types of impressions: previous final

Imprints, their classification, method of receipt. Classification of materials of

imprint. Clinical, physical and chemical descriptions of materials for imprint

• Impression is a negative (reverse) reflection of any organ of the dentomaxillar system: teeth, alveolar sprout or part, palate, nose,

• ear and others like that.

• Impression is a negative (reverse) reflection of hard and soft tissues, placed in the area of dental prosthesis and it’s borders which

• Is being taken by means of the special impression materials

Types of impressions:•Previous•Final

Final impressions:•Anatomical•Functional

Types ofTypes of impressionsimpressions

• Single layer

• Double layer

• Combined

Types ofTypes of impressionsimpressions• Anatomical

(orientation)– take with standard or individual tray in the state of calmness of tissues of prosthetic bed and tissues, which are placed on a border with them.

• Functional - take with individual tray by means of the special functional tests, in the case of making of removable constructions of dentures :

compression - in the case of pressing of buffer areas of prosthetic bed, by masticatory pressure or by the hand of doctor;

decompression - in the case of minimum pressure on the tissues of prosthetic bed

• Double layer – an exact reflection of gingival edge is taken by means of impression materials of the same group (previous layer + correction layer)

• Combined– is taken by means of impression materials of different groups (previous layer + correction layer)

• Occlusal–for taking impression in position of central occlusion

Impression traysImpression trays

• Standard: made factory- On maxillae different sizes- On mandible different sizes• Individual: made in dental

laboratory• By material:- plastic- metallic- waxen• Presence of retentin

points- perforated- unperforated

Impression trays for taking impression at the same time

Placing of impression tray in oral cavity

Impression of maxillae

Double layer impression

Impression Materials• Non-elastic• Elastic

– Aqueous hydrocolloids• Agar• Alginate

– Non-aqueous elastomers• Polysulfide• Silicones

– Condensation– Addition

• Polyether

Indications

• Diagnostic casts– preliminary– opposing

• Indirect reconstruction– fixed– removable

• Bite registration

Elastomeric Impression Materials

• Viscoelastic– physical properties vary

• rate of loading

• Rapidly remove– decreases permanent

deformation• chains recoil from a recoverable distance

– increases tear strength

Impr

essi

on

Mat

eria

ls

Non-elastic

Elastic

Aqueous Hydrocolloids

Non-aqueous Elastomers

Polysulfide

Silicones

Polyether

Condensation

Addition

Agar (reversible)

Alginate (irreversible)

Plaster

Compound

ZnO - Eugenol

Waxes

Aqueous Hydrocolloids• Colloidal suspensions

– chains align to form fibrils– traps water in interstices

• Two forms– sol

• viscous liquid

– gel• elastic solid

• Placed intra-orally as sol– converts to gel

• thermal or chemical process

Aqueous Hydrocolloids

• Semi-permeable membranes– poor dimensional stability

• Evaporation• Syneresis

– fibril cross linking continues• contracts with time• exudes water

• Imbibition– water absorption

• swells

Elastic

Aqueous Hydrocolloids

Non-aqueous Elastomers

Polysulfide

Silicones

Polyether

Condensation

Addition

Agar (reversible)

Alginate (irreversible)

Reversible Hydrocolloid (Agar)

• Indications– crown and bridge

• high accuracy

• Example– Slate Hydrocolloid (Van R)

Composition• Agar

– complex polysaccharide• seaweed

– gelling agent

• Borax– strength

• Potassium sulfate– improves gypsum

surface

• Water (85%)

agar hydrocolloid (hot) agar hydrocolloid (cold)

(sol) (gel)

cool to 43ºC

heat to 100ºC

Manipulation

• Gel in tubes– syringe and tray material

Manipulation• 3-chamber conditioning unit

– (1) liquefy at 100C for 10 minutes

• converts gel to sol

– (2) store at 65C– place in tray– (3) temper at 46C for 3 minutes– seat tray– cool with water at 13C for 3 minutes

