Dent Mater 11 :19-23, January, 1995

Disinfection of dental stone casts:

Antimicrobial effects and physical property alterations

Saso Ivanovski, Neil W. Savage, Peter J. Brockhurst, Philip S. Bird

Department of Dentistry, The University of Queensland, Brisbane, Queensland, AUSTRALIA

ABSTRACT contamination is the ideal situation. Several studies have

Objectives. The purpose of this study was to evaluate the effective-
ness of disinfecting solutions incorporated into dental stone casts against casts separated from contaminated impressions (FirteII et al.,
a standard and representative group of microorganisms and to note
changes in the physical properties of the casts.
Methods. Irreversible hydrocolloid impressions were con-taminated
individually with Escherichia co/i, Sfaphy/ococcus aureus, Enterobacter of these systems rely on either spraying or immersing the
cloacae, Pseudomonas aeruginosa, Klebsiella pneumoniae, Actinobacfer
calcoaceticus, Bacillus subtilis, Mycobacterium phlei and Candida
albicans. Four readily available disinfecting solutions (glutaraldehyde,
povidone-iodine, chlorhexidine and sodium hypochlorite) were added to
the die stone mix used to pour up the impressions. The set cast
surfaces were swabbed at 1 h and 24 h, the samples plated on agar
and incubated at 37°C for 24 h and 3 d for M. phlei. Subsequently,
colony forming units were counted. The physical properties assessed
were setting time, setting expansion, compressive strength, detail
reproduction and delayed expansion of the stone.
Results. Only glutaraldehyde and povidone-iodine killed all contaminat-
ing microorganisms within 1 h, while the 15 dilution of sodium hypochlo-
rite solution was equally effective after 24 h. Two percent glutaralde-
hyde was the most effective disinfectant with the least adverse effects
on the physical properties of the set cast. Although povidone-iodine
caused a decrease in the compressive strength of the set cast, it can be
considered to be a sound alternative.
Significance. This study supports the concept of incorporating
disinfectants into model stone as a standard operating procedure for
impressions of unknown history and, most sensibly, all dental
impressions.
INTRODUCTION
Direct physical interaction between the dental clinic and
dental laboratory is intrinsic in the practice of general
dentistry. It is also one of the areas most ditEcuIt to deal with
from a cross-infection control point of view. Transmission of been evaluated quantitatively. Nevertheless, some work has
infected materials from the clinic to the laboratory not only
places unwary staff at risk but results in a high level of of a number of commercially available gypsum products
avoidable cross-contamination.
The prevention of contaminated dental impressions
leaving the immediate chairside area or zone of
shown that microorganisms can be recovered readily from stone
1972; Rowe and Forest, 1978; Leung and Schonfeld, 1983). As
a result of this, a number of systems have been proposed which
aim to disinfect impressions satisfactorily and efficiently. Most
contaminated impressions in disinfectants (Minagi et al.,
1986; 1987; Watkinson, 1988; Look et al., 1990; GibIin et al.,
1990; Matyas et al., 1990) or incorporating a disinfectant into
the impression material at the time ofmixing (Touyz and Rosen,
1991; Ramer et al., 1993). Studies carried out on the effect of
such systems on some dimensionally sensitive impression
materials such as the hydrocolloids and hydrophilic elastomers
have been inconsistent and inconclusive (Herrera and
Merchant, 1986; Dun- and Novak, 1987; Drennon and Johnson,
1990; Peutzfeldt and Asmussen, 1990; Rueggeberg et al.,
1992; Tan et al,, 1993).
An alternative or additional approach to cast/impression
disinfection is to accept that the impression may be
contaminated and aim to decontaminate the cast produced
from the impression by incorporating a disinfecting chemical
into the gypsum at the time of mixing. Tebrock et al. (1989)
reported that the addition of 5.25% sodium hypochlorite to a
gypsum mix destroyed aII viable forms of the spore-forming
organism Bacillus subtilis, which is a standard screening
organism in sterilization testing. Furthermore, Mansfield and
White (1991) demonstrated that the addition of 5.25% sodium
hypochlorite and 2% neutral glutaraldehyde yielded a
biologicaUy safe cast after 1 h. However, with the exception of
Tebrock et al. (1989) who included a qualitative description of
the dimensional stability and surface smoothness of the cast,
the effects of the incorporation of disinfectants into the
gypsum mix on the physical properties of the casts have not
been done on the bactericidal effects and physical properties
containing Chloramine-T, which upon activation is similar to
a diluted form of sodium hypochlorite (Lotzmann et al., 1989;
Donovan and Chee, 1989; Schutt, 1989). Although it was

