Professional Documents
Culture Documents
FEBRUARY 2002
Scientic Prole
S C I E N T I F I C
P R O F I L E
Table of Contents
Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Requirements of an Ideal Impression Material . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Vinylpolysiloxanes Chemistry and Setting Reaction. . . . . . . . . . . . . . . . . . . . . . . . . 6 Currently Available Vinylpolysiloxanes and their Respective Manufacturers . . . . . . . 7 Viscosity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Working and SettingTimes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Reproduction of Detail. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Hydrophilicity and Contact Angles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Moisture Displacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Wetting of Set Material Laboratory Signicance . . . . . . . . . . . . . . . . . . . . . . . 13 Wetting of Hard and Soft Tissues Clinical Signicance . . . . . . . . . . . . . . . . . . 14 Hardness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Readability, Color Combinations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Elastic Recovery; Permanent Deformation and Tear Strength (Tensile Strength). . . . . . 18 Tear/Tensile Strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Elastic Recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Dimensional Stability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Flexibility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Impression Trays and Adhesives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Disinfection of Virtual Impressions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Compatibility with Die Materials. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Gloves and the Inhibition of Polymerization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Impression Techniques with Vinylpolysiloxanes. . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
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General
Impression materials are used to make an accurate replica of the oral tissues (both hard and soft). The area involved may vary from a single tooth to the whole dentition or in some situations an impression may be made of an edentulous mouth. The impression provides a negative reproduction of the tissues and by lling it with dental stone or other model material, a positive cast is made which can be removed when the stone has set. Good impressions are dependent on proper technique as well as optimal material characteristics of the impression material.
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Impressions represent key communication devices between the clinician and the laboratory, as each party utilizes the impression as the most important component of the restorative and fabrication procedures.
There are generally six categories of elastomeric impression materials commonly used in dentistry:
1. 2. 3. 4. 5. 6. Condenstation Silicones Irreversible Hydrocolloid (alginate) Reversible Hydrocolloid Polysulde (rubber base) Polyether Vinylpolysiloxane (addition reaction silicones)
Vinylpolysiloxane is the one most often used and provides the ideal combination of physical properties and handling for most crown and bridge impression techniques. They have achieved a high level of dentist, technician, and patient acceptance as they are clean, odorless and tasteless. Virtual is a vinylpolysiloxane impression material. In general all vinylpolysiloxanes have similar characteristics and physical properties, they work when placed with accepted techniques. Differences that are detectable and preferred by clinicians include; viscosity, ease of mixing, mouth removal times, cost, and readability.
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Variable viscosities Variable setting times Ease of use good handling characteristics Compatible with various die materials
Negative features of Vinylpolysiloxanes may include; Innately hydrophobic/relatively moisture intolerant require surfactants to pour in the laboratory Require separate adhesive for adhesion to impression tray Sulfur in latex (gloves) or ferric and aluminum sulfate used as clinical homeostasis, can inhibit setting
Centrix Clinicians Choice Dentsply/Caulk Dentsply/Caulk Glidewell Direct Discus Dental GC America GC America GC America Heraeus Kulzer Jeneric/Pentron Jeneric/Pentron J Morita Kerr/Sybron Kerr/Sybron 3M/Espe 3M/Espe 3M/Espe 3M/Espe 3M/Espe Parkell DMG/Zenith Danville Materials
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Viscosity
International Standards Organizations (ISO) and the American Dental Association (ADA) have dened categories for the nonaqueous elastomeric impression materials which are not based on chemistry, but on 24-hour dimensional change following setting and certain elastic properties (maximum permanent deformation and maximum ow in compression) and are related to viscosity. Example Material Light Body Medium Body Heavy Body Putty ISO Specication 4823 Type 3 - Low Consistency Type 2 - Medium Consistency Type 1 - High Consistency Type 0 - Very High Consistency ADA Specications 19 Type 1 - Low Viscosity Type 1 - Medium Viscosity Type 1 - High Viscosity Type 1 - Very High Viscosity
Vinylpolysiloxanes are available in viscosities ranging from very low (for syringing or wash use), to medium, high and very high (putty). The viscosity of the material increases with the proportion of ller present. Viscosity is also affected by the shear force placed on the material. The mixed base and catalyst pastes exhibit a decrease in their relative viscosities in response to high shear stresses. This is termed shear thinning. This is why Virtual Monophase, a medium body impression material can possess sufcient viscosity to avoid excess ow if loaded into an impression tray, yet it can also exhibit an apparent lowered viscosity suitable for intrasulcular placement, when it is expressed through an impression syringe tip.