• converts sol to gel

Advantages

• Dimensionally accurate• Hydrophilic

– displaces moisture, blood, fluids

• Inexpensive– after initial equipment

• No custom tray or adhesives• Pleasant flavor• No mixing required

Disadvantages

• Initial expense– special equipment

• Material must be prepared in advanced• Tears easily• Dimensionally unstable

– Must be poured immediately– Can only be used for a single cast

• Difficult to disinfect

Elastic

Aqueous Hydrocolloids

Non-aqueous Elastomers

Polysulfide

Silicones

Polyether

Condensation

Addition

Agar (reversible)

Alginate (irreversible)

Irreversible Hydrocolloid (Alginate)

• Most widely used impression material

• Indications– study models– removable fixed partial dentures

• framework

• Examples– Jeltrate (Dentsply/Caulk)– Coe Alginate (GC America)

Composition• Sodium alginate

– salt of alginic acid• mucous extraction of

seaweed (algae)

• Calcium sulfate– reactor

• Sodium phosphate– retarder

• Filler• Potassium fluoride

– improves gypsum surface

2 Na3PO4 + 3 CaSO4 Ca3(PO4)2 + 3 Na2SO4

Na alginate + CaSO4 Ca alginate + Na2SO4

(powder) (gel)

H2O

Manipulation

• Weigh powder• Powder added to water

– rubber bowl– vacuum mixer

• Mixed for 45 sec to 1 min• Place tray• Remove 2 to 3 minutes

– after gelation (loss of tackiness)

Advantages

• Inexpensive

• Easy to use

• Hydrophilic– displace moisture, blood, fluids

• Stock trays

Disadvantages

• Tears easily• Dimensionally unstable

– immediate pour – single cast

• Lower detail reproduction– unacceptable for fixed pros

• High permanent deformation• Difficult to disinfect

Non-Aqueous Elastomers

• Synthetic rubbers– mimic natural rubber

• scarce during World War II

• Large polymers– some chain lengthening– primarily cross-linking

• Viscosity classes– low, medium, high, putty– monophasic

Elastic

Aqueous Hydrocolloids

Non-aqueous Elastomers

Polysulfide

Silicones

Polyether

Condensation

Addition

Agar (reversible)

Alginate (irreversible)

Polysulfide

• First dental elastomers• Indications

– complete denture– removable fixed partial denture

• tissue

– crown and bridge

• Examples– Permlastic (Kerr)– Omni-Flex (GC America)

Composition• Base

– polysulfide polymers– fillers– plasticizers

• Catalyst– lead dioxide (or copper)– fillers

• By-product– water

--SH HS---------------------SH HS--

S H

O

=

Pb

=

O

O

=

Pb

=

OO = Pb = O

HS

-S-S---------------S-S-

S

S

+ 3PbO + H2O

mercaptan + lead dioxide polysulfide rubber + lead oxide + water

Polysulfide Reaction

Manipulation

• Adhesive to tray• Uniform layer

– custom tray

• Equal lengths of pastes• Mix thoroughly

– within one minute

• Setting time 8 – 12 minutes• Pour within 1 hour

Advantages

• Lower cost– compared to silicones and polyethers

• Long working time

• High tear strength

• High flexibility

• Good detail reproduction

Disadvantages• Poor dimensional stability

– water by-product– pour within one hour– single pour

• Custom trays• Messy

– paste-paste mix– bad odor– may stain clothing

• Long setting time

Elastic

Aqueous Hydrocolloids

Non-aqueous Elastomers

Polysulfide

Silicones

Polyether

Condensation

Addition

Agar (reversible)

Alginate (irreversible)

Condensation Silicone

• Indications– complete dentures– crown and bridge

• Examples– Speedex (Coltene/Whaledent)– Primasil (TISS Dental)

