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IMPRESSION MATERIALS
IMPRESSION
Definition. : a dental impression is a negative replica of the tissues of the oral cavity.

CLASSIFICATION OF IMPRESSION MATERIALS.

I) Based on mode of setting & elasticity
    a) Rigid
        i) Reversible (thermoplastic)
            E.g. impression compound

        ii) Irreversible (thermosest)
              E.g. Zoe impression paste
                   Impression plaster.
   b) elastic
     i) Hydrocolloid
         a) reversible
             E.g. Agar
        b) Irreversible
             E.g. Alginate


   ii) Elastomeric impression materials
      E.g. Polysulfides
           Polyether
          Addition silicones
         Condensation silicones

   II) Based on type of impression & area of use
      A) Dentulous
          i) Primary
                E.g. alginate
         ii) Secondary
        E.g. Elastomers
             Agar

   B) Edentulous
      i) Primary
             E.g. Impression compound
                 Impression plaster
                 Alginate
ii) Secondary
     e.g. ZOE impression paste
         Elastomers for CD

III) based on their use in dentistry
A) edentulous
      For complete denture prosthesis
     e.g. Impression compound
         zoe impression paste
         alginate
         Elastomers
B) dentulous
i) FPD
ii) RPD
     E.g. Agar
     Alginate
     Elastomers

IV) based on the amount of pressure applied
  i) Mucocompressive
            e.g. Impression compound
  ii) mucostatic
           e.g. Impression plaster

V) based on the manipulation
 A) hand mixing
       i) kneading
               e.g. Impression compound – wet kneading
       putty consistency Elastomers
       ii) circular motion (with glass slab & spatula)
          eg.zoe impression paste
                  polysulfide
      iii) vigorous mixing
         e.g. Alginate (figure of 8 motions)

   B) mechanical mixing

VI) based on the tray used for impression
     A) stock tray
        i) types of tray
             a) rim locked perforated
                e.g. Alginate Elastomers
           b) water cooled
                    e.g. Agar
c) plastic
         e.g. Orthodontic tray
   ii) based on type of perforation
        a) perforated
                e.g. Alginate
      Elastomers
              • putty wash impression

       b) non perforated
              e.g. Impression compound

B) special tray
        i) base plate wax
                  e.g. Zoe impression paste
                         medium body
       ii) resin.
IDEAL REQIUREMENTS OF IMPRESSION MATERIAL

  1. have a pleasant taste & odor

  2. not contain toxic or irritant constituents.

  3.   adequate shelf life for requirements of storage & distribution.

  4.   economically commensurate with the results obtained.

  5.   easy to use with the minimum of equipment.

  6.   setting characteristics that meet clinical requirements.

  7.   satisfactory consistency texture.

  8.   readily wets oral tissues

  9.   elastic properties with freedom from permanent deformation after strain.

  10. adequate strength so it will not break or tear on removal from the mouth.

  11. dimensional stability over temp. & humidity ranges normally found in clinical &

       lab. Procedures for a period long enough to permit the production of a cast or die.

  12. compatibility with cast & die materials.

  13. accuracy in clinical use.

  14. readily disinfected without loss of accuracy.

  15. no release of gas or other by products during the setting of the impression or cast

       & die materials.
IMPRESSION COMPOUND

It is a rigid, reversible impression material which sets by physical change.

Classification:
        Acc to ADA sp. No.3:
        Type I:
        low fusing compound – green stick compound.
        medium fusing compound – impression compound.
        Type II:
         high fusing compound – tray compound.

Supplied as:
       1. as sticks, cakes, & cones.
       2. colors – green, brown, red.

Applications:
       Type I:
              For making primary impressions.
              For individual tooth impression
              For peripheral tracing or border moulding.
              To check undercuts in inlay preparation.
       Type II:
              To make a special tray.

Requirements of an ideal impression compound:
   1. harden at or little above mouth temp.
   2. be plastic at a temp. not injurious or harmful to oral tissues.
   3. not containing irritating or toxic ingredients.
   4. harden uniformly when cooled without distortion.
   5. have a consistency when softened which will allow it to reproduce fine details.
   6. be cohesive but not adhesive.
   7. not undergo permanent deformation or fracture while withdrawing the impression
       from the mouth.
   8. be dimensionally stable after removal from mouth & during storage.
   9. exhibit a smooth glossy surface after flaming.
   10. withstand trimming with sharp knife without flaking or chipping after hardening.

