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The function of an impression material is to make a ve copy, which records the dimensions of the oral tissue and their relationships. The impression must be accurate so that the model, cast, or die will be accurate.

Initial requirement of an impression material


Must be a semi-liquid material that will flow and adapt itself around the structure of interest. It must set and harden into a solid that is rigid enough to be removed from the mouth without becoming deformed.

Other characteristics of an impression material


Copy details accurately Dimensional stability after removal from the mouth Appropriate working time and setting time Bio-compatibility

Impression trays
Trays need to be rigid enough to support impression material. For impression material to be retained in tray, tray maybe perforated, and adhesive spray can be used to enhance retention.

Study model a physical model of the oral tissue for study. Used in diagnosis and treatment planning. Cast a model requiring very exact replication of size and shape Die replica of a single tooth (cut from a cast)

Classification of dental impression materials


Inelastic / Elastic Mechanism of hardening Thermal behavior

Impression material (rigid)


Inelastic materials
Impression compounds Dental compounds

Setting mechanism
Cooling to mouth temperature

Zinc-oxide eugenol (ZOE) Chemical reaction Impression plaster Chemical reaction

Impression materials (aqueous)


Elastic material (hydro-colloid) Reversible (Agar) Irreversible (Alginate) Setting mechanism Cooling Chemical reaction

Impression materials (rubber)


Elastic material (non- Setting mechanism aqueous) Polysulfides Polymerization reaction Condensation silicon Polymerization reaction Polyether Addition silicon Polymerization reaction Polymerization reaction
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Hydrocolloids
The colloid state represents a highly dispersed phase of fine particles within another phase, some where between solution and a suspension. The colloid can exist as a viscous liquid known as a sol or a solid known as gel. If the particles are suspended in water, the suspension is called a hydrocolloid (hydrosol, hydrogel Hydrocolloids come in two forms:
Reversible agar Irreversible alginate

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Composition of Agar
Material Agar (seaweed extract) Potassium sulfate Borax Alkyl benzoate water Percentage purpose 12-15% 1% 0.2% 0.1% 85% Colloidal particles as basis of the gel Ensures set of gypsum materials Strengthens gel Antifungal agent Dispersing medium for the colloidal suspension
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Properties
Flows well Accurate reproduction , however, the impression need to be poured immediately or stored in 100% humidity. Distortion is more likely to occur if impression not poured within an hour.

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Tear strength is not high. If compressed it might rebound if compression is not too sever otherwise deformation occurs. Material suffers from loss or gain of water: Syneresis: a process by which the gel contracts and some of the liquid is squeezed out, forming an exudate on the surface. Evaporation: loss of water which causes the material to shrink, and impression is distorted. Imbibition: uptake of water, this will swell and distort the impression.

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Clinical application
Agar is supplied in two viscosities, thick and thin (depending on the amount of agar).

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Alginate
Inexpensive Easy to manipulate Requires no special equipment Reasonably accurate Diagnostic cast (study model) Preliminary impression for complete denture Partial denture framework Custom trays for fluoride or bleaching

Common uses:

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Composition/setting rxn/ working time


Material Na, K alginate Ca sulfate dihydrate Potassium sulfate Trisodium sulfate Diatomaceous earth Percentage purpose 15-20% 14-20% 10% 2% 55-60% Basis of the gel Creates irreversible gel with alginate ensures set of gypsum Retarder to control setting Filler to increase thickness and strength

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Setting rxn/working time


Setting rxn occurs when the powder is mixed with water: Ca sulfate dihydrate + NaAlginate Ca alginate
Working time: total time from start of mixing to the final time at which an impression tray can be fully seated without distortion Regular set: 2-3 minutes Fast-set: 1.25-2 minutes Setting time: elapsed time from the start of mixing until impression material becomes firm enough to resist permanent deformation. Regular set: 2-5 minutes, Fast set: 1-2 minutes

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Setting rxn/working time


Controlling water temperature shortens or lengthens setting time Changing P:L has adverse effect on materials property and strength Allow extra 1-2 minutes, tear strength increases, and rebound from undercuts w/out deformation improves
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Important considerations to ensure accurate impression


2-4 mm bulk material in tray Snap action removal from mouth Stored in a moist environment to avoid loss of water and deformation

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Impression making

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Examples of packaging for alginate.

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Scoop and water measure for alginate.

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An alginate impression

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Troubleshooting alginate impression


Premature set Slow set Voids Distortion Excess alginate at back of tray *cause & solution*

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Criteria for acceptable alginate impression


All teeth and relevant soft tissue recorded No large voids Free of debris No distortion Etc etc etc (refer to text book)

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Elastomers
Often called rubber materials since they have properties similar to rubber. Clinical uses:
Bridges Implants Partial dentures complete dentures Indirect esthetic restorations

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Polymerization reaction
Involves formation of long-chain polymers and cross-linking of chains General properties:
Not as sensitive to water as hydrocolloids Have a certain amount of rebound, the highest is for addition silicon and polyethers, medium for condensation silicon and poorest for Polysulfides Not wet well by water (hydrophobic) possible solution: surfactants

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Polysulfides

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Dispensing & Composition


Supplied in two tubes as base and catalyst, equal lengths are mixed. Light, regular, heavy viscosities Chemical composition of base: 80% low-molecular-weight organic polymer containing mercaptan reactive groups (-SH), and 20% reinforcing agents: titanium dioxide, silica, zinc sulfide Chemical composition of catalyst: Lead dioxide or copper hydroxide