Composition

• Base– poly(dimethylsiloxane)– tetraethylorthosilicate– filler

• Catalyst– metal organic ester

• By-product– ethyl alcohol

Phillip’s 1996

HO – Si – O – Si - O - H

CH3

CH3 CH3

CH3 n

HO – Si – O – Si - O - H

CH3

CH3 CH3

CH3 n

C2H5O OC2H5

Si

C2H5O OC2H5

HO – Si – O – Si - O -

CH3

CH3 CH3

CH3 n

HO – Si – O – Si - O -

CH3

CH3 CH3

CH3 n

OC2H5

Si

OC2H5

+ 2C2H5OH

Condensation Silicone Reaction

metal organic ester

ethanol

Manipulation• Mix thoroughly

– paste - paste– paste - liquid

• Putty-wash technique– reduces effect of polymerization shrinkage– stock tray

• putty placed

• thin plastic sheet spacer

• preliminary impression– intraoral custom tray

• inject wash material

Advantages

• Better elastic properties

• Clean, pleasant

• Stock tray– putty-wash

• Good working and setting time

Disadvantages

• Poor dimensional stability– high shrinkage

• polymerization

• evaporation of ethanol

– pour immediately• within 30 minutes

• Hydrophobic– poor wettability

Elastic

Aqueous Hydrocolloids

Non-aqueous Elastomers

Polysulfide

Silicones

Polyether

Condensation

Addition

Agar (reversible)

Alginate (irreversible)

Addition Silicones• AKA: Vinyl polysiloxane• Indications

– crown and bridge– denture– bite registration

• Examples– Extrude (Kerr)– Express (3M/ESPE)– Aquasil (Dentsply Caulk)– Genie (Sultan Chemists)– Virtual (Ivoclar Vivadent)

Composition

• Improvement over condensation silicones– no by-product

• First paste– vinyl poly(dimethylsiloxane)

prepolymer

• Second paste– siloxane prepolymer

• Catalyst– chloroplatinic acid

Phillip’s 1996

O

H - Si – CH3

O

CH3 - Si - H

O

---O – Si – CH = CH2

CH3

CH3 CH = CH2 – Si – O ---

CH3

CH3

O

- Si – CH3

O

CH3 - Si -

O

---O – Si – CH2 - CH2

CH3

CH3

CH2 - CH2 – Si – O ---

CH3

CH3

Chloroplatinic Acid Catalyst

Addition Silicone Reaction

Manipulation

• Adhesive to tray

• Double mix– custom tray

• heavy-body

– light-body to prep

• Putty-wash– stock tray

Advantages

• Highly accurate

• High dimensional stability– pour up to one week

• Stock or custom trays

• Multiple casts

• Easy to mix

• Pleasant odor

Disadvantages• Expensive• Sulfur inhibits set

– latex gloves– ferric and Al sulfate

retraction solution

• Pumice teeth beforeimpressing

• Short working time• Lower tear strength• Possible hydrogen gas release

– bubbles on die– palladium added to absorb

Addition Silicones

• Surfactants added– reduce contact angle– improved

• castability– gypsum

• wettability– still need dry field clinically

Elastic

Aqueous Hydrocolloids

Non-aqueous Elastomers

Polysulfide

Silicones

Polyether

Condensation

Addition

Agar (reversible)

Alginate (irreversible)

Polyether

• Indications– crown and bridge– bite registration

• Examples– Impregum F (3M/ESPE)– Permadyne (3M/ESPE)– Pentamix (3M/ESPE)– P2 (Heraeus Kulzer)– Polygel (Dentsply Caulk)

• Base– difunctional epimine-terminated prepolymer– fillers– plasticizers

• Catalyst– aromatic sulfonic acid ester– fillers

• Cationic polymerization– ring opening and chain extension

Composition

SO3-

+ R+

CH3 – CH – CH2 – CO2 – CH – (CH2)n – O – CH – (CH2)n – CO2 –CH2 – CH –CH3

N

H2C CH2

R R

m

N

H2C CH2

N

H2C CH2

R – N – CH2 – CH2 – +N

H2C CH2

N

H2C CH2

R – + +

Polyether Reaction

catalyst

base

ring opening

Manipulation

• Adhesive to tray– stock or custom tray

• very stiff

• Paste-paste mix• Auto-mixing

– hand-held• low viscosity

– mechanical dispenser• high viscosity

Advantages

• Highly accurate• Good dimensional stability• Stock or dual-arch trays• Good surface detail• Pour within one week