Composition

       Rosin                                  30
       Copal resin                            30
       Carbuna wax                            10
       Stearic acid                           5
       Talc                                   25
       Coloring agent                         app.
Properties:

        Thermal properties
i) thermal conductivity:
        has low thermal conductivity.
         Significance:
           • during softening of the material , the outside will soften first & inside last.
               So to ensure uniform softening the material should be kept immersed for a
               long time in water bath.
           • the layer adjacent to the mouth tissue swill remain soft. Therefore Its imp
               to cool the compound thoroughly before removing the impression.

ii) Coefficient of linear expansion. (CTE)
        high CTE , 0.3% acceptable.

iii) Flow
   high fusing compounds – < 2% at 37 .C & < 70-85 % at 45.C
   low fusing compounds - < 3% at 37 C & < 80-85% at 45 C
   impression compound to be manipulated at least 8 .C for adequate flow.

iv) Glass transition temp
    • it is the temp. at which the material loses its hardness or brittleness on heating or
       forms a rigid mass.
    • App. 39.C
    • Material removed from the mouth after glass transition temp. is reached.

v) Fusion Temp.
    • it’s the temp. at which the impression compound becomes plastic.
    • Its 43.5.C

vi) Dimensional stability.
    • Poor dimensional stability.
    • To prevent distortion pour the cast within 1 hr.

vii) surface detail reproduction
  less because of high viscosity & low flow.

Manipulation
       Sticks
                Small amt. softened over flame
       Cakes
                Softened in a thermostatically controlled water bath.
Precautions:
           o prolonged immersion in a water bath is not indicated
           o overheating In water makes the compound sticky & difficult to handle.
           o avoid incorporating water while kneading.

Advantages:
   1. cheap
   2. reusable
   3. does not produce irritation to the patient
   4. impression can be remodified & resoftned again till an accurate impression is
      obtained.
   5.
Disadvantages:
   1. difficult to record details accurately.
   2. Soft tissues are compressed due to pressure applied while taking the impression.
   3. Distortion.
   4. Difficult to remove undercuts.
   5. Does not have an pleasant taste.
   6. Can be uncomfortable in patients because of the rigidity.
ZINC OXIDE EUGENOL PASTE

Introduction
     Produce a rigid impression.
     High degree of accuracy & good surface reproduction of details.
     Is irreversible, sets by chemical change.

Classification:
        ADA specification No. 16
                Type I or hard
                Type II or soft

Available as
       In paste form in 2 tubes
               Base paste (white)
                Accelerator/ reactor/catalyst paste (red)

Composition:

   Base Paste:
               Zinc oxide                     87 %
               Olive oil /linseed oil          13%

 Accelerator paste:
               Oil of cloves                  12%
              Gum or polymerized rosin        50%
              Filler (silica type) :          20%
              Lanolin                         3%
              Resinous balsam                 10%
              Accelerator solution            5%

Setting Reaction :
        ZnO + H2O  Zn (OH)2

       Zn (OH)2 + 2HE  ZnE2+ 2 H2O

Manipulation:
  • Dispense equal length of the 2 pastes. Variation in length alters setting time.
  • Paper pad is used as a mixing slab & a stiff stainless steel spatula with an 8-10 cm
      blade should be used.
  • Mixing is done for 30-40 sec. until no color streaks in the mix & a uniform
      consistency is obtained.
Setting time:

                       Initial setting time         final setting time
     Type I                 3-6 min.                       10 min.
     Type II                3-6 min                        15 min.

Factors controlling setting time:

       Decreasing setting time:
          • Small amt. of zinc acetate
          • Accelerators
          • Small drop of water mixed in the paste containing eugenol
          • Increasing the mixing time.
          • Increasing accelerator paste while mixing.

       Increasing setting time:
           • Cooling the spatula & mixing slab
           • Addition of inert oils & waxes during mixing to reduce hardness like:
              olive oil.
           • Increasing base paste while mixing.


Properties:
       i) consistency & flow
                   thick consistency compress the tissues.

       ii) dimensional stability
                   quite satisfactory,
                   less than 0.1 % shrinkage occurs during hardening.

       iii) reproduction of details
                   • good.