Dental Materials/January 1995 19

 incubated at 37C for 2-4 h to allow the microorganisms r c1
reach a log phase of growth.
Fifty-four quadrant impressions were made from a singk
(NCTC 4163)
plastic dental arch model using irreversible hydrocolloid
Staphylococcus aureus
(alginate)impressionmaterial ~Ivopal,IvoclarPty Ltd.,Sydnq:
BaciMs s&i/is (UQM 40) Australia; Batch No. 352067). This impression material wa::
Enterobacter cloacae (UQM 1995) selected because it exhibits a greater retention ofbacteria than
other materials such as the elastomers (Samaranayake et al.
Escherichia co/i (UQM 845, NCTC 8196)
1991). Furthermore, this method of disinfection is particularI>
Klebsiella pneumoniae (UQM 90) relevant to the dimensionally sensitive. irreversiblrz
Actinobacter calcoaceticus (UQM 676) hydrocolloids which are least suited to spray and immersiot 2
disinfection.
Pseudomonas aeruginosa (NCTC 6749)
The material was mixed according to the manufacturer‘~
Myc&act&um phlei (UQM 120) instructions and allowed to set for the recommended setting
Candida albicans (UQM 4Y) time of 90 s. Upon separation from the model, the impressions
were contaminated immediately by bacteria from the broth
One 25 pL drop ofbroth was placed in each of four sites on tht,
quadrant impression (2nd premolar and the lst, 2nd and
3rd molars) using a sterile transfer pipette. Five impressions
Sterile water were contaminated with each microorganism.
Fifty grams of die stone (Fujirock, G-C Dental Industrial
Glutaraldehyde
2.0%W/V WHI Atdecyde 28, ICI Australia Corp., Tokyo, Japan; Batch No. 070301) was spatulated with
Qper&xis F’& Ltd., 10 mL of one of the four disinfecting solutions or sterile Waters
Melfxxme, Victoria and the stone mix vibrated into one of the five contaminated
impressions and allowed to set. The five solutions used are
Povidone-iodine 10% w/v 1085250 Betadine, Faulding given in Table 1.
(1% available iodine) Pharmaceuticals, Preliminary studies showed that dilutions of sodium
Salisbury, South Australia hypochlorite of less than 15 gave unacceptable disinfectant
activity while dilutions greater than 15 prolonged setting time
Chlorhetiine gkmn~te 0.2% J100687 to an unacceptable level (range 1:2 to 1:20). Thus a dilution of
1:5 was used in this study
Sodium hypochlorite 1% BNPEA 188 X Milton Solution, Procter Sterile water was used instead of the disinfecting solution
with sodium chloride 16.5% and Gamble Australia to serve as the positive control indicatingthe maximum amount
(used in dilution of 15) Pty. Ltd., Villawood, of bacteria recoverable from an undisinfected cast and that
New South Wales the stone cast mixture was not bactericidal or bacteriostatic.
Negative controls consisted of an uncontaminated impression
shown that this disinfectant had a negative influence on the and a sterile water mix. This indicated the number of
physical properties of some gypsum materials (Donovan and “background” contaminating microorganisms present in the
Chee, 19891, this specific product was found to be effective in st,onc. t,he impression material and the working
eliminating bacterial contamination of both dental impres- environment.
sions and stone casts (Lotzmann et al., 1989; Schutt, 1989). One hour after pouring the stone mix, the cast was
The work already done on the effectiveness of separated from the impression. A sterile cotton swab was
incorporating a disinfectant into the gypsum mix has shown moistened with sterile water and used to wipe the surfaces of
that this is a potentially viable method of cast/impression the 2nd premolar and the 2nd molar on the stone cast. Each
decontamination. Accordingly, the objective of this study was cotton swab was then used to inoculate a trypticase soy aga:ar
to examine the antimicrobial effect, of adding a number of plate and incubated overnight (3 d for M. phlei) at WC. Tht~
disinfectants to stone and to quantitatively evaluate their effect casts were returned to the impression and the swabbing.
on the physical properties of the set cast. plating and incubating sequence repeated for the 1st and 3rd
molars after 24 h. Following incubation, the number of
METHODS AND MATERIALS colonies formed on each plate was counted using a colony
Pure cultures of nine microorganisms, revived from counter, and the results were recorded as a logarithmic value
freeze-dried vials, were plated on trypticase soy agar (BBL (1 colony = 0, 10 colonies = 1, 100 colonies = 2, etc. ) for each
Microbiology Systems, Becton Dickenson and Company, disinfectant.
Cockeysville, MD, USA) and incubated overnight (3 d for A&r determining the effectiveness of each disinfectant in
M. phlei) at 37C. The nine representative microorganisms eliminating specific microorganisms, the effects on the
selected are given in Table 1. physical properties of the set stone were investigated. The
These represent a standard panel of microorganisms used five properties examined were: setting time, compressive
to test the efficacy of disinfection procedures with the addition strength, setting expansion, detail reproduction and delayed
of representative oral organisms. After overnight incubation, expansion.
6-8 colonies were selected and emulsified in separate tubes Die stone (Fujirock) was used to test the physical
containing 5 mL trypticase soy broth. The tubes were then properties. The stone was mixed with each of the five