– kept dry

• Multiple casts• Good wettability

Disadvantages• Expensive

• Short working time

• Rigid– difficult to remove from undercuts

• Bitter taste

• Low tear strength

• Absorbs water– changes dimension

Impression Material Usage*Civilian General Dentists

• Crown & Bridge– vinylpolysiloxane 81%– alginate 38%– polyether 28%

• Inlays and Onlays– vinylpolysiloxane 71%– polyether 22%– alginate 20%

Impression Material Usage*Civilian General Dentists

• Complete dentures– alginate 58%– vinylpolysiloxane 55%– polyether 27%

• Partial dentures– alginate 78%– vinylpolysiloxane 43%– polyether 15%

Handling Properties

Agar Alginate PolysulfideCondensation

SiliconeAddition Silicone

Polyether

PreparationBoil,

temper, store

Powder, water

2 pastes2 pastes or paste/liquid

2 pastes 2 pastes

Ease of Use Technique sensitive

Good Fair Fair Excellent Good

Patient Reaction

Thermal Shock

Pleasant, clean

Unpleasant, stains

Pleasant, clean

PleasantUnpleasant

clean

Ease of removal

Very easy

Very easy

Easy Moderate ModerateModerate to difficult

Disinfection Poor Poor Fair Fair Excellent Fair

Handling Properties

Agar Alginate PolysulfideCondensation

SiliconeAddition Silicone

Polyether

Working Time (min)

7 – 15 2.5 5 – 7 3 2 –4.5 2.5

Setting Time

(min)5 3.5 8 – 12 6 – 8 3 – 7 4.5

Stability 1 hour 100% RH

Immediate pour

1 hourImmediate

pour1 week

1 week kept dry

Wettability and

castabilityExcellent Excellent Fair Fair

Fair to good

Good

Cost Low Very low Low ModerateHigh to

very highVery high

Properties

Agar Alginate PolysulfideCondensation

SiliconeAddition Silicone

Polyether

Elastic Recovery (%)

98.8 97.3 94.5 – 96.9 98.2 – 99.6 99 – 99.9 98.3 – 99.0

Flexibility (%) 11 12 8.5 – 20.0 3.5 – 7.8 1.3 – 5.6 1.9 – 3.3

Flow (%) -- -- 0.4 – 1.9 < 0.10 < 0.05 < 0.05

Shrinkage, 24 hours (%)

Extreme Extreme 0.4 – 0.5 0.2 – 1.0 0.01 – 0.2 0.2 – 0.3

Tear Strength (g/cm)

700380 – 700

2240 – 7410 2280 – 43701640 – 5260

1700 - 4800

Comparison of Properties

• Working time– longest to shortest

• agar > polysulfide > silicones > alginate = polyether

• Setting time– shortest to longest

• alginate < polyether < agar < silicones < polysulfide

Comparison of Properties

• Stiffness– most to least

• polyether > addition silicone > condensation silicone > polysulfide = hydrocolloids

• Tear strength– greatest to least

• polysulfide > addition silicone > polyether > condensation silicone >> hydrocolloids

Comparison of Properties

• Cost– lowest to highest

• alginate < agar = polysulfide <condensation silicone < addition silicone < polyether

• Dimensional stability– best to worst

• addition silicone > polyether > polysulfide > condensation silicone > hydrocolloid

Phillip’s 1996

Comparison of Properties

• Wettability– best to worst

• hydrocolloids > polyether > hydrophilic addition silicone > polysulfide > hydrophobic addition silicone = condensation silicone

• Castability– best to worst

• hydrocolloids > hydrophilic addition silicone > polyether > polysulfide > hydrophobic addition silicone = condensation silicone

Regularly-Used Impression Materials*Civilian Practitioners

• Alginate 88%

• Polyvinyl Siloxane 85%

• Polyether 27%

• Other 6%

Summary

• Study models– Alginate most widely used

• inexpensive

• displaces moisture

• lower detail reproduction

• dimensionally unstable

Summary

• Prosthodontics– Addition silicones most popular

• accurate

• dimensionally stable

• user friendly

• expensive