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Setting reaction
Mercaptan + lead dioxide polysulfide+H2O

The reaction is sensitive to temperature and moisture so increase in any will accelerate the setting. Also sensitive to correct mixing ratio

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Manipulation and dispensing

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Uses
Crown and bridge impressions Partial and complete denture impressions Clinical considerations when used Used with custom trays Allow 2mm thickness Use tray adhesive Dry field

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Properties of clinical interest


Setting time: 8-14 minutes Higher tear strength than hydrocolloids Accuracy improves if impression is poured within 30 minutes very unpleasant taste and odor Messy (orange solvent to remove stains) Can be irritant to oral mucosa For all these reasons, Polysulfides have been largely replaced by other rubber materials

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Silicon rubber

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Classification according to polymerization rxn

Condensation silicon

Addition silicon

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Condensation silicon
Developed as alternative to Polysulfides Has more desirable qualities in comparison:
Easy mix Better taste and odorless Shorter setting time (5-7 minutes)

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Dispensing & Composition


Two pastes, base and catalyst. Comes as light, medium, or heavy viscosity Base: dimethylsiloxane + filler (silica) Catalyst: suspension of stannous octoate + alkyl silicate

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Setting rxn
Condensation reaction that produces ethyl alcohol as by product. The alcohol evaporates which causes dimensional instability. The material continues to contract with time, so needs to be poured within minutes.

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Addition silicon (PVS)


Desirable clinical qualities:
Dimensional stability Accuracy Clean Easy to mix No foul odor or taste

However, they are among the most expensive

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Dispensing & composition


Light, regular and heavy viscosities and also putty Dispensed as cartridge with 2 chambers (pastes), or two putty- system Base: low-molecular-weight silicon with vinyl groups (paste system), or lowmolecular-weight silicon with silane hydrogens (putty) + silica filler Catalyst: chloroplatinic acid

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Setting rxn
Polymerization rxn of chain lengthening and cross-linking with reactive vinyl groups, producing a stable silicon rubber. No ethyl-alcohol by product Some addition silicons produce hydrogen as by product, manufacturers incorporated palladium powder that absorbs hydrogen setting time: 3-7 minutes

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Impression making techniques


Putty/wash technique
One step Two step

Pros and cons for each technique and possible solution

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Clinical use
Crown and bridge work Bite registration

(rapid setting 1-2 minutes)

Indirect composite inlays (silicon die


technique)

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Polyethers
Also used for crown and bridge work since they are very accurate and also more hydrophilic than other silicons

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Dispensing & composition


Dispensing same as other rubber materials (2 tubes) In addition its supplied in pouches of base and catalyst placed in mechanical mixer. Base: low- molecular-weight polyether with cation reactive group Catalyst: aromatic sulfonic acid *clinical tip: mix well to avoid irritation from unmixed catalyst.

Composition:

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Properties
Stiff, difficult to remove from undercuts Short working and setting times Setting time 3-5 minutes Sensitive to moisture and temperature More hydrophilic (must not be stored in water or disinfectant) accurate

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Inelastic impression materials


Impression compound: softens with heat, hardens in the mouth. Cakes (sheets) and sticks Clinical uses: Sheets:

Sticks are used for border molding

Primary impression in metal trays To make custom trays

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Composition & properties


Thermoplastic resin and waxes Fillers to reduce flow Plasticizers Organic acids or oils Pigments Softened at 60C, remains plastic at 45C, firm at 37C Heated in water not by flame Should be poured ASAP to avoid distortion

Properties

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Other impression materials


Impression plaster: seldom used
Composed of plaster gypsum (Ca hemihydrae) Used for primary impression (high P:L) Scored with a knife in the mouth then removed and reassembled in the lab (distortion?) Wash impression Easy to use inexpensive

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ZNO eugenol
Secondary impression for complete dentures, or wash impression (mucostatic impression) 2 tube paste system, different colors Zinc oxide (80%) and fillers, eugenol (15%) with oils, resin, fillers. In addition to chemical accelerator (zinc acetate) Dispensed in 2 equal lengths and mixed to Initial set:3-6 minutes, final set:10 minutes To accelerate the setting?

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Properties
Brittle, so not suitable for areas with undercut Flows readily Accurate Eugenol can be irritant (burning sensation) Once set, dimensionally stable

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Impression wax
Clinical uses:
Preliminary impression for edentulous patients Bite registration Baseplate wax used to be used for provisional crown and bridge work Melted to correct voids in gypsum casts

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Disinfection of impressions
The disinfectant should be compatible with the impression materials. After taking the impression, it should be rinsed with water, excess water shaken off, and disinfectant sprayed (2 disadvantages?) or impression immersed in disinfectant Protective gloves should be worn Rinse after disinfection is complete
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Disinfecting casts
Maybe necessary if impression was not properly disinfected, or if immersion of impression adversely affects the impression Casts should be set and stored for 24 hours before disinfection. Solution used: Na hypochlorite, iodophors.

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Sterilizing trays
Trays should be properly sterilized before use Disposable trays are recommended if appropriate Sterilization can be achieved by heated steam, dry heat, chemical vapors

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Reference: dental materials, clinical applications for dental assistants and dental hygienists

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