDS : impressions accuracy, wash bulk, polyvinyl siloxane, xed prosthodontics

Undesirable dimensional changes and stone model

inaccuracies, which resulted from excessive or uncontrolled thickness of the wash impression material, have
been reported (Eames et al., 1979; Williams et al., 1984;
DeAraujo & Jorgensen, 1985; Donovan, 1988;
Donovan & Chee, 1989; Chee & Donovan, 1992; Tjan
et al., 1992; Takahashi & Finger, 1994; Nissan et al.,
2000).
The purpose of this study was to determine the
amount of wash necessary to achieve accurate stone
models in using putty-wash impression technique with
PVS impression material.

Materials and methods

A metal master model, containing three full-crown
xed partial denture abutment preparations, was constructed and used as a positive control. The abutments
were prepared with cross-grooves on occlusal surfaces

357

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J . N I S S A N et al.

Fig. 1. Metal master model containing three full-crown abutment

preparations, a perforated metal custom tray and a metal index
device.

Fig. 2. Master model with three different pre-fabricated stainless

steel copings (1, 2 and 3 mm).

as reference points for taking measurements. A perforated custom tray was fabricated to accurately relocate
on the master model for each impression. A model
indexing device was fabricated to cast uniform stone
models (Fig. 1). Three different stainless steel copings
were used to create three different wash spaces (Fig. 2):
Group A: copings of 1 mm thickness
Group B: copings of 2 mm thickness
Group C: copings of 3 mm thickness
For each group, 15 impressions were made, using the
putty/wash two-step impression technique. The stainless steel pre-fabricated copings were seated on each
abutment to create a uniform wash space and the putty
impression was taken and allowed to set for 10 min. In
the second step, the copings were removed, the wash
material added and the preliminary impression was

Fig. 3. Stone model of master model.

re-seated for setting (12 min) on the master model.

Then the impressions were poured in improved die
stone (type IV)* (Fig. 3).
Impressions were made using President-Plus, a PVS
impression material at viscosities of putty soft
(1504823, type 1, Cat. A, high) and light body
(1504923, type 3, Cat. A, low).
All materials were mixed in standardized proportions
according to the manufacturer's recommendations. The
tray adhesive supplied by the manufacturer was applied
evenly over the tray's surface. Setting time, according
to the manufacturer, was doubled to compensate for
impression making at room temperature instead of at
mouth temperature (Johnson & Craig, 1985). All
impressions were stored at room temperature, 25 C,
for 1 h before pouring. The improved stone was rst
mixed by hand to incorporate the water and then
mechanically mixed under vacuum for 15 s. All mixes
were vibrated into the impressions and allowed to set
for 1 h before separation from the impressions.
Assessment of impressions accuracy
All measurements of the master and stone models were
made with a Toolmakers Microscope (TM 300, Series
No. 176), capable of measuring up to 0001 mm. The
microscope was attached to a two-dimensional data
processor (MicroPack 5 MK II, Series 264) so the
distance between two points was provided on a digital
readout to the accuracy indicated (Fig. 4). The location
*Suprastone, Kerr, Sybron, Romulus, MI, USA.

Coltene, Altstatten, Switzerland.

Mitutoyo, Japan.
2002 Blackwell Science Ltd, Journal of Oral Rehabilitation 29; 357361

EFFECT OF WASH BULK ON PVS

One-way analysis of variance (ANOVA ) was used to
compare the differences amongst the three wash bulk
thickness groups and the master model, for each
measurement.

Results

Fig. 4. Toolmaker's Microscope with electronic data processor.

Fig. 5. Diagram of master model displaying interabutment (LC,

CR, LR) and occlusogingival (L, C, R) measurements.

of the distances measured (occlusogingival and interabutments) on each of the master and stone models are
illustrated in Fig. 5.
Each distance on the master model at each measurement location was measured 10 times. The mean and
standard deviation (s.d.) for all distance measurements
were calculated and used as the control to compare
amongst the three impression techniques. The intraobserver variability for all distance measurements
ranged between 5 and 8 lm, which was 001 to
007% of measurement errors. Each stone die measurement was repeated three times. The distance between
the mean of the stone models (msm) and the mean of
the master model (mmm) divided by mmm multiplied
by 100 was expressed as the percentage of deviation
from the master model for each impression technique
of each measurement location
Percentage of deviation msm

mmm)/mmm  100

Mitutoyo, Japan.

2002 Blackwell Science Ltd, Journal of Oral Rehabilitation 29; 357361

Table 1 presents the mean (in mm) and s.d. of the

interabutment (LC, CR, LR) and occlusogingival
(L, C, R) distance measurements on the master and
stone models for the three wash bulk thicknesses.
Table 2 shows the percentage of deviation and
absolute change (lm) from the master model at each
wash bulk thickness at each interabutment (LC, CR,
LR) and occlusogingival (L, C, R) measurements.
The mean for all measurements in the three groups
showed a decrease of 008 to 197% in the occlusogingival and an increase of 0009 to 011% in the
interabutment measurements. One-way ANOVA showed
statistically signicant differences amongst the three
groups (Table 2), for all occlusogingival and interabutment locations (P < 0001). These statistical analyses
revealed a signicant difference between Groups 1 and 2
(wash thickness of 1 and 2 mm) and Group 3 (3 mm
wash thickness). The overall discrepancies of Groups 1
and 2 were signicantly smaller than Group 3.

Discussion
Thickness of impression materials has been shown to
affect the dimension of stone dies. Wash bulk is a
critical factor that inuences accuracy when using PVS
(Eames et al., 1979; Williams et al., 1984; DeAraujo &
Jorgensen, 1985; Donovan, 1988; Donovan & Chee,
1989; Chee & Donovan, 1992; Takahashi & Finger,
1994; Nissan et al., 2000). In the present study, the twostep putty-wash impression technique was used. This
technique was shown to result in minimal dimensional
changes at the fabrication of stone dies (Eames et al.,
1979; Williams et al., 1984; DeAraujo & Jorgensen,
1985; Donovan, 1988; Donovan & Chee, 1989; Tjan
et al., 1992; Takahashi & Finger, 1994; Nissan et al.,
2000). Three different thicknesses (1, 2 and 3 mm) of
wash material were used to determine the bulk of wash
that will result in accurate stone models.
The data revealed that wash bulks of 1 and 2 mm
result in more accurate stone models than a wash bulk of
3 mm. Wash thickness larger than 2 mm caused a
greater distortion than 1 and 2 mm thickness (Figs 6

359

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J . N I S S A N et al.
Master

1 mm

2 mm

3 mm

Measurements

Mean

s.d.

Mean

s.d.

Mean

s.d.

Mean

s.d.

LC
LR
CR
Left
Centre
Right

21998
4406
22054
8092
8057
7986

0005
0007
0005
0007
0008
0006

220071
44071
22056
8061
8048
7976

0006
0005
0016
0055
0028
0003

22006
44071
22055
8063
8049
7977

0006
0007
0004
0006
0002
0004

22023
44082
22039
7932
7953
7837

0011
0009
0014
0034
0032
0087

1 mm
Locations

2 mm
lm

3 mm
lm

Interpreparation (LC) 004

9
003
8
011
Interpreparation (LR) 002
11
002
11
004
Interpreparation (CR) 0009
2
0009
1 007
Occlusogingival (L)
)038 )31 )023 )29 )197
Occlusogingival (C)
)011
)9 )008
)8 )129
Occlusoginigval (R)
)012 )10 )011
)9 )186

ANOVA

lm
25
22
)15
)160
)104
149

F(p)*
2180
933
1396
19899
12413
3289

Scheffe contrasts
3
3
3
3
3
3

>
>
>
>
>
>

1,
1,
1,
1,
1,
1,

2
2
2
2
2
2

Table 1. Mean and s.d. of occlusogingival and interabutment

measurements (in mm) on the
master and stone models for the
three wash bulk thicknesses

Table 2. Percentage of deviation (%)

and absolute change (lm) from
master model of each wash bulk
thickness

*P < 000.

Fig. 6. Graphic representation of percentage deviations from

master model for each wash bulk thickness at the occlusogingival
measurements.

Fig. 7. Graphic representation of percentage deviations from

master model for each wash bulk thickness in interabutment
measurements.

and 7). These results support the ndings of a previous

study (Nissan et al., 2000), which showed that the puttywash two-step impression technique, using a wash bulk
of 2 mm, was more accurate than the one-step puttywash impression technique or the two-step putty-wash
impression technique with a polyethylene spacer. These
last two techniques are characterized by uncontrolled
wash bulks, either insufcient or excessive.

Most dimensional differences were shown in the

3 mm wash thickness and were minimized in the 1 and
2 mm thickness. This may occur because of differential
contraction at the wash bulk that results in uneven
dimensional changes (Lewinstein, 1993). Furthermore,
changes in the vertical dimensions (occlusogingival)
were greater than the horizontal (interabutment). This
phenomenon occurred because of the impression
2002 Blackwell Science Ltd, Journal of Oral Rehabilitation 29; 357361

EFFECT OF WASH BULK ON PVS

material's contraction towards the tray walls, making
the stone dies wider in the horizontal aspect and shorter
in the vertical one (Eames & Sieweke, 1980; Johnson &
Craig, 1986; Lewinstein, 1993).
The results of this study are in agreement with
other studies. Eames et al. (1979) compared the effect
of bulk on the accuracy of 2, 4 and 6 mm thickness of
wash with condensation-type silicones using puttywash technique and found that 2 mm produced the
most accurate impressions. DeAraujo and Jorgensen
(1985) found that the wash bulk of elastomeric
impression materials must be controlled because it
affects the accuracy of stone dies. However, Tjan et al.
(1992) found that tray spaces of 26 mm did not affect
the accuracy of stone dies for individual castings, but
it did affect the interpretation dimension in xed
partial dentures. Thus, a potential problem may arise
when a xed partial denture is cast in one piece
because of a signicantly reduced distance between
the abutments. The nding that impression accuracy is
not affected by wash thickness of 12 mm justies the
use of provisional restorations as impression spacers at
the preliminary putty impression (Marshak et al.,
1990).

Conclusion
Under the conditions of the present study, wash
thickness of 1 to 2 mm are most accurate for fabricating
stone dies, when using PVS impression materials with
the two-step putty-wash impression technique.

Acknowledgment
The authors wish to thank Ms. Rita Lazar for editorial
assistance.

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Correspondence: Dr Joseph Nissan, Department of Prosthodontics,
The Maurice and Gabriela Goldschleger, School of Dental Medicine,
Tel Aviv University, Tel Aviv, Israel.
E-mail: nissandr@post.tau.ac.il

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