Impression Materials

Course Date: 5/05 Reviewed/Updated: 10/10 Expiration Date: 10/13

Objectives
Provide general review of types of dental impression materials. Provide general information on the physical and handling properties and indications for use of various types of impression materials.

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.

Impression Materials
Non-elastic Elastic
Aqueous hydrocolloids
Agar Alginate

Non-aqueous elastomers
Polysulfide Silicones
Condensation Addition

Polyether

Indications
Diagnostic casts
preliminary opposing

Indirect reconstruction
fixed removable

Bite registration
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

Phillips Science of Dental Materials 1996

Plaster Non-elastic Compound Waxes Impression Materials

ZnO - Eugenol

Aqueous Hydrocolloids Elastic

Agar (reversible) Alginate (irreversible) Polysulfide

Non-aqueous Elastomers

Condensation Addition

Silicones Polyether

OBrien, Dental Materials & their Selection 1997

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
thermal or chemical process
Phillips Science of Dental Materials 1996

Aqueous Hydrocolloids
Semi-permeable membranes
poor dimensional stability

Evaporation Syneresis
fibril cross linking continues
contracts with time exudes water

Imbibition
water absorption
swells
Phillips Science of Dental Materials 1996

Agar (reversible)

Aqueous Hydrocolloids
Elastic

Alginate (irreversible)
Polysulfide Condensation

Non-aqueous Elastomers

Silicones Addition Polyether

OBrien, Dental Materials & their Selection 1997

Reversible Hydrocolloid (Agar)

Indications
crown and bridge
high accuracy

Example
Slate Hydrocolloid (Van R)

Composition
Agar
complex polysaccharide
seaweed

Potassium sulfate
improves gypsum surface

gelling agent

Borax
strength

Water (85%)

cool to 43C

agar hydrocolloid (hot)

(sol)

agar hydrocolloid (cold)

(gel)
OBrien, Dental Materials & their Selection 1997

heat to 100C

Manipulation
Gel in tubes
syringe and tray material

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
OBrien, Dental Materials & their Selection 1997

Advantages
Dimensionally accurate Hydrophilic
displaces moisture, blood, fluids

Inexpensive
after initial equipment

No custom tray or adhesives Pleasant flavor No mixing required

Phillips Science of Dental Materials 1996

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
Phillips Science of Dental Materials 1996

Agar (reversible)

Aqueous Hydrocolloids
Elastic

Alginate (irreversible)
Polysulfide Condensation

Non-aqueous Elastomers

Silicones Addition Polyether

OBrien, Dental Materials & their Selection 1997

Irreversible Hydrocolloid (Alginate)

Most widely used impression material Indications
study models removable fixed partial dentures
framework

Examples
Jeltrate (Dentsply/Caulk) Coe Alginate (GC America)
Phillips Science of Dental Materials 1996

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)
H2O

Ca3(PO4)2 + 3 Na2SO4 Ca alginate + Na2SO4

(gel)
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)
Caswell JADA 1986

Advantages
Inexpensive Easy to use Hydrophilic
displace moisture, blood, fluids

Stock trays

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

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
Phillips Science of Dental Materials 1996

Agar (reversible)

Aqueous Hydrocolloids
Elastic

Alginate (irreversible)
Polysulfide Condensation

Non-aqueous Elastomers

Silicones Addition Polyether

OBrien Dental Materials & their Selection 1997

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
Phillips Science of Dental Materials 1996

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-

OBrien Dental Materials & their Selection 1997

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

Phillips Science of Dental Materials 1996

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

Phillips Science of Dental Materials 1996

Agar (reversible)

Aqueous Hydrocolloids
Elastic

Alginate (irreversible)
Polysulfide Condensation

Non-aqueous Elastomers

Silicones Addition Polyether

OBrien Dental Materials & their Selection 1997

Condensation Silicone
Indications
complete dentures crown and bridge

Examples
Speedex (Coltene/Whaledent) Primasil (TISS Dental)

Composition
Base
poly(dimethylsiloxane) tetraethylorthosilicate filler

Catalyst
metal organic ester

By-product
ethyl alcohol
Phillips 1996 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 CH3 CH3 n

OC2H5

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

inject wash material

Advantages
Better elastic properties Clean, pleasant Stock tray
putty-wash

Good working and setting time

Phillips Science of Dental Materials 1996

Disadvantages
Poor dimensional stability
high shrinkage
polymerization evaporation of ethanol

pour immediately
within 30 minutes

Hydrophobic
poor wettability

Phillips Science of Dental Materials 1996

Agar (reversible)