       Biologic considerations:
              Some patients experience burning sensation in the mouth due to eugenol
              & can also cause tissue irritation. This maybe overcome by using a non
              eugenol paste.
Uses:
        1.   cementing & insulating medium
        2.   temporary filling
        3.   root canal filling material
        4.   surgical pack in periodontal surgical procedures.
        5.   bite registration pastes
        6.   temporary relining material for dentures.
        7.   impression material for edentulous patients.


Advantages:
      1. Good dimensional stability
      2. good detail reproduction
      3. impression surface can be modified by adding in deficient areas
      4. easy to manipulate
      5. long working time, so border moulding can be done while relining
         dentures.

 Disadvantages
      1. burning sensation due to eugenol.
      2. messy to work with
      3. sticks to skin & instruments , difficult to clean.
      4. rigid so tends to break off in areas of undercuts.
ALGINATE

Introduction:
                •   Comes from the term ‘algin’ coined by Scottish chemist.
                •   It is an elastic irreversible hydrocolloid because its sets by
                    chemical reaction.


Types:
   Type I fast setting : 1-2 min.
   Type II normal setting : 2-4.5 min.

Available as :
   1. bulk powder
   2. preweighed packages
   3. color changes alginates: violet during mixing, pink when ready to be seated
       white when set

Composition:

   Ester salts of alginic acid(sodium or potassium or triethanolamine alginate) 15%
   Calcium sulphate (reactor)                                                   16%
   Zinc oxide                                                                  4%
   Potassium titanium fluoride                                                 3%
   Diatomaceous earth                                                          60%
   Sodium phosphate                                                            2%
   Coloring & flavoring agents                                                 traces

   Setting reaction:

           2 Na3PO4 + 3 CaSO4  Ca3(PO4)2 + 3Na2SO4


   Setting Time:
           Type I (fast set) : 1-2min
           Type II (normal) : 2-4.5 min.


   Control Of gelation time:
      • Under control by manufacturers:
              o By the amt of retarder added during manufacturing.

       •   Under Control of clinicians
              o by altering the W:P ratio
o by changing the mixing time.
              o by altering the temp. of water


                  o increase in temp. decreases gelation time & vice versa.
                  o Premature gelation causes distortion in the impression & it is
                    rendered useless.
                  o Prolonged gelation time is tedious for both pt. & the dentist.


Manipulation :

      aerate the powder by inverting the can several times. This ensures uniform
distribution of the filler before mixing. The top of the can should be taken off
carefully to prevent the silica particles from being inhaled. The proper W/P ratio
as pacified by the manufacturer should be used measured quantity of water and
powder are added in the rubber bowl & mixing is started, with a stirring motion to
wet the powder with water. Once its moistened rapid spatulation by swiping or
stropping against the side of the bowl is done. A vigorous figure eight motion is
used.
                                   Mixing time:                 Working time
      For fast set alginate          45 sec.                         1 ¼ min.

   For normal set alginate           60 sec.                             2 min

Properties:

       i) taste & odor
                       • pleasant
       ii) flexibility
                       • lower w/p ratio results in lower flexibility.

       iii) elasticity & elastic recovery
                highly elastic, permanent deformation less if the impression is
                removed from the mouth quickly.

       iv) reproduction of the surface detail
                    • lower than agar.

       v) strength
                      •   compressive strength : 5000-8000 gm/cm2
                      •   tear strength : 350-700 gm/cm2

       vi) dimensional stability.
                      Poor
Biologic properties:
   • Silica present in the dust which rises from the can after fluffing alginate
       powder is a health hazard.
   • Dustless alginate is also present in the market which contain glycol.


Uses:
    1. for making primary impression of edentulous patients with undercut
       ridges.
    2. for preliminary impressions for complete dentures.
    3. for making impressions for dentulous pts. For construction of study
       models & temporary removable prosthesis.
    4. for making impression for orthodontic study models.
    5. used for making impressions for the preparation of mouth protectors for
       athletes.
    6. used as duplicating material.

Advantages:
     1. ease of mixing & manipulation.
     2. no elaborate equipment required.
     3. material is elastic & comes out easily from undercuts.
     4. economical
     5. impression can be removed easily & has pleasant taste & odor, so
         comfortable for the patient.
     6.
Disadvantages:
      1. can’t be electroplated.
      2. poor tear strength especially in thin sections.
      3. dimensional stability is poor.
      4. distortion may occur if tray is shifted during setting.
      5. cant be refined.


