Chapter 17: IMPRESSIONS • Can result to syneresis and imbibition (absorb water)

Impressions • The sooner it is poured, the less distortion there will

• imprint or negative likeness be in the resulting cast.
Cast
• positive reproduction ideal conditioner for preparing hydrocolloid for use has
Requirements: three baths:
• should be an exact duplication of the prepared tooth 1. Liquefying bath
• Other teeth and tissue adjacent to the prepared tooth ✓ 10 mins boiled in 212-degree F
must be accurately reproduced to permit proper 2. Storage bath
articulation of the cast and contouring of the ✓ 10 mins minimum in 150-degree F
restoration 3. Tempering bath.
• Free of bubbles ✓ 10 mins in 110–115-degree F
✓ Tray remains for no less than 3 mins
COMPARISON OF IMPRESSION MATERIALS
• choice is based on personal preference, ease of
manipulation, and, to some extent, economics
Wettability
• classification
a) (hydrophilic)
✓ Irreversible hydrocolloid (alginate)
✓ reversible hydrocolloid
✓ polyether
b) (hydrophobic)
✓ PVS materials
Laminate Technique
✓ condensation-reaction silicones
• A technique combining reversible and irreversible
hydrocolloid
***The greater the contact angle, the greater the probability
of air entrapment during pouring. • Advantage:
✓ requiring less complicated (and less
Viscosity expensive) equipment for liquefaction and
storage
• Least viscous
✓ sufficient accuracy for clinical use
✓ Light-body polysulfide
✓ bond strength
✓ Condensation silicone
• disadvantage:
• Most viscous
✓ fast gelation time
✓ Heavy-body polysulfide
• Shear thinning
Impression making with reversible hydrocolloid
✓ Low viscous when shear rate increases
• two impressions are made:
• Thixotropic
1) sectional (quadrant) impression
✓ becoming more fluid when the shear rate is
✓ for making a die
increased by deforming or disturbing it (eg,
2) full-arch impression
shaking, spatulating, or injecting through a
✓ for the working cast
syringe)
• Adhesive plastic strips (Tacky Stops)
✓ placed into the tray to keep the teeth from
Cost
pushing all the way through to the tray
• pvs is the expensive

Reversible Hydrocolloid
• agar
✓ polysaccharide from seaweed
✓ sodium tetraborate – increases strength and
viscosity of sol.
✓ Retarder – contact with any gel and borax
✓ Potassium sulfate – accelerate and harden
the stone, increases rupture and deformation
• fabrication of cast gold restorations
• pack as semi-solid gel
• 2 stages when using:
a) Storage
• Wet towels
• Humidor
• Water baths
• 2% solution
b) Tempering
✓ Increase viscosity
• gel tube → sol container → gel impression tray
• 85% water
 CUSTOM RESIN TRAYS Tray Preparation For Autopolymerizing Acrylic Resin
• elastomeric impression techniques
• more accurate in uniform, thin layers of 2 to 3 mm
• must be rigid
• have stops on the occlusal surfaces

Tray preparation for VLC

• baseplate wax
✓ folded in half
✓ excess more than 2-3 mm trimmed
✓ spacer
✓ horseshoe-shaped, no palatal coverage on
maxillary arch

• arbor band is used to cut back any areas that come

too close to the cast, especially in the area of the
prepared teeth. I
• The tray should be prepared at least 6 hours in
advance of making the impression
• Elastomeric impressions should not be stored in a
moist environment because an acrylic resin tray may
imbibe water and distort.

DUAL-ARCH IMPRESSIONS
• Advantages:
✓ Use of only one tray without the need of
interocclusal record
✓ Produce extremely accurate occlusion
✓ Less impression material is needed
• best used for a patient with an intact, mutually
protected Angle Class I occlusion. The restoration
should be for a single tooth with intact adjacent and
opposing teeth. There should be no arc-of-closure
interference in closure to maximal intercuspation
• All but the anterior segment tray have a distal bar
connecting the lingual to the facial side

Technique:
 POLYSULFIDE
• elastomer that is also known as mercaptan, Thiokol,
or simply as rubber base
• packaged in two tubes:
✓ base
✓ contains a liquid polysulfide polymer
mixed with an inert filler
✓ accelerator
✓ lead dioxide mixed with small
amounts of sulfur and oil, acts as an
oxidation initiator on terminal thiol
groups on the polymer.
• greater dimensional stability than does hydrocolloid
• it contracts as curing occurs. Therefore, if maximum
accuracy is to be obtained, a polysulfide impression
should be poured within approximately 1 hour of
removal from the mouth 62 or less
• hydrophobic
• unique because radiopaque due to lead dioxide

