Impression Materials 2

Impression Materials
6/9/2012
Dr Nabeel Safwat Al Nahass Prosthodontist and Implant Specialist
Official Disclaimer
The opinions expressed in this presentation are those of the author and do not necessarily reflect the official position of the US Air Force or the Department of Defense (DoD). Devices or materials appearing in this presentation are used as examples of currently available products/technologies and do not imply an endorsement by the author and/or the USAF/DoD.
6/9/2012 Dr Nabeel Safwat Al Nahass Prosthodontist and Implant Specialist 2
Impression Materials
Non-elastic Elastic
Aqueous hydrocolloids
Agar Alginate
Non-aqueous elastomers
Polysulfide Silicones
Condensation Addition
6/9/2012
Polyether
Indications
Diagnostic casts
preliminary opposing
Indirect reconstruction
fixed removable
Bite registration
6/9/2012 Dr Nabeel Safwat Al Nahass Prosthodontist and Implant Specialist 4 Giordano, Gen Dent 2000
Elastomeric Impression Materials

Viscoelastic
physical properties vary
rate of loading
Rapidly remove
decreases permanent deformation
chains recoil from a recoverable distance
increases tear strength

6/9/2012 Dr Nabeel Safwat Al Nahass 5 Phillips Science of Dental Materials 1996 Prosthodontist and Implant Specialist
Plaster Non-elastic Compound Waxes Impression Materials
ZnO - Eugenol
Aqueous Hydrocolloids Elastic
Agar (reversible) Alginate (irreversible) Polysulfide
Non-aqueous Elastomers
Condensation Addition
Silicones Polyether
6/9/2012
Dr Nabeel Safwat Al Nahass 6 OBrien, Dental Materials & their Selection 1997 Prosthodontist and Implant Specialist
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
6/9/2012
thermal or chemicalSafwat Al Nahass Dr Nabeel process
7 Phillips Science of Dental Materials 1996 Prosthodontist and Implant Specialist
Semi-permeable membranes
poor dimensional stability
Evaporation Syneresis
fibril cross linking continues
contracts with time exudes water
Imbibition
water absorption
swells
Agar (reversible)
Elastic
Alginate (irreversible)
Polysulfide Condensation
Silicones Addition Polyether
6/9/2012
Reversible Hydrocolloid (Agar)

Indications
crown and bridge
high accuracy
Example
Slate Hydrocolloid (Van R)
6/9/2012
10
Composition
Agar
complex polysaccharide
seaweed
Potassium sulfate
improves gypsum surface
gelling agent
Borax
strength
Water (85%)
cool to 43C
agar hydrocolloid (hot)

(sol)
6/9/2012
agar hydrocolloid (cold)

(gel)
heat to 100C
Manipulation
Gel in tubes
syringe and tray material
6/9/2012
12
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
6/9/2012
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
Agar (reversible)
Elastic
6/9/2012
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)
Sodium phosphate
retarder
Calcium sulfate
reactor
Filler Potassium fluoride

improves gypsum surface
2 Na3PO4 + 3 CaSO4 Na alginate + CaSO4

(powder)
6/9/2012
Ca3(PO4)2 + 3 Na2SO4
H2O
Ca alginate + Na2SO4
(gel)
Dr Nabeel Safwat Al Nahass 18 Prosthodontist and Implant Specialist OBrien Dental Materials & their Selection 1997
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)
6/9/2012 Dr Nabeel Safwat Al Nahass Prosthodontist and Implant Specialist 19 Caswell JADA 1986
Advantages
Inexpensive Easy to use Hydrophilic
displace moisture, blood, fluids
Stock trays
6/9/2012
Dr Nabeel Safwat Al Nahass 20 Prosthodontist and Implant Specialist Phillips Science of Dental Materials 1996
Disadvantages
Tears easily Dimensionally unstable
immediate pour single cast
Lower detail reproduction

unacceptable for fixed pros
High permanent deformation Difficult to disinfect

6/9/2012 Dr Nabeel Safwat Al Nahass 21 Prosthodontist and Implant Specialist Phillips Science of Dental Materials 1996
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
Agar (reversible)
Elastic
6/9/2012
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 6/9/2012
Polysulfide Reaction
--SH O = Pb = O H S mercaptan + lead dioxide polysulfide rubber + lead oxide + water S H O = Pb = O HS---------------------SH O Pb = O = S + 3PbO + H O 2 S HS--S-S---------------S-S-
6/9/2012
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
6/9/2012
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