Types of failures:
       1. defects:
               a. improper mixing
               b. prolonged mixing
               c. undue gelation
               d. w/p ratio is too low.
       2. tearing:
               a. inadequate bulk
               b. moisture contamination
               c. premature removal from mouth
               d. prolonged mixing
3. external bubbles:
       a. undue gelation preventing flow
       b. air incorporated during mixing
4. irregularly shaped voids:
       a. moisture
5. rough or chalky stone model:
       a. inadequate cleaning of the impression
       b. excess water left in impression
       c. premature removal of model.
6. distortion:
       a. impression not poured immediately
ELASTOMERIC IMPRESSION MATERIALS

          •      basically synthetic rubbers.
          •      Initially they were called rubber impression materials.
          •      Currently known as non aqueous elastomeric dental impression materials.

          Classification: ( Based on chemical composition)
                  1. polyether
                  2. polysulfide
                  3. silicones.
                           Addition
                           Condensation .

POLYSULFIDE ELASTOMERIC IMPRESSION MATERIAL
       • First elastomeric impression material to be introduced.
       • also known as mercaptan / thymol

Supplied as
                 Base paste (white)
                 Accelerator (brown/grey)

Available in 3 viscosities:
               Light bodied
                Medium bodied
                Heavy bodied

Composition:
    Base paste:
                      Liquid polysulfide polymer                        80-85%
              Inert fillers (titanium oxide, zinc sulfate, silica)     16-18%

       Reactor Paste:
               Lead dioxide                                             60-69%
              Dibutyl phthalate                                        30-35%
              Sulfur                                                   3%
             Other substances (like magnesium stearate)                2%
               and deodorants

       Setting reaction:

               HS - R - SH ----------PbO2 + S---->    HS - R- S – S – R - SH + H2O

       Properties:
1) setting time – 5-8 min.
          • colder climate increases setting time.
          • Drop of water accelerates the reaction.
      2) excellent detail reproduction.
      3) dimensional stability
          • curing shrinkage – 0.45% due to continued reaction.
          • Shrinkage due to loss of byproduct.
      4) permanent deformation – 3-5%
                   • highest amongst elastomers.
      5) high tear strength – 7000gm/cm2
      6) good flexibility of 7%, allows elastic recovery of the material.
      7) hydrophobic- tissue should be thoroughly dried before making the impression.
      8) can be electroplated with copper.

      Advantages:
                1.   long working time.
                2.   proven accuracy
                3.   high tear resistance.
                4.   inexpensive to use
                5.   less hydrophobic
                6.   longer shelf life.

      Disadvantages:
                1. must be poured with dental stone immediately.
                2. potential for significant distortion.
                3. odor is offensive.
                4. messy & stains clothes.
                5. second pour is less accurate.


CONDENSATION SILICONES
                  • It was the first type of silicone impression material.
                  • Also known as conventional silicones.
                  • Setting occurs in room temp , so called as RTV silicones.

      Composition:
             Base paste
                   1. Polydimethyl siloxane (hydroxy terminated)
                   2.Colloidal silica or micro sized metal oxide filler
                                   putty viscosity – 60-70%
                                   medium viscosity – 35-75 %
                                   low viscosity – 5-15%
                   3. color pigments

             accelerator paste
                    1. alkyl silicate (ortho ethyl silicate)
2. stannous octate
                        3. inert filler.

Setting reaction:

       Dimethyl         orthoethyl                                   silicone             ethyl
                    +                ----STANNOUS   OCTATE-----
                                                              >            +
        Siloxane        silicate                                  rubber        alcohol


       Properties:
          1. Setting time – 8-9 min.
              Mixing time – 45 sec.
          2. excellent detail reproduction
          3. dimensional stability – high curing shrinkage.
          4. permanent deformation – 1-3 %
          5. tear strength – 3000gm/cm
          6. stffer & harder than polysulfide material.
          7. hydrophobic
          8. can be electroplated with silver & copper.
          9. shelf life - 2 yrs.