Impression making with polysulfide

 CONDENSATION SILICONE
• called organo-tin silicones, which is a reference to
their catalyst
• the base paste is a liquid silicone polymer with
terminal hydroxyl groups, mixed with inert fillers
• The reactor, a viscous liquid, consists of a cross-linking
agent, ethyl silicate, with an organo-tin activator, tin
octoate
• The evaporation of this alcohol is believed to be
responsible for shrinkage of the material and
resultant poor dimensional stability
• Problem: limited shelf life
Impression Making with Condensation Silicone
POLYVINYL SILOXANE
• dimensional stability of this group of impression
materials is so much better than that of condensation
silicone
• called addition silicone
• packaged as two pastes.
✓ One paste contains silicone with terminal
silane hydrogen groups and an inert filler.
✓ made up of a silicone with terminal vinyl
groups, chloroplatinic acid catalyst, and a
filler
• no by-products.
• least affected by pouring delays or by second pours,
76 and it is still accurate, even when poured 1 week
after removal from the mouth
• Early formulations of this material released hydrogen
gas from the impression surface, resulting in voids in
the surface of the setting stone cast
• Hydrophobic
 • If putty is used, it should not be dispensed or mixed
while wearing latex gloves because setting of the
material may be impeded. The polymerization
retardation probably results from sulfur derivatives in
the latex
• The inhibition is not restricted to putty, 85 but the
putty is more easily contaminated because it is hand
mixed.

Impression Making with PVS3

POLYETHER
• elastomeric impression material
• It is a copolymer of 1,2-epoxyethane and
tetrahydrofuran that is reacted with an α,β-
unsaturated acid, such as crotonic acid, to produce
esterification of the terminal hydroxyl groups
• packaged in two tubes using a much larger volume of
base than accelerator (slightly less than 8:1).
• excellent dimensional stability
• exhibits accuracy on par with, or somewhat superior
to, that of other elastomers.
• accurate when poured 1 week
• hydrophilic
• resistance to tearing upon removal is roughly equal to
that of silicone and less than that of polysulfide.
• somewhat brittle
• problems with allergic reactions. Due to aromatic
sulfonate catalyst

Impression making with polyether

• Operator must be organized and work swiftly due to
the fast setting time of the material
• Custom tray is coated with adhesive supplied with
polyether
• Dispenser is used to mix the lightbody polyether
• Gun with attached mixing tip is inserted into the front
end of impression syringe
• Material is expressed into the syringe as the tip is
slowly removed
• Clear tip is inserted into the locking ring and attached
to the syringe
• Assistant loads the tray while the operator proceeds
• Medium- or heavy-body polyether is expressed into
the tray from the mechanical mixer
• Gauze pack is removed
• Retraction cord should be slightly damp before
removal from the sulcus
• Cord is carefully removed from the sulcus, and
impression material is injected starting in one
interproximal area
• Syringe is exchanged for the loaded tray, which is
firmly seated in the mouth
• Tray is held in place for 4 minutes
• Impression is removed, rinsed, and blown dry
• Impression is inspected and treated with disinfectant,
preferably sprayed due to polyether's moisture
absorption tendency
• Impression of the opposing arch can be made with
alginate
DIGITAL IMPRESSIONS
• (CAD/CAM) - a computer-aided design/computer-
assisted manufacture
✓ uses optical scanning and requires the entire
area to be captured in the impression to be
coated with a reflective powder.
• Two digital impression system
1) The iTero system (Cadent)
✓ uses a laser scanner that does not
require reflective powder to
facilitate the impression.
✓ indicated for crowns, fixed partial
dentures, inlays/onlays, veneers,
and abutment-level implant
impressions
✓ dual-cord retraction technique is
recommended
2) The Lava Chairside Oral Scanner (COS) (3M
ESPE)
✓ uses light powder to facilitate
scanning by an optical video system.

IMPRESSIONS FOR PIN-RETAINED RESTORATIONS

• nylon bristles must be used to duplicate the pinholes
• It should be approximately 0.002 inches smaller in
diameter than the pinhole
• To prevent distortion, the bristle should not touch the
impression tray
• Use scalpel to the cut the bristle

DISINFECTION OF IMPRESSIONS
• There are five types of chemical disinfectants that can
be used for this purpose:
1) chlorine compounds,
2) combination synthetic phenolic compounds
3) glutaraldehydes
4) iodophors
5) phenol-alcohol combinations
• A prolonged immersion in 2% glutaraldehyde or
hypochlorite solution with 10,000 ppm available
chlorine for 1 hour was recommended for disinfecting
impressions
• (5.25%) sodium hypochlorite to be the most effective
disinfectant when sprayed on alginate.
• 10-minute immersion in 2% alkaline in agar
• The use of 0.5% or 1.0% dilution of sodium
hypochlorite caused unacceptable changes in
dimensional stability, setting time, and detail
reproduction