20 lvanovski et a/./Disinfect/on of dental stone casts


1 Hour
Background
Sterile Water
Chlorhexidine
Hypochlorite
I I
I I
0 1 2 3 4 5
Number of Colonies (log,,)
Fig. 1. The effect of incorporation of disinfectants into dental casts on the total
numbers (log,,) of recoverable microorganisms at 1 h. The disinfectants used were
Chlorhexidine gluconate 0.2%, Glutaraldehyde 2.0%, Povidone-iodine lo%, Sodium
hypochlorite 1:5. Total number of recoverable microorganisms was determined by
incorporating sterile distilled waler into the stone cast, while background levels
used sterile water instead of a disinfectant.
solutions outlined previously at the water-powder ratio (W/P)
recommended by the manufacturer (0.20). The water and the
powder were weighed on an electronic scale to a sensitivity of
2 0.1 g. The mixing procedure followed the guidelines of the
International Organization for Standardization (ISO) (1983).
The setting time, compressive strength and setting
expansion of each specimen were determined according to the
procedures specified by the ISO. The IS0 specifications for
evaluating gypsum products require two specimens to be tested
for both setting time and setting expansion, and five
specimens to be tested for compressive strength. Stone casts
containing disinfectants such as glutaraldehyde, which
demonstrated adequate antimicrobial properties, were
studied more extensively by using a greater number of
specimens, especially with regard to the critical parameters of
setting time and compressive strength. A greater number of
specimens were also tested with the water standard.
Conversely, only one setting expansion test was carried out
with the chlorhexidine mix, as this disinfectant had already
been shown to be inadequate in terms of both antimicrobial
and physical properties. The physical properties of the dental
stones containing the various disinfectants were evaluated on
the basis of whether or not they fell within the bounds of a set
standard. An analysis of variance and Scheffe’s test were
conducted to determine differences among the test groups
(p < 0.05).
The setting time was measured using a customized Vicat
needle apparatus as the total time from the start of mixing to
the time when the needle first failed to penetrate the
specimen to a depth of at least 2 mm, and it was recorded to
the nearest 15 s. The compressive strength of the stone casts
was determined by testing cylindrical specimens, each having
a diameter of 20 + 0.2 mm and length of 40 + 0.4 mm as
specified by the ISO. The specimens were cast in a silicone
mold and tested 1 h after the commencement of mixing using
a testing machine (Hounsfield tensometer Type W,
Tensometer Limited, Croyden, England). The setting
expansion was measured using a setting expansion
apparatus with a micrometer barrel (Moore and Wright,
Sheffield, England) 2 h after the mix had lost its surface gloss
(l-2 min before setting). The result was reported as a
percentage to the nearest 0.01%.
Following the measurement of setting expansion, the
specimen was removed from the setting expansion apparatus
and remeasured after both 24 h and 7 d. These measurements
represented the delayed expansion.
Detail reproduction was determined using a grooved,
machined, brass test block. The test block contained five
grooves, each ofwhich had walls inclined at 120 degrees. The
depth of the grooves decreased at a constant rate from 1 mm
to zero over a length of 20 mm, providing continuously
varying detail. The smallest width of detail reproduced was
measured to the nearest 10 pm using a microscope with
binocular microscale and a calibrated graticule.
RESULTS
The effectiveness of the addition of a disinfectant to the stone
mix prior to preparing the stone cast was tested. A test group
of standard and specific microorganisms was used as listed in
Table 1. The major parameter judged was the recovery of the
microorganism from the stone cast. The number of
microorganisms recovered varied markedly, and this was
dependent upon the contact time the microorganism had with
the disinfectant-treated stone cast, which test species of
microorganism was used, and which disinfectant was
incorporated in the stone mix. The stringency of the test was
such that survival of even one species from the panel was
judged to compromise the efficacy of the test disinfectant.
The results showed that after a 1 h incubation of a
sterile water mix stone cast at room temperature, all
microorganisms were recoverable, thus indicating the total
possible number of recoverable organisms. When glutaralde-
hyde was used, all the microorganisms tested were killed
atter a 1 h incubation with the disinfectant-treated stone cast.
Similarly, povidone-iodine reduced all microorganisms to
background levels, when compared with the sterile
water-treated stone cast. Sodium hypc&lorite was able to kill
all microorganisms at a 15 dilution with the exception of
M. phki, and at a 1:lO dilution, it was ineffective against a
number of the microorganisms (data not shown for 1:lO).
Chlorhexidine was ineffective against most microorganisms.
The results are shown in Fig. 1.
The results obtained &r 24 h indicated that the number
of microorganisms recovered from the stone cast was reduced
by at least 2 to 3 log. This suggested that either the microor-
ganisms were affected by the gypsum or they were unable to
survive for 24 h on the stone casts. These results are shown in
Fig. 2.
The addition of the different disinfectants to the stone mix