Agar (reversible)
Elastic
6/9/2012
Condensation Silicone
Indications
complete dentures crown and bridge
Examples
Speedex (Coltene/Whaledent) Primasil (TISS Dental)
6/9/2012
31
Composition
Base
poly(dimethylsiloxane) tetraethylorthosilicate filler
Catalyst
metal organic ester
By-product
ethyl alcohol
6/9/2012 Phillips 1996 Dr Nabeel Safwat Al Nahass 32 Prosthodontist and Implant Specialist Phillips Science of Dental Materials 1996
CH3
CH3 C2H5O OC2H5
Condensation Silicone Reaction
HO Si O Si - O - H CH3 CH3 CH3 CH3 n
Si
HO Si O Si - O - H CH3 CH3 n
C2H5O
OC2H5
metal organic ester CH3 CH3 OC2H5 n
HO Si O Si - O CH3 CH3 CH3 CH3
Si
+ 2C2H5OH
ethanol
HO Si O Si - O 6/9/2012
OC2H5 nDr Nabeel Safwat Al Nahass

33
CH3
CH3
Prosthodontist and Implant Specialist Phillips Science of Dental Materials 1996
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
6/9/2012
inject wash material Safwat Al Nahass Dr Nabeel

Prosthodontist and Implant Specialist
34
Advantages
Better elastic properties Clean, pleasant Stock tray
putty-wash
Good working and setting time
6/9/2012
Disadvantages
Poor dimensional stability
high shrinkage
polymerization evaporation of ethanol
pour immediately
within 30 minutes
Hydrophobic
poor wettability
Agar (reversible)
Elastic
6/9/2012
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)
Prosthodontist and Implant Specialist Dr Nabeel Safwat Al Nahass 38 Click here for DIS evaluations of VPS impression materials
6/9/2012
Composition
Improvement over condensation silicones
no by-product
First paste
vinyl poly(dimethylsiloxane) prepolymer
Second paste
siloxane prepolymer
Catalyst
chloroplatinic acid
6/9/2012 Phillips 1996 Dr Nabeel Safwat Al Nahass 39 Prosthodontist and Implant Specialist Phillips Science of Dental Materials 1996
CH3
---O Si CH = CH2
O
H - Si CH3 O CH3 CH = CH2 Si O ---
Addition Silicone Reaction

CH3
CH3
CH3 - Si - H
O
CH3
Chloroplatinic Acid Catalyst
---O Si CH2 - CH2 - Si CH3 CH3 O CH3
CH3 - Si - CH2 - CH2 Si O --O

6/9/2012
CH3
Manipulation
Adhesive to tray Double mix
custom tray
heavy-body
light-body to prep
Putty-wash
stock tray
6/9/2012
41 Craig Adv Dent Res 1988
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 before impressing Short working time Lower tear strength Possible hydrogen gas release
bubbles on die palladium added to absorb
6/9/2012 Dr Nabeel Safwat Al Nahass Prosthodontist and Implant Specialist 43 Manikos Aust Dent J 1998
Addition Silicones
Surfactants added
reduce contact angle improved
castability
gypsum
wettability??
still need dry field clinically
6/9/2012
44 Pratten J Dent Res 1987 Mandikos Aust Dent J 1998
Agar (reversible)
Elastic
6/9/2012
Polyether
Indications
crown and bridge bite registration
Examples
Impregum F (3M/ESPE) Permadyne (3M/ESPE) Pentamix (3M/ESPE) P2 (Heraeus Kulzer) Polygel (Dentsply Caulk)
Dr Nabeel Safwat Al Nahass Prosthodontist and Implant Specialist 46
6/9/2012
Composition
Base
difunctional epimine-terminated prepolymer fillers plasticizers
Catalyst
aromatic sulfonic acid ester fillers
Cationic polymerization
ring opening and chain extension
Polyether Reaction
R R base
CH3 CH CH2 CO2 CH (CH2)n O CH (CH2)n CO2 CH2 CH CH3 m