Aqueous Hydrocolloids
Elastic

Alginate (irreversible)
Polysulfide Condensation

Non-aqueous Elastomers

Silicones Addition Polyether

OBrien Dental Materials & their Selection 1997

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)

Composition
Improvement over condensation silicones
no by-product

First paste
vinyl poly(dimethylsiloxane) prepolymer

Second paste
siloxane prepolymer

Catalyst
chloroplatinic acid
Phillips 1996 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 CH3

Phillips Science of Dental Materials 1996

Manipulation
Adhesive to tray Double mix
custom tray
heavy-body

light-body to prep

Putty-wash
stock tray

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

Phillips Science of Dental Materials 1996

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
Manikos Aust Dent J 1998

Addition Silicones
Surfactants added
reduce contact angle improved
castability
gypsum

wettability??
still need dry field clinically

Pratten J Dent Res 1987 Mandikos Aust Dent J 1998

Agar (reversible)

Aqueous Hydrocolloids
Elastic

Alginate (irreversible)
Polysulfide Condensation

Non-aqueous Elastomers

Silicones Addition Polyether

OBrien Dental Materials & their Selection 1997

Polyether
Indications
crown and bridge bite registration

Examples
Impregum F (3M/ESPE) Permadyne (3M/ESPE) Pentamix (3M/ESPE) P2 (Heraeus Kulzer) Polygel (Dentsply Caulk)

Composition
Base
difunctional epimine-terminated prepolymer fillers plasticizers

Catalyst
aromatic sulfonic acid ester fillers

Cationic polymerization
ring opening and chain extension
Phillips Science of Dental Materials 1996

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+ H2C CH2

+
H2C

N CH2

R N CH2 CH2 N +
ring opening

H2C

CH2

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

Phillips Science of Dental Materials 1996

Disadvantages
Expensive Short working time Rigid
difficult to remove from undercuts

Bitter taste Low tear strength Absorbs water

changes dimension
Phillips Science of Dental Materials 1996

Impression Material Usage*

Civilian General Dentists

Crown & Bridge

vinylpolysiloxane alginate polyether 81% 38% 28% 71% 22% 20%
DPR 2001

Inlays and Onlays

vinylpolysiloxane polyether alginate
*Multiple responses

Impression Material Usage*

Civilian General Dentists

Complete dentures
alginate vinylpolysiloxane polyether 58% 55% 27% 78% 43% 15%
DPR 2002

Partial dentures
alginate vinylpolysiloxane polyether
*Multiple 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

Poor

Poor

Fair

Fair

Excellent

Fair

OBrien Dental Materials & their Selection 1997

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

1 hour

1 week
Fair to good

Excellent

Fair

Low

Very low

Low

Moderate

High to very high

Very high

OBrien Dental Materials & their Selection 1997

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

OBrien Dental Materials & their Selection 1997

Comparison of Properties
Working time
longest to shortest
agar > polysulfide > silicones > alginate = polyether

Setting time
shortest to longest
alginate < polyether < agar < silicones < polysulfide

OBrien Dental Materials & their Selection 1997

Comparison of Properties
Stiffness
most to least
polyether > addition silicone > condensation silicone > polysulfide = hydrocolloids

Tear strength
greatest to least
polysulfide > addition silicone > polyether > condensation silicone >> hydrocolloids

OBrien Dental Materials & their Selection 1997

Comparison of Properties
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

OBrien Dental Materials & their Selection 1997

Comparison of Properties
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
OBrien Dental Materials & their Selection 1997

Regularly-Used Impression Materials*

Civilian Practitioners

Alginate Polyvinyl Siloxane Polyether Other

88% 85% 27% 6%

*Multiple Responses

DPR 2005

Summary
Study models
Alginate most widely used
inexpensive displaces moisture lower detail reproduction dimensionally unstable

Summary
Prosthodontics
Addition silicones most popular
accurate dimensionally stable user friendly expensive

References
Phillips Science of Dental Materials, edited by K Anusavice, 11th ed., 2008, Saunders Publishing. Dental Materials and their Selection, edited by WJ OBrien, 4th ed., 2008, Quintessence Publishing. Dental Products Report, 2001, 2002, 2005. CW Caswell, AS von Gonten, and TR Meng, Volumetric proportioning techniques for irreversible hydrocolloids: a comparative study, J Am Dent Assoc 1986 112:859-861. MN Mandikos, Polyvinyl Siloxane Impression Materials: An Update on Clinical Use, Australian Dental Journal, Dec 1998, 43(5): 428-434. RG Craig, Review of Impression Materials, Advance in Dental Research, Aug 1988, 2,51-64.