Virtual Impression System is available in the following viscosities and Types (according to ISO 4823 and ADA specications 19):
Virtual Extra Light Body Light Body Monophase Heavy Body Putty Viscosity Extra Low Low Medium High Very High Color Beige Beige Blue Blue Blue Type (ISO4823) Type 3 Type 3 Type 2 Type 1 Type 0 Type
(ADA spec 19)
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3:00 1:45 2:35 1:35 2:35 1:35 2:05 1:15 1:25 1:15
4:30 2:30 4:30 2:30 4:30 2:30 4:30 2:30 4:30 2:30
Light Body
Monophase
Heavy Body
Putty
*Occasionally, situations will present which require extended working times (full mouth or implant impressions). The most convenient and widely advocated method for extending working time of vinylpolysiloxanes is to refrigerate the impression material before mixing.
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Reproduction of Detail
Surface Detail is the ability of an impression material to reproduce intricacies on the surface of an object and is necessary to achieve good marginal t of nal restoration. Vinylpolysiloxanes are currently considered to reproduce the greatest detail of all the impression materials. The international standard for dental elastomeric impression materials1 states that a type III (light body) impression material must reproduce a line 0.020 mm (20 microns) in width. With the exception of the very high viscosity putty materials, all vinylpolysiloxanes (light, medium and heavy body) achieve this.
Note: Smooth preparations reproduce better with all impression materials and die stones. Material Type Type 3 LowViscisity Type 2 Medium Viscosity Type 1 High Viscosity Type 0 Very High Viscosity Internal Data Virtual VPS Material Extra Light Body Light Body Monophase Heavy Body Putty Detail Reproduction () Required (ISO-4823) 20 20 50 50 75 Detail Reproduction () of Virtual VPS Materials 20 20 20 20 50
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Moisture Displacement
Moisture Displacement
Meniscus Diameter, Relative Units
Meniscus Diameter, Relative Units
5 5.0 5.5 5 5.0 5.5 4 4.0 4.5 4 4.0 4.5 3 3.0 3.5 3 3.5 3.0 2 2.5 2.0 2 2.5 2.0 1 1.5 1.0 1 1.5 1.0 0 0 0 Virtual XL Virtual L Express Express Splash L Splash L Reg XL Aquasil XL Aquasil L
Moisture Displacement
An extracted human third molar was mounted in acrylic resin in a PVC ring with the crown exposed. Right angle grooves 1.5mm wide by 1.5mm deep were milled mesio-distally along the facial and lingual surfaces using a water- cooled FG-57 bur in a high-speed handpiece. For ten replicates of each of six impression materials, the tooth was immersed in deionized water and removed, leaving the adherent water in the grooves and an impression made. After curing, the impressions were sectioned bucco-lingually and photographed at 45 magnication using a digital camera on an Olympus zoom microscope. The photographs were imported into Corel Draw and magnied 2x. A circle was drawn which matched the radius of the meniscus where the impression material had failed to displace water from the tooth surface. These circle diameters were analyzed by ANOVA and post hoc multiple comparison tests and compared with previously measured contact angles (slurry) by correlation analysis. Radii were analyzed by ANOVA and StudentNeuman-Keuls multiple comparison test. Note lower number values higher displacement. The materials fell into three statistical subsets, p<0.05. Both viscosities of Virtual displaced moisture better than any of the others, although they shared a statistical subset with the 3M Express Materials.
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P R O F I L E
The correlation between contact angle (slurry) and moisture displacement was examined by plotting the two variables against one another. There was no relationship between the two variables. Indeed, the materials with the best moisture displacement also had the highest contact angles (slurry). The results of these evaluations conrm previous results which suggest that there is little if any correlation between contact angles (slurry) and moisture displacement for vinylpolysiloxanes. Moisture displacement is probably a much more clinically relevant consideration to take into account when selecting an impression material or system than simply measuring static contact angles. However, when discussing the wetting characteristics (contact angles) of impression materials, it is important to distinguish between the ability of the material to ow around the soft and hard tissues of the mouth, and the ability of the set impression material to be wet by a gypsum slurry or water.