Advantages:
         1.    adequate working & setting timer.
         2.    pleasant odor & no staining.
         3.    adequate tear strength
         4.    better elastic properties on removal.
         5.    less distortion on removal.

Disadvantages:
          1. adequate accuracy if poured immediately.
          2. poor dimensional stability.
          3. potential for significant distortion.
          4. putty-wash method is technique sensitive.
          5. slightly more expensive.



ADITION SILICONES
              • Introduced after condensation silicones
              • Have better properties than condensation silicones.
              • Also known as poly vinyl siloxane.
Composition:
            Base paste
                    1) poly(methyl hydrogen siloxane)
                     2) other siloxane prepolymers
                    3) fillers
                        • putty viscosity – 60-70 %
                        • medium viscosity – 35-75 %
                        • low viscosity – 5-15%
            accelerator paste
                        1. divnyl polysiloxane
                        2. inert oils & fillers
                        3. platinum salt
                        4. palladium
                        5. retarders
                        6. fillers.


Setting reaction:

       Poly vinyl siloxane + silane siloxane    -----Pt ,Salt -----> silicone rubber


Properties:
              1. setting time: - 5.9 min.
                 mixing time - 45 sec
              2. excellent surface detail reproduction.
              3. highest dimensional stability amongst elastomers
              4. lowest curing shrinkage – 0.17 %
              5. good tear strength – 3000gm/cm
              6. extremely hydrophobic
              7. low flexibility
              8. electroplated with copper & silver.
              9. shelf life - 1-2 yrs.

Advantages:
      1. short setting time
      2. adequate tear strength
      3. extremely high accuracy
      4. minimal distortion on removal
      5. dimensionally stable even after 1 week
      6. if hydrophilic, good compatibility with gypsum.

Disadvantages:
          1. hydrogen gas may cause dimensional change.
2. hydrophobic & hence requires a very dry field.
              3. expensive.

POLYETHER IMPRESION MATERIAL

   •   Introduced in Germany in late 1960’s
   •   1st Elastomers to be developed as impression material.

Composition:
     Base Paste:
          1. imine terminated polymer(polyether)
          2. colloidal silica
          3. glycol ether or phthalate

       Accelerator Paste:
          1. alkyl aromatic sulfonate
          2. colloidal silica
          3. plasticizers ( glycoether )

Setting Reaction:
                         polyether + sulfonic ester ---- cross linked rubber.

Properties:
              1. setting time: 8.3 min.
                 mixing time – 30 sec.
              2. dimensional stability is good.
              3. decreased flexibility – 3%
              4. hydrophilic
              5. activator paste can produce allergy if handled frequently.
              6. tear strength – 3000gm/cm
              7. shelf life > 2 yrs.

Advantages:
          1.      short working & setting time
          2.      proven accuracy
          3.      adequate tear strength
          4.      hydrophilic
          5.      long shelf life
          6.      less distortion on removal
          7.      good dimensional stability.



Disadvantages:
          1. stiffness requires blocking of undercuts
          2. slightly more expensive
3. multiple casts can’t be poured due to stiffness of the material.

Manipulation of Elastomers:
      Manipulation of two paste systems
          • equal length of base & activator paste are taken.
          • Paper pad with graduations is provided by manufacturer.
          • Pastes are mixed till no streaks are present.
          • Tray coated with tray adhesive. Uniform two-layer coat is applied &
              allowed to dry.
          • The mixed material can either be taken in a syringe or loaded directly in
              the tray.

Manipulation of Putty Material:
          • Putty dispenser is supplied with scoops for dispensing.
          • Activator may be a liquid or paste.
          • Putty material is taken in a scoop & the activator is added. Usually the
              activator is of different color.
          • It is kneaded till no streaks are present.
          • Putty material is used with stock trays.
IMPRESSION TECHNIQUES

Impression can be classified as :

1. depending on the theories of impression making:
      a. mucostatic/passive impression.
      b. Mucocompressive/functional impression
      c. Selective pressure impression.
2. depending on the technique:
      a. open mouth technique
      b. closed- mouth technique
3. hand manipulation for functional movements:
      a. border moulding
4. depending of the type of tray:
      a. stock tray impression
      b. custom tray impression
5. depending on the purpose of the impression :
      a. diagnostic impression
      b. primary impression
      c. secondary impression
6. depending on the material used:
      a. reversible hydrocolloid impression
      b. irreversible hydrocolloid impression
      c. modeling plastic impression
      d. plaster impression
      e. wax impression
      f. silicone impression
      g. Thiokol rubber impression.
MUCOSTATIC / PASSIVE IMPRESSION
     • Proposed by Richardson
     • Impression is made with the oral mucous membrane & the
        jaws in a normal relaxed condition.
     • Border moulding not done.
     • Impression material – impression plaster
     • Retention due to interfacial surface tension.
     • Taken with an oversized tray.
     • Denture closely adapted to the denture bearing area but has
        poor peripheral seal. Therefore these dentures have good
        stability but poor retention.