affected the physical properties of the cast to varying degrees.
These results are summarized in Table 2. The setting time
was not affected by the addition of glutaraldehyde to the stone
mix but it was increased by the addition of povidone-iodine,
chlorhexidine gluconate and the various dilutions of the
sodium hypochlorite solution. However, the setting time was
within the bounds of the IS0 requirements for all of the
disinfectants. The compressive strength was unaffected by
the glutaraldehyde and the lower concentrations of sodium
hypochlorite ( 1:lO and 1:20 dilutions) but it was decreased by
Dental Materials/January 1995 21
 the period of time during ;Yhich the casts
are most likely to be handled by dental and
laboratory personnel.
The incorporation of’ some of the
IS0 Requirement 6-30 min > 35.0 O-0.15% disinfectants into the stone mix produced a
Water 14.30 t 2.00” (9) 50.4 + 8.4” (36) 0.09 ?r 0.01” (4) 20 (5) significant and acceptable reduction in the
Glutaraldehyde 13.00 k 1.OO”(4) 53.3 + 7.7” (23) 0.09” (2) 20 (5) number of viable bacteria present 1 h and
Povidoneiodine 22.45 r 2.00b (3) 31.9 f 4.3b (12) 0.09” (2) 20 (5) 24 h after contamination. This finding
Chlorhexidine 25.30 + 0.45b (2) 31.9 f 5.3b (12) 0.07” (1) 20 (5) corroborates results reported previously
NaClO (1:5) 25.45 A l.l!jb (4) 31.5 + 3.5b (12) 0.07” (2) 20 (51 (Tebrock c’tal.. 1989; Mansfield and White.
1991) which indicate that the addition of
disinfectants to the stone mix may be a USC’-
ml disinfection method. Nevertheless, the
current study indicated that the effective
ness of this method of disinfection was
dependent on the type of disinfectant used.
Glutaraldehyde and povidone-iodine
destroyed all microorganisms at both 1 h and 24 h but sodium
Background hypochlorite and chlorhexidine gluconate were unable to
achieve a satisfactory level of disinfection under the condi-
Sterile Water tions of this study The inability of 75 sodium hypochlorite to
kill I%‘.phlei abler 1 h is significant, since both Mansfield and
Chlorhexidine White( 1991) andTebrocketnf. i1989)demonstrated that, afiei
1 h, sodium hypochlorite destroyed all of the microorganisms
Glutaraldehyde
they investigated. Hence. it was suggested that the incorpo-
ration of this disinfectant into the stone mix would probabl!,
yield a biologically safe cast. The effectiveness of sodium
Povidoneiodine
hypochlorite must now be challenged. Additional studies
using both Milton solution and other solutions containing
Hypochlorite
sodium hypochlorite are indicated.
The effects of the disinfectant, solutions on the phvsical
0 1 2 3 4 5 properties of the stone casts were variable. The addition of’
glutaraldehyde to the stone casts had the least effect on i,htL
Number of Colonies (log,,) physical properties ofthe casts. This finding, coupled with the
Fig. 2. The effect of incorporation of disinfectants into dental casts on the total acceptable germicidal activity of glutaraldehyde, established
numbers (log,,) of recoverable microorganisms at 24 h. The disinfectants used were in both this study and by Mansfield and White i 1991), suggest
Chlorhexidine gluconate 0.2%, Glutaraldehyde 2.0%, Povidone-iodine lo%, Sodium that this disinfectant is an ideal method of disinfecting stont>
hypochlorite 1:5. Total numbers of recoverable microorganisms were determined
by incorporating sterile distilled water into the stone cast, while background levels
casts.
used sterile water instead of a disinfectant. The addition of chlorhexidine gluconate to the stone rnlx
decreased the compressive strength by approximately 40’;;
the presence of povidone-iodine, chlorhexidine gluconate and almost doubled the setting time and caused a small
the 15 dilution of sodium hypochlorite in the stone mix to a contraction of the cast. Although these alterations in the
value marginally outside the lower limits of the IS0 physical properties of the cast may not absolutely justify the
requirements. The setting expansion remained within the IS0 rejection of this disinfectant as a useful agent, its inability to
requirements for all of the disinfectants, although chlor- destroy many of the microorganisms on the surface of the cast
hexidine gluconate and sodium hypochlorite caused a slight renders 0.2V chlorhexidine inadequate for this method of’
reduction compared with the standard. The surface detail disinfection. Higher concentrations of this agent, may warrant
and delayed expansion were not affected by any of the further investigation.
disinfectant solutions. The germicidal effectiveness of povidone-iodine has already
been established. Of greater concern is the alteration of the
DISCUSSION physical properties of the casts which occur upon the
The results of this study confirm previous reports (Firtell incorporation of povidone-iodine into the stone mix. While the
1972; Rowe and Forest, 1978; Leung and Schonfeld, 19831
et al., setting expansion and detail reproduction remain unaffected,
showing that gypsum casts are possible routes of microbial the povidone-iodine alters the setting time and the
cross-contamination. In addition, microorganisms which have compressive strength of the stone cast. Although the
contaminated the surface of an impression can be recovered moderate increase in setting time is undesirable, the decrease
readily from gypsum casts at 1 h and 24 h periods following in compressive strength is ofgreater concern because it lowers
the pouring-up of the impression. This indicates clearly that the strength close to an unacceptable level just below the IS0