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Video Contact Angle Measurement of Impression Materials on Various Substrates. Sorensen JA. J Dent Res #80. 2001.
Fresh at samples of each impression material were fabricated with the natural gloss obtained by pressing the material against a microscope slide. For each material, 10 drops of water were left after falling on the surface. The drops were of a standardized volume of 7 micro liters.
Although the contact angles of the Virtual impression materials are relatively high in comparison to others, numerous clinical and laboratory eld tests and evaluations conrmed excellent pourability of the impressions and high quality of the models. The resultant restorations and t were considered ideal.
Imprint, Impregum, Exafast, Dimension, Honigum, Splash, Take 1 and Aquasil are not registered trademarks of Ivoclar Vivadent, Inc.
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Degrees
90 80 70 60 50
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Video Contact Angle Measurement of Impression Materials on Various Substrates. Sorensen JA. J Dent Res #80. 2001.
Freshly extracted human teeth were embedded in methacrylate and trimmed to expose dentin. Drops of impression materials were delivered over moist surfaces. The contact angle was measured in the VCA Optima Machine. An average between the left angle and the right angle was calculated and documented. A total of ten drops per surface were made for each material.
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P R O F I L E
Degrees
40 30 20 10 0
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Video Contact Angle Measurement of Impression Materials on Various Substrates. Sorensen JA. J Dent Res #80. 2001.
Freshly collected samples of fresh bovine intraoral mucosa were collected in a full thickness form. Drops of impression materials were delivered over wet and dry gingival surfaces. The contact angle was measured in the VCA Optima Machine. An average between the left angle and the right angle was calculated. A total of ten drops per surface were made for each material. All impression materials had a better (lower) contact angle when placed on wet gingiva than when placed on dry.
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Hardness
The relative hardness of elastic materials such as rubber or soft plastics can be determined with an instrument called a Shore A durometer. If the indenter completely penetrates the sample, a reading of 0 is obtained, and if no penetration occurs, a reading of 100 results. The reading is dimensionless.
Shore Hardness
Clinically it is desirable to have increasing hardness from wash to tray to provide support for the nal impression. The results demonstrate an increasing hardness of the various viscosities of the Virtual line of impression materials from Extra Light Body Wash to the Heavy Body Tray material.
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S C I E N T I F I C
P R O F I L E
Virtual (Ivoclar Vivadent, Inc.) Beige/Blue Blue Splash (Discus Dental) Yellow/Sky Blue Yellow/Purple Mint Green/Sky Blue Mint Green/Purple Sky Blue Aquasil (Dentsply/Caulk) Orange/Purple Orange/Green Aqua Green/Purple
Imprint II (3M/ESPE) Yellow-Green/Mauve Lavender/Bluish-Green Yellow/Mauve Orange/Bluish-Green Take 1 (Kerr/Sybron) Orange/Blue Orange/Purple Orange/Light Green Light Green Impregum (3M/ESPE) Purple Aqua Green/Green Purple
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Tear/Tensile Strength
Tear Strength
10 9 8 7 6 5 4 3 2 1 0 Express Express Splash L Reg L Aquasil L
Tear Strength
N/mm
Virtual XL
Impression materials must have sufcient strength to allow removal from a gingival sulcus without tearing. Tear energy is that energy required to sustain a tear through a material, and is of obvious importance in thin intrasulcular or interproximal areas.
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Internal Data
N/mm
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Elastic Recovery
J. Powers, Houston
Internal Data
Permanent deformation is the lack of recovery from deformation of an elastic impression or duplicating material compressed at a xed strain, usually for 30 seconds. The trend is to report percent recovery rather than permanent deformation. Therefore a material with a permanent deformation of 1% has a 99% recovery. Rapid straining tends to maximize recovery from deformation, thus the set impression should be removed from the mouth with a rapid pull (in as far as is practicable) and not stressed slowly. ADA/ANSI Standards require greater than a 96.5% Recovery from Deformation, which all viscosities of Virtual surpass. Vinylpolysiloxanes are frequently reported to be the best suited elastic impression materials because they exhibit better elastic recovery and less permanent deformation than the other elastomers. They can absorb over three times more energy up to the point of permanent deformation than other elastomers, and if elongated to over 100% (strain at tear), they rebound to only 0.6% permanent deformation.