N H2C CH2 + R+ catalyst SO3H2C N CH2
R N+
6/9/2012
+
CH2 H2C
N CH2
R N CH2 CH2 N + H2C CH2

48
H2C
ring opening Dr Nabeel Safwat Al Nahass
Prosthodontist and Implant Specialist Phillips Science of Dental Materials 1996
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 alginate polyether 81% 38% 28% 71% 22% 20%
DPR 2001 52
Inlays and Onlays

vinylpolysiloxane polyether alginate
*Multiple 6/9/2012 responses
Impression Material Usage*

Civilian General Dentists
Complete dentures
alginate vinylpolysiloxane polyether 58% 55% 27% 78% 43% 15%
DPR 2002 53
Partial dentures
alginate vinylpolysiloxane polyether
*Multiple 6/9/2012 responses
Handling Properties
Agar
Preparation
Boil, temper, store
Technique sensitive
Alginate Polysulfide
Powder, water
Condensation Silicone 2 pastes or paste/liquid
Addition Silicone
Polyether
2 pastes
2 pastes
2 pastes
Ease of Use
Patient Reaction Ease of removal
Good
Pleasant, clean Very easy
Fair
Unpleasant, stains Easy
Fair
Pleasant, clean Moderate
Excellent
Good
Unpleasant clean Moderate to difficult
Thermal Shock Very easy
Pleasant
Moderate
Disinfection
6/9/2012
Poor
Poor
Fair
Fair
Excellent
Fair
Handling Properties
Agar
Working Time (min) Setting Time (min) 7 15 5 1 hour
100% RH
Alginate
2.5 3.5 Immediate pour Excellent
Polysulfide
57 8 12
Condensation Addition Silicone Silicone 3 68 Immediate pour Fair 2 4.5 37
Polyether
2.5 4.5 1 week kept dry Good
Stability Wettability and castability

Cost
6/9/2012
1 hour
1 week
Fair to good
Excellent
Fair
Low
Very low
Low
Moderate
High to very high
Very high
Properties
Agar
Elastic Recovery (%) Flexibility (%) Flow (%) Shrinkage, 24 hours (%) Tear Strength (g/cm) 98.8 11
--
Alginate Polysulfide
97.3 12 -Extreme
Condensation Silicone 98.2 99.6 3.5 7.8 < 0.10 0.2 1.0 2280 4370
Addition Silicone 99 99.9 1.3 5.6 < 0.05 0.01 0.2 1640 5260
Polyether
98.3 99.0 1.9 3.3 < 0.05 0.2 0.3 1700 4800
94.5 96.9 8.5 20.0 0.4 1.9 0.4 0.5 2240 7410
Extreme
700
380 700
6/9/2012
Comparison of Properties
Working time
longest to shortest
agar > polysulfide > silicones > alginate = polyether
Setting time
shortest to longest
alginate < polyether < agar < silicones < polysulfide
6/9/2012
Stiffness
most to least
polyether > addition silicone > condensation silicone > polysulfide = hydrocolloids
Tear strength
greatest to least
polysulfide > addition silicone > polyether > condensation silicone >> hydrocolloids
6/9/2012 Dr Nabeel Safwat Al Nahass 58 Prosthodontist and Implant Specialist OBrien Dental Materials & their Selection 1997
Cost
lowest to highest
alginate < agar = polysulfide <condensation silicone < addition silicone < polyether
Dimensional stability
best to worst
addition silicone > polyether > polysulfide > condensation silicone > hydrocolloid
Phillips 1996 6/9/2012 Dr Nabeel Safwat Al Nahass 59 Prosthodontist and Implant Specialist OBrien Dental Materials & their Selection 1997
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
6/9/2012 Dr Nabeel Safwat Al Nahass 60 Prosthodontist and Implant Specialist OBrien Dental Mateials & their Selection 1997
Regularly-Used Impression Materials*