MUCOCOMPRESSIVE/ IMPRESSION
      • Given by Carole Jones
      • Records oral tissues in a functional & displaced form.
      • Imp. Material – imp. Compound , waxes , soft liners.
      • Dentures don’t get displaced due to tissue rebound at rest.
      • During function, the constant pressure exerted onto soft
        tissues limit the blood circulation leading to residual ridge
        resorption.

SELECTIVE PRESSURE TECHNIQUE
           • Given by Boucher.
           • Impression made to extend over as much denture
             bearing area as possible without interfering with the
             limiting str. At function at rest.
           • Forces acting on the denture are confined to the stress
             bearing areas.
           • Relief is given by using wax in the special tray, which
             is removed before impression making.

FOR ELASTOMERS:
 PUTTY WASH/RELINE TECHNIQUE
        • Combination of putty & light body impression are used.
        • Putty material forms the bulk & supports light bodied
          material
        • Light bodied material records fine details.

                 o Single mix technique
                 o Multiple mix technique
                 o Triple tray/ double arch technique
 Single mix technique
              Equal lengths of base paste & accelerator
                paste are taken.
              Both putty & light bodied material are
                simultaneously mixed.
              The syringe material is then injected into
                prepared area of impression, tray seated over
                it, material allowed to set.

 Multiple Mix Technique
               Material loaded on the stock tray & primary
                  impression taken with putty material. Relief
                  with cellophane spacer given.
               Light bodied material mixed & filled in the
                  space provided in the impression, syringe
                  material is injected into the impression area.
               Putty impression is then seated over it &
                  held till it sets.
 Triple tray technique
               Uses a special tray having a plastic frame
                  with a thin mesh work.
               Material loaded into either side of the tray.
               Patient asked to occlude into the tray
                  between the arches.
               Impression records the teeth in both
                  impression arches.
IMPRESSION PROCEDURES.

RECORDING THE PRIMARY IMPRESSION.

        TRAY SELECTION
           o Known as stock trays.
           o Can be metal / plastic, perforated or non perforated.
           o Available in standard sizes.
           o There should be 2-3 mm clearance between the stock tray
              & the ridge & should have 5-6 mm clearance for
              impression compound.
           o Tray should be extend over the tuberosity & the hamular
              notch.
           o If try too large – it will distort the tissue in the borders of
              the impression & push the tissues away from the bone.
           o If tray is too small – then modeling wax should be added
              along the posterior border of the tray.
           o The tray material should not react with the impression
              material & should not distort.

        PRIMARY IMPRESSION MAKING IN MAXILLARY ARCH.
          o Objective – to obtain a preliminary impression that is slightly
             overextended along the borders.
          o Imp material with high viscosity preferred
          o Imp. Compound softened in water bath at 140.F, then
             kneaded.
          o Kneaded material rolled into a tray & rolled into a ball &
             placed on the tray. Using thumb the operator should spread &
             adapt the material allover the tray so that it app. To the ridge
             contour.
          o If alginate used then small amt. of material is placed in the
             post. Part of the palate & tuberosities before making the imp.
          o Pt. asked to sit upright & open the mouth halfway. Operator
             should position himself towards the side & rear of the patient.
          o Tray centered over the upper residual ridge by using labial
             frenum as a centering guide.
          o After proper positioning the tray is seated over the ridge by
             applying pressure in the first molar region, until it touches the
             posterior palatal seal.
          o Tray stabilized with a finger placed in its center
o Borders are refined by asking the pt. to suck down into the
               tray, move the mandible side to side & then open wide. This
               record the labial & buccal vestibules & influence of coronoid
               process on the shape of the buccal vestibules.
             o Once the material has set, the cheeks & upper lip are lifted
               away from the borders to allow for air entry. Tray is then
               removed from the mouth in one motion & inspected for any
               deficiency.
             o Borders of the custom tray can be marked by
                              Marking the peripheral outline on the
                                 impression.
                              Outlining the cast
             o Cast is observed & then poured with dental plaster.