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Dimensional Stability
The accuracy of an impression material is dependent on the dimensional stability. There are a number of possible causes for dimensional changes in elastomeric impression materials. All rubber polymers must contract slightly during polymerization as a result of reduction in spatial volume as they cross-link. Some impression materials like the polyethers are very sensitive to the moisture content of their surroundings and can absorb and then even lose water if they are placed in wet or varying humidity environments. Changes in temperature can also lead to varying changes in the nal dimensions. Vinylpolysiloxanes show the smallest dimensional changes on setting of all the elastomeric impression materials.
The majority of this shrinkage is due to continued polymerization occurring within the rst three minutes of removal of the impression from the mouth. This linear contraction is well matched to the setting expansion of modern type III and type IV die stones and results in a slightly larger replication of the preparation. Long term dimensional stability of vinylpolysiloxanes is ideal because they are not susceptible to changes in humidity, and they do not undergo any further chemical reactions or release any by-products.
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Flexibility
Strain in Compression
Internal Data
J.Powers, Houston
Strain in compression or exibility of an elastomeric impression or duplicating material is measured between stresses of 100 and 1000 g/sq. cm (ca. 0.01 and 0.1 MPa).
Strain in compression is a measurement is how much the material can be compressed. The higher the value the more "exible" the material, the lower the value, the stiffer the material. There is no ideal value (thats why ISO allows 0.8 - 20 %), it depends much more on the material and especially the technique used. For example, low value indicates low elasticity meaning that the impression might be difcult to remove (hard to move over undercuts). Yet it may be easily cut with a knife if someone is using the putty-wash technique in a two-step mode (usually in this technique you cut back some of the putty material after having taken the rst impression to allow space for the low viscosity material). Therefore, strain in compression can be viewed as another way to measure the ridgity of a material.
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References
1. Albers, HF. Impressions; A Text for Selection of Materials and Techniques; Alto Books. January, 1990 First Edition. 2. International Standards Organization. Dental elastomeric impression material. ISO 4823-1992. 3. Lee EA, Culp L, Friebauer W. Accurate Elastomeric Impressions: Precise Transfer for Predictable Indirect Restorations. Collaborative Techniques. Winter 2001. Montage Media. 4. Mandikos, M.N. Vinylpolysiloxane Impression Materials: An Update on Clinical Use. Australian Dental Journal 1998; 43: (6) 428-34. 5. Materials Handling and Evaluation Center (MHEC), Ivoclar Vivadent, Inc. Impression Materials Handling Report. Internal Report. 2001. 6. Miller, M. REALITY 2001, Impression Materials. REALITY Publishing Co. Vol. 15. 7. Norling BK. Report of Laboratory Tests. Ivoclar Vivadent Impression Materials. Internal Report. 2001. 8. OBrien W. Biomaterials Properties Database, University of Michigan. Updated from Dental Materials and Their Selection, 2nd ed., 1997. Quintessence Publishing. 9. Paquette JM, Sheets CG, Mastering the Impression Technique for Simple to Complex Treatments. Dentistry Today, June 2000.68-75. 10. Phillips RW. Skinners science of dental materials. 9th edition. Philadelphia: Saunders, 1991. 11. Powers J. Impression Materials UTHSC. Internal Report, 2001. 12. Ray NJ, Lecture Notes, Dental Material Science - Chapter Five; Rubber Impression Materials. UCC, 2000-2001. Internet download. 13. Shillingburg HT, Hobo S, Whitsett LD. Fundamentals of xed prosthodontics. 2nd edition. Chicago: Quintessence Publishing Co., 1981. 14. Sorensen, JA. Video Contact Angle Measurement of Impression Materials on Various Substrates. J Dent Res #80. 2001. 15. Virtual Instructions for Use and Technical Data.
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Virtual
Scientic Prole