Fixed partial dentures

A wash technique using rubber-base

impression material

Alexander A. Calomeni, lieutenant Colonel, USAF (DC)*

Wilford Hall USAF Hospital, Aerospace Medical Division (AFSC), Lackland
AFB, Texas

R epairing faulty impressions by covering them with a thin wash of new material
is not recommended by some dentists.l, 2 However, others have reported that a
wash technique is accurate if adequate spillways are provided in the preliminary
impression to prevent rebound and the wash material from setting under pressure.3
This article describes a simplified wash technique that permits making accurate,
sharply detailed rubber-base impressions for fixed partial dentures and crown and
inlay restorations.

MAKING THE PRELIMINARY IMPRESSION

Diagnostic casts are made using alginate (irreversible hydrocolloid) impression
material, and a preliminary treatment plan is developed. A tray of autopolymerizing
(cold-curing) acrylic resin is constructed on the diagnostic cast (Fig. 1).
The tray is made using a 3 to 4 mm. spacer of wet asbestos or wax on the cast
instead of the usual 2 mm. spacer. The extra space in the tray makes it possible to
cut escapeways for the flow of injection rubber-base material used in making the final
impression. Stops are provided on the occlusal surfaces of teeth not involved in the
restorations. The tray must be rigid and thick enough to prevent distortion or bend-
ing and have a strong handle to facilitate removal of the impression from the mouth.
The tray is tried in the mouth and adjusted to avoid impingement on the soft
tissues. Then, the tray is thoroughly dried, and rubber-base adhesive is applied to
the inside surface and allowed to dry for 10 minutes.
The preliminary impression is made using regular or heavy-bodied rubber-base
impression material in the customized acrylic resin tray before preparing the teeth
(Fig. 2). The gingival tissues are not retracted at this time. The final impression will
be made after temporary acrylic resin restorations have been constructed and the
teeth prepared.

The views expressed are those of the author and do not necessarily reflect the views of the
United States Air Force or the Department of Defense.
*Chief, Prosthodontics Service, Base Dental Department, Directorate of Dental Services.

520
 Wash technique 521

Fig. 1. An individualized acrylic resin impression tray is made with a strong rigid handle.
Fig. 2. The preliminary rubber-base impression contains thin “flash” in embrasures that mubt
b,s trimmed away.

Fig. 3. Cold-curing tooth-colored acrylic resin temporary crowns for the prepared teeth are
fo.pmed in the preliminary rubber-base impression.
Fig. 4. The acrylic resin temporary restorations are in place on the abutment teeth in the
mouth.

CONSTRUCTING TEMPORARY RESTORATIONS

After the teeth have been prepared, the preliminary rubber-base impression is
&o used for constructing temporary acrylic resin restorations.
Cold-curing tooth-colored acrylic resin* is placed in the involved part of the
prlzliminary impression and it is replaced in the mouth firmly for 3 minutes (Fig.
3). The impression is removed from the mouth, and the soft, pliable acrylic resin
temporary crowns are taken out of the impression. The excess material is removed
and the temporary restorations arc replaced on the abutment teeth in the mouth
(Fig. 4) .
The pontic for the temporary fixed restoration is constructed using an acrylic

“Neopar, Minner Dental Products, Inc., Emeryville, Calif.

 522 Calomeni J. Prosth. Dent.
May, 1971

Fig. 5 6

Fig. 5. The preliminary impression is prepared by cutting away and removing flash and ex-
cess impression material from the embrasures. Overhanging borders of the rubber impression
are reduced to eliminate soft tissue undercut areas.
Fig. 6. Light-bodied rubber-base impression material is applied to the preliminary impres-
sion. None of the light-bodied material is placed in the regions of the prepared teeth.
Fig. 7. The final impression made with the light-bodied rubber-base materials provides ex-
cellent detail.

resin artificial tooth of the appropriate size and color. The tooth is adjusted to fit the
edentulous space directly in the patient’s mouth while the temporary acrylic resin
restorations are in place on the abutment teeth. Soft, red counter wax is placed on
the tissue side to hold the tooth in place while cold-curing acrylic resin is added to
attach the denture tooth to the temporary abutment restorations.
After the resin has set, the occlusion is adjusted and the temporary restoration is
carefully removed from the mouth. The temporary restoration is cemented using a
zinc oxide and eugenol cement.*

MAKING THE WASH USING RUBBER-BASE IMPRESSION MATERIAL

The preliminary impression must be prepared and adjusted to receive the wash
material. An injection-type, light-bodied, rubber-base material is used for the wash.
All thin tags and the flash of rubber-base material from inside the impression are

l Moyco, J. Bird Moyer Company, Inc., Philadelphia, Pa.