 PRIMARY IMPRESSION MAKING IN MANDIBULAR ARCH

             o Choice of material – impression compound / high viscosity
               alginate.
             o Astringent mouthwash given to reduce the viscosity of the
               saliva.
             o Impression material manipulated & loaded into the tray, if
               alginate used then small quantity placed on the retromolar
               pads.
             o Tray should be rotated within the patients mouth in a
               horizontal plane until it is in the center of the residual ridge.
               The pt. should be asked to raise the tongue to fit into the
               tongue space of the impression tray.
             o Tray is seated gently using alternate pressure on the molar
               regions of either side,.
             o Then passive movements of peripheral musculature is done.
             o Once the imp. Material sets, the lips & cheek are retracted &
               the imp. Is removed in a single snap from the patients mouth.
             o Imp. Should be Checked for any errors like voids etc.
RECORDING THE SECONDARY IMPRESSION

   SECONDARY IMPRESSION MAKING IN MAXILLARY ARCH

    It includes:
                      •   Border Moulding
                      •   Tray preparation after border moulding
                      •   Making the wash impression
                      •   Recording the posterior palatal seal
                      •   Checking for errors in the posterior palatal seal.



            Border Moulding

            Two techniques for border moulding:
                      1. single step or simultaneous border moulding.
                      2. incremental or sectional border moulding.

                   Single step border moulding
                          Polyether is the material of choice.
                          Done in single step.

                   Incremental border moulding
                         Greenstick compound is the material of choice.
                         Spacer is removed just before impression making.

                           Clinical procedure:
                                  o greenstick compound is softened over flame &
                                      added along portion of the tray, material should
                                      be tempered with warm water before placing
                                      intraorally.
                                  o Order: Labial vestibule -> buccal vestibule ->
                                      posterior palatal seal.
                                  o Passive Movements are made.
                                  o After border moulding , the moulded section is
                                      immersed in cold water.
                                  o Then the procedure is repeated for another
                                      section.
Tray preparation after border moulding.
               o The wax spacer is removed to provide space for the
                  impression material.
               o 0.5-1 mm of the tracing material is removed from the
                  outer, inner & top surfaces of the border.
               o The material over the posterior palatal seal is not
                  removed.
               o Green stick compound removed using a scalpel.
               o The thickness of the flanges & the border should be
                  2.5-3 mm.
               o Holes are drilled into the impression tray to allow
                  escapement of the impression material.

Making the Master / wash impression.
             o Material of choice – zinc oxide eugenol impression
                 paste.
             o Impression material is manipulated & loaded onto the
                 tray. The patient made to sit in an upright position.
                 Operator stands towards the rear or the side of the
                 patient.
             o Tray is placed in the patients mouth using the labial
                 notch as a guide.
             o Tray is seated into position by applying alternating
                 pressures on the right & left molar regions using index
                 fingers.
             o Tray is maintained in this position by placing a finger in
                 the palatal region of the tray, immediately anterior to
                 the posterior palatal seal.
             o Passive movements are made.
             o After material has set, the tray is removed in a single
                 jerk.
             o Impression inspected for deficiencies & voids & is
                 repeated if necessary.

Recording the posterior palatal seal.

       Methods used to record it are:
          1. conventional approach
          2. fluid wax technique.
          3. arbitrary scraping of the master cast.
          4. extended palatal technique.