Civilian Practitioners
Alginate Polyvinyl Siloxane Polyether Other
88% 85% 27% 6%
*Multiple Responses
6/9/2012 Dr Nabeel Safwat Al Nahass Prosthodontist and Implant Specialist
DPR 2005
61
Summary
Study models
Alginate most widely used
inexpensive displaces moisture lower detail reproduction dimensionally unstable
6/9/2012
62
Summary
Prosthodontics
Addition silicones most popular
accurate dimensionally stable user friendly expensive
6/9/2012
63
THANK YOU
6/9/2012
64

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Impression Materials 2

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Impression Materials

Dr Nabeel Safwat Al Nahass Prosthodontist and Implant Specialist

Dr Nabeel Safwat Al Nahass Prosthodontist and Implant Specialist

Elastomeric Impression Materials

increases tear strength

Plaster Non-elastic Compound Waxes Impression Materials

Aqueous Hydrocolloids Elastic

Agar (reversible) Alginate (irreversible) Polysulfide

Placed intra-orally as sol

thermal or chemicalSafwat Al Nahass Dr Nabeel process

7 Phillips Science of Dental Materials 1996 Prosthodontist and Implant Specialist

Silicones Addition Polyether

Reversible Hydrocolloid (Agar)

Dr Nabeel Safwat Al Nahass Prosthodontist and Implant Specialist

agar hydrocolloid (hot)

agar hydrocolloid (cold)

Dr Nabeel Safwat Al Nahass Prosthodontist and Implant Specialist

No custom tray or adhesives Pleasant flavor No mixing required

Material must be prepared in advanced Tears easily Dimensionally unstable

Silicones Addition Polyether

Irreversible Hydrocolloid (Alginate)

Filler Potassium fluoride

2 Na3PO4 + 3 CaSO4 Na alginate + CaSO4

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

Lower detail reproduction

High permanent deformation Difficult to disinfect

Silicones Addition Polyether

crown and bridge

Equal lengths of pastes Mix thoroughly

Setting time 8 12 minutes Pour within 1 hour

Custom trays Messy

Long setting time

Silicones Addition Polyether

Dr Nabeel Safwat Al Nahass Prosthodontist and Implant Specialist

CH3 C2H5O OC2H5

Condensation Silicone Reaction

HO Si O Si - O - H CH3 CH3 CH3 CH3 n

metal organic ester CH3 CH3 OC2H5 n

HO Si O Si - O CH3 CH3 CH3 CH3

OC2H5 nDr Nabeel Safwat Al Nahass

Prosthodontist and Implant Specialist Phillips Science of Dental Materials 1996

inject wash material Safwat Al Nahass Dr Nabeel

Good working and setting time

Silicones Addition Polyether

Addition Silicone Reaction

Chloroplatinic Acid Catalyst

---O Si CH2 - CH2 - Si CH3 CH3 O CH3

CH3 - Si - CH2 - CH2 Si O --O

Dr Nabeel Safwat Al Nahass Prosthodontist and Implant Specialist

41 Craig Adv Dent Res 1988

Stock or custom trays Multiple casts Easy to mix Pleasant odor

Dr Nabeel Safwat Al Nahass Prosthodontist and Implant Specialist

44 Pratten J Dent Res 1987 Mandikos Aust Dent J 1998

Silicones Addition Polyether

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

R N CH2 CH2 N + H2C CH2

ring opening Dr Nabeel Safwat Al Nahass

Prosthodontist and Implant Specialist Phillips Science of Dental Materials 1996

Paste-paste mix Auto-mixing

Multiple casts Good wettability

Bitter taste Low tear strength Absorbs water

Impression Material Usage*

Crown & Bridge