22 lvanovski et a/./Disinfect/on of dental stone casts

limits.Some of this decreasecan be attributedto the increase
in setting time caused by the povidone-iodine. Because the
IS0 guidelines require the specimens to be tested 1 h
following the mixing of the stone powder and the
povidone-iodine solution, an increased setting time would
decrease the amount of time that specimens have to reach
the same compressive strength as the standard water mix,
resulting in reduced strength values. Hence, a stone cast
disinfectedby the incorporation of povidone-iodineinto the
stone mix can stillbe consideredclinicallyacceptableas long
as the yellow discolorationis not of concern. If the increased
setting time is inconvenient, an accelerating agent may be
incorporatedduring mixing.
The effecton the physicalpropertiesof the stonecastcaused
by the incorporationof a 1% dilution of sodium hypochlorite
(Miltonsolution)was also investigated.At this concentration,
the sodiumhypochloritealteredthe physicalpropertiesof the
set cast. While therewas an increasein settingtime,ofgreater
concern was the fact that the compressive strength was
lowered to a level marginallybelow the IS0 requirement.
In summary,glutaraldehydeis the solutionmost suitedto
this method of disinfection. Unfortunately,due to concerns
regarding the toxicity of glutaraldehyde, there may be
difficultiesin using it on a day-m-daybasis in the clinic and
laboratory A sound alternative is the povidone-iodine
solution which, notwithstanding a decrease in the
compressive strength of the set cast, is a viable option.
Further studiesaimed at reducingthe effectthis solutionhas
on some of the physicalpropertiesof the set cast are currently
being planned.
ACKNOWLEDGMENTS
The authors acknowledge gratefully the support of the
AustralianDental Research Fund Incorporated. Julie Khan
is thanked for assistancewith microbialcultures. Dr.L. Sly of
the Australian Culture Collection, Department of
Microbiology,is thanked for supplyingthe bacterialcultures.
Received July 26,1994 /Accepted December 20,1994
Address correspondence and request reprints to:
Neil W. Savage
Dental School
University of Queensland
Turbot Street
Brisbane, Q. 4000. AUSTRALIA
REFERENCES
Donovan T, Chee WW (1989). Preliminaryinvestigationof a
disinfectedgypsum die stone.Int JProsthodont 2:245-248.
Drennon DG, Johnson GH (1990). The effect of immersion
disinfection of elastomeric impressions on the surface
detail reproductionof improved gypsum casts. J Prosthet
Dent 63:233-241. TebrockOC,EngelmeierRL, MayfieldTG, Adams HJU ( 1989).
Durr DP,Novak EV (1987). Dimensionalstabilityof alginate
impressionsimmersedin disinfectingsolution.JDent Child
54:45-48. TouyzLZ, Rosen M (1991).Disinfectionof alginateimpression
Firtell DN, Moore DJ, Pelleu GB Jr (1972). Sterilizationof
impressionmaterialsfor use in the surgicaloperatingroom.
J Prosthet Dent 271419-422. Watkinson AC (1988). Disinfections of impressions in UK
Giblin J, Podesta R. White JM (1990). Dimensional stabilitv
of impression materials immersed in an iodophor
disinfectant.Int JProsthodont 3:72-77.
Herrera SP, Merchant VA (1986). Dimensional stability of
alginate impressionsimmersed in disinfectingsolution.J
Am Dent Assoc 113:419-422.
International Organization for Standardization (1983).
Dental gypsum products. InternationalStandard 6873.
Leung RL, SchonfeldSE (1983). Gypsum casts as a potential
source of microbial cross-contamination.J Prosthet Dent
49:210-211.
Look JO, Clay DJ, Gong K, Messer HH (1990). Preliminary
results from disinfection of irreversible hydrocolloid
impressions.J Prosthet Dent 63:701-707.
Lotzmann U, Patyk A, Hillebrecht S (1989). Bactericidal
effectsof antisepticgypsum. ZWR 2:962-965.
Mansfield SM, White JM (19911.Antimicrobialeffects from
incorporation of disinfectants into gypsum casts. Int J
Prosthodont 4:180-185
Matyas J, Dao N, CaputoAA, LucatortoFM (1990). Effectsof
disinfectants on dimensional accuracy of impression
materials.J Prosthet Dent 64:25-31.
Minagi S, Fukushima K Maeda N, Satomi K, Ohkawa S,
Akagawa Y, Miyake Y, Suginaka H, Tsuru H (1986).
Disinfectionmethodforimpressionmaterials:Freedomfrom
fear of hepatitis B and acquired immunodeficiency
syndrome.JProsthet Dent 56:451-454.
Minagi S, Yano N, Yoshida K, Tsuru H (1987). Prevention of
acquired immunodeficiencysyndromeand hepatitisB. II:
Disinfectionmethod for hydrophilicimpressionmaterials.
J Pros&t Dent 58:462-465.
PeutzfeldtA, Asmussen E (1990). Effect of disinfectingsolu-
tionson surfacetextureof alginateand elastomericimpres-
sions.Stand J Dent Res 98174-81.
Ramer MS, GerhardtDE, McNallyK ( 1993).Accuracy of irre-
versible hydrocolloid impression material mixed with
disinfectantsolutions.Int JProsthodont 2:X%-158.
Rowe AH, Forest JO (1978). Dental impressions: The
probabilityof contaminationand a method of disinfection.
Br Dent J 145:184-186.
Rueggeberg FA, Beall FE, Kelly MT, Schuster GS (1992).
Sodium hypochloritc disinfectionof irreversiblehydrocol-
loid impressionmaterial.J Prosthet Dent 67:628-631.
SamaranayakeLP,Hunjan M, Jennings KJ (1991). Carriage
of oral flora on irreversiblehydrocolloid and elastomeric
impressionmaterials.J Prosthet Dent 65:244-249.
Schutt RW ( 1989).Bactericidaleffect of a disinfectantdental
stoneon irreversiblehydrocolloidand stonecasts.JProsthet
Dent 62:605-607.
Tan HK, WolfaardtJF,Hooper PM, Busby B ( 1993).Effectsof
disinfectingirreversiblehydrocolloidimpressionson the re-
sultant gypsum casts: Part 2 - Dimensional changes. J
Pros&t Dent 69:532-537.
Managing dental impressionsand casts of patients with
communicablediseases.Gen Den 37:490-495.
materialusing disin&ctantsas mixing and soak solutions.
J Dent 19:255-257.
dental schools.Br Dent J X4:22-23.
Dental Materials/January 1995 23