 Wash technique 523

cut away with small delicate scissors. The impression material that has filled the
embrasures also must be removed. Thin flash is removed with a long, straight hemo-
stat. The thin flash in the subgingival crevices must be trimmed away.
The borders of the preliminary rubber-base impression are reduced until the rim
of the impression tray is exposed. In this manner, soft tissue undercuts are removed
and escapeways are provided for the light-bodied impression material which is to
be used. V-shaped spillways are cut in the impression tray as a further safeguard
against excess pressure and for use as escapeways (Fig. 5).
The prepared preliminary impression is tried in the mouth to ensure that it seats
completely and easily without impinging on soft tissues. Then the impression is dried
completely, and a small amount of rubber base adhesive is applied to the exposed
rim of the tray.
A cord impregnated with 8: 100 racemic epinephrine” is placed in the gingival
crevices of the prepared teeth. Air blasts and excessive drying of the teeth should be
avoided.
While the retraction cord remains in place (3 to 5 minutes), the light-bodied
rubber-base impression material is mixed for application to the prepared teeth with
.a syringe and for application to the preliminary impression except in the region cor-
responding to the prepared teeth. The slow setting time of the light-bodied material
.allows more than enough time for mixing and applying it. Ten minutes should be
.allowed for the impression material to reach its complete set?
A thin layer of the light-bodied rubber-base material is applied to the preliminary
impression with a small blade cement spatula. None of the light-bodied material is
:placed in the regions of the prepared teeth (Fig. 6).
The cotton rolls and retraction cord are removed, and the light-bodied material
::s injected in a continuous flow until a11prepared teeth are covered.
The impression tray is seated with a firm, smooth, constant pressure, and held
::n place to prevent movement until the material sets. After the material has set com-
pletely, the impression is removed (Fig. 7) . A 4 by 4 inch gauze pad is useful for
grasping the handle of the tray in order to prevent slippage.

ADVANTAGES OF THE WASH TECHNIQUE

1. More detail is possible with this technique, not only in the regions of the pre-
pared teeth, but throughout the impression.
2. The occurrence of voids in critical parts of the impression is prevented.
3. Adequate working time is available for making the impression.
4. Minimal retraction of gingival tissues is required.
5. Only the usual rubber-base impression materials and equipment are necessary.
6. The preliminary rubber-base impression can be used in the construction of the
temporary acrylic resin restorations and gives better results than irreversible hydro-
colloid impression materials.
7. A uniform layer of impression material is present in the final impression with
polymerization occurring at a uniform rate. The final restoration reflects the accu-
racy of the technique (Fig. 8).

“Orostat, Surgident, Ltd., Los Angeles, Calif.

524 Calomeni J. Prosth.Dent.
May, 1971

Fig. 8. The finished restoration is in place in the mouth.

SUMMARY
The rubber-base impression materials are versatile and extremely accurate when
the procedures are sound. A simplified technique using a preliminary impression
of heavy-bodied material and a final wash impression of light-bodied, rubber-base
impression material has been described. This technique reduces considerably the oc-
currence of voids or defects in the impression and gives good detail. In addition, the
preliminary rubber-base impression can be used to construct temporary acrylic resin
restorations.

References
1. Skinner, E. W., and Cooper, E. N.: Desirable Properties and Use of Rubber Impression
Materials, J. Amer. Dent. Ass. 51: 523-536, 1955.
2. Ewing, J. E.: Fixed Partial Prosthesis, ed. 2, Philadelphia, 1959, Lea & Febiger, Pub-
lishers, p. 158.
3. Myers, G. E., and Stockman, D. G.: Factors That Affect the Accuracy and Dimensional
Stability of the Mercaptan Rubber-Base Impression Material, J. PROSTH. DENT. 10: 525-
535, 1960.
4. Johnston, J. F., Phillips, R. W., and Dykema, R. W.: Modern Practice in Crown and
Bridge Prosthodontics, ed. 2, Philadelphia, 1965, W. B. Saunders Company, pp. 165-166.

6234 WAR LODGE DR.

SAN ANTONIO, TEXAS 78238