               Conventional approach :
                  o done after the wash impression is made & master
                     cast is poured.
o Trial base is fabricated using shellac base plate.
                       o The patient is asked to sit in an upright position &
                         asked to rinse his mouth.
                       o T burnisher is used to locate the hamular notch. the
                         full extent of the hamular notch is marked with an
                         inedible pencil.
                       o Posterior vibrating line is marked using a inedible
                         pencil by asking the patient to say “ah” in a non
                         vigorous manner.
                       o Line marked in the hamular notch is connected with
                         the posterior vibrating line using an inedible pencil.
                       o Trial base inserted into the patient’s mouth so that
                         the inedible markings are transferred to the trial
                         base.
                       o Trial base is seated on the master cast to transfer the
                         markings marked in the patient’s mouth to the cast.
                       o Trial base is trimmed till the posterior border.
                       o Anterior vibrating line marked in the patient’s
                         mouth with an inedible pencil & while recording it
                         the patient should perform the valsalva maneuver.
                       o The area between the anterior & posterior vibrating
                         line is scraped in the master cast to a depth of 1-1.5
                         mm on either side of the mid palatine raphe.
                       o The posterior border of the posterior seal should be
                         tapered so that it blends with the palatal tissues.


 SECONDARY IMPRESSION MAKING IN MANDIBULAR ARCH

             It includes:
                      Border moulding
                      Tray preparation after border moulding
                      Making the wash / master impression.


       Border moulding
              o Done by two techniques:
                        Single step border moulding
                        Incremental border moulding

             o Same procedure is carried out in both techniques.
             o Anterior portion is moulded before the posterior portion.
             o Labial & buccal flange is moulded first followed by the lingual
               flange.
Recording the Labial & buccal flange
                    • Labial portion moulded by moving the lip
                        outward, upward & inward.
                    • Buccal frenum is recorded by moving the cheek
                        outward , upward , backward & forward,
                    • Distobuccal sulcus is recorded by retracting the
                        cheek & moving it upward & inward.


       Recording the lingual flange.
                 • Anterior lingual flange is recorded by asking the
                     patient to protrude his tongue out & touch the
                     anterior part of the palate.

       Recording the retromolar pad
                 • To record the distal end of the tray the patient is
                     asked to open his mouth wide
                 • After recording the distal end the impression is
                     verified, if a notch is produced in the posteromedial
                     end of the tray it indicates that the tray is
                     overextended up to the pterygomandibular raphe.

Tray preparation after border moulding
          o Procedure similar to maxillary impression.
          o Escape holes placed 10 mm apart in the alveolar ridge &
               retromolar pad.


Making the final / master / wash impression.
          o Tray placement should be practiced before making the final
              impression.
          o Dry gauze should be placed in the floor of the mouth to
              remove the saliva & removed before making the
              impression.
          o The impression material is manipulated & loaded onto th
              tray.
          o The tray is rotated in a horizontal plane & inserted into the
              mouth using the anterior handle.
          o Tray is seated completely by applying alternating pressure
              over the posterior handles.
          o After the material is set the impression is removed &
              examined for any defects.
REFERENCES:

          Basic dental materials by John J. Manappallil

          Textbook of dental materials by Sharmila Hussain

          Boucher’s Prosthodontics Treatment for Edentulous Treatment, 9th ed.

          Textbook of Prosthodontics of Deepak Nallaswamy.

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impression-materials-techniques-procedures-for-complete-dentures-prostho

  • 1. IMPRESSION MATERIALS IMPRESSION Definition. : a dental impression is a negative replica of the tissues of the oral cavity. CLASSIFICATION OF IMPRESSION MATERIALS. I) Based on mode of setting & elasticity a) Rigid i) Reversible (thermoplastic) E.g. impression compound ii) Irreversible (thermosest) E.g. Zoe impression paste Impression plaster. b) elastic i) Hydrocolloid a) reversible E.g. Agar b) Irreversible E.g. Alginate ii) Elastomeric impression materials E.g. Polysulfides Polyether Addition silicones Condensation silicones II) Based on type of impression & area of use A) Dentulous i) Primary E.g. alginate ii) Secondary E.g. Elastomers Agar B) Edentulous i) Primary E.g. Impression compound Impression plaster Alginate
  • 2. ii) Secondary e.g. ZOE impression paste Elastomers for CD III) based on their use in dentistry A) edentulous For complete denture prosthesis e.g. Impression compound zoe impression paste alginate Elastomers B) dentulous i) FPD ii) RPD E.g. Agar Alginate Elastomers IV) based on the amount of pressure applied i) Mucocompressive e.g. Impression compound ii) mucostatic e.g. Impression plaster V) based on the manipulation A) hand mixing i) kneading e.g. Impression compound – wet kneading putty consistency Elastomers ii) circular motion (with glass slab & spatula) eg.zoe impression paste polysulfide iii) vigorