Chapter 14

Impression Materials
Part 2

Impression
Material used
Reproduce the form of teeth
CASTING RESTORATION PREPARATIONS FOR RESTORATIONS FORM OF THE ORAL HARD AND SOFT TISSUES

Known as a negative replica of the teeth

IMPRESSION TRAYS
Used to carry the impression material to the mouth and support it until it sets Can be made for edentulous and full dentition Full arch/ or quad Metal or plastic Adults, children Solid or perforated with holes

Solid impression trays

Have raised borders, expensive Internal surfaces that help lock in the material (need to clean!) Known as rimlock trays May need adhesive
Retain material Prevent distortion

Plastic trays
Inexpensive Disposable

Custom Trays
Constructed in lab
Chemical cured Light-cured Resins on casts Custom fit the mouth of the individual

Triple Trays
Also called
Double-bite Dual-arch Check-bite

Used to make an impression of the teeth being treated and the opposing arch

Bite Registration Trays

Typically U-shaped plastic frames with a fiber mesh stretched between the sides of the frame Place material on both sides of the mesh

Alginate
Irreversible hydrocolloid Most widely used impression material Easy to manipulate Inexpensive No special equipment needed Reasonable accurate
Dental casts, partial denture frameworks, repair of broken partial/dtr, fluoride and bleaching trays, mouth guard, preliminary impressions Not accurate enough for final impressions

Composition
Main active ingredient
Potassium or sodium alginate = 15-20%
Colloidal particles as basis of the gel

Produced from derivatives of seaweed Other ingredients

Calcium sulfate dihydrate
Creates irreversible gel with alginate

Potassium sulfate
Ensures set of gypsum materials

Trisodium phosphate and diatomaceous earth

Retarder to control setting time and filler

Flavoring agents, coloring agents

Color, reduce dust, antibacterial action, taste

Setting reaction
Regular set
2 5 minutes

Fast set
1 2 minutes

Setting time lengthened

Cold water

Setting time shortened

Hot water

Should leave the impression in the mouth for additional 1-2 minutes after it appears set

Removing the Impression

Need a thickness of 2-4 mm between impression tray and the teeth Thin alginate will tear more easily Remove
Rapidly With a snap Loosen the back of the tray by pushing down on the edge of the tray

Dimensional stability
Alginate
Sensitive to moisture losswill shrink Remove from mouth
Rinse and disinfect

Wrap in damp paper towel, seal in zip lock bag Need to create 100% humidity Syneresis squeezing out some liquid from contracting gels; appears on surface of impression

Cause for Distortion and Dimensional Change

Imbibition
Alginate impression stored in water or a very wet paper towel will absorb the additional water and expand.

Syneresis
If an alginate impression remains in the open air, its moisture will evaporate, causing the impression to shrink and distort.
Copyright 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Impression Making
Objective
To reproduce the oral structures with an acceptable accuracy

Tray selection
Need adhesive?
Perforated trayno Rim lockno but recommended Solid trayyes Size selected needs to cover teeth Extends posteriorly to include
Retromolar pad, hamular notch

Dispensing
Manufacturers directions Supply measuring tools
Powder has scoop Liquid has measuring cup

Need to fluff powder

Turn canister end-over-end a couple of times
Powder will pack tightly while shipping and ingredients will settle Will not mix correctly if ingredients are not evenly dispensed in alginate powder MAKE SURE YOU WEAR MASK

Mixing
Moderate large maxillary tray/arch
3 scoops of powder

Small maxillary tray/arch

2 scoops of powder

Most lower trays/arch

2 scoops

One unit of water per scoop of powder Room temperature water in one bowl Scoops of powder in another bowl Cold water will retard the set
Consider pt. sensitivity

Mixing
Warm water will accelerate the set Add powder to water Powder stirred into water so that powder is wet Mix against the sides of the bowl Aggressively mix
Creamy not grainy

Regular set
Mix for 45 seconds

Fast set
Mix for 30 seconds

Loading the tray

Pick up large amounts on spatula and force into the depth of the tray
Forces air out

Load quickly Alginate should be even to the sides of the tray Wet your gloved finger with water and smooth the surface of alginate and create shallow trough

Seating the tray

Wipe alginate on occlusal surfaces of teeth and place alginate up in the maxillary vestibule Regular set
2 minutes of working time 45 seconds of that is mixing time 1 minute and 15 seconds to manipulate

Fast set
Setting time 75 seconds(1.25 seconds-2minutes) 30 seconds for mixing 45 seconds to manipulate and seat tray

Seating the lower tray

Seat the lower impression
Stand in front of the patient

Use the tray to retract the pt.s left cheek Use a mirror/or gloved finger to retract the pt.s right cheek Seat the posterior first and then continue anteriorly with the seat

Seating the lower tray

as you move the tray anteriorly, have the patient lift up their tongue and then have them sit it down and extend it forward Stabilize the tray with your fingers to hold it in place You have to hold the tray in place

Seating the maxillary tray

Operator stands just behind the patient at 11 o clock Retract the right corner of cheek with tray and left corner with finger Rotate tray into position Seat posteriorly first and gently seat toward anterior
Allows alginate not to flow down the throat

Patient can be in supine position However, upright prevents gagging and alginate/saliva from going down the throat

Removing the tray

Check the alginate left in the mixing bowl for completeness of set Leave impression in the mouth for 2 minutes after the set
Patient gags, cannot do this

Use a finger at the side of the tray to apply pressure to break the seal while pulling the tray quickly away form the teeth with a snap Rinse with water Disinfect the impression

Evaluate the impression

Need to evaluate impression in case you have to re-do the impression Alginate will cover all areas of interest Will not have a grainy surface
Inadequate mixing

Minimal voids of trapped air Alginate seated in tray and not pulled free Free of debris

Acceptable Impression
All teeth and alveolar processes recorded Peripheral roll and frenums included No large voids and few small bubbles present Good reproduction of detail Free of debris No distortion Aglinate firmly attached to tray

Maxillary Criteria
Palatal vault Vestibule Hamular notch area included All teeth No holes

Mandibular arch
Retromolar areas included Lingual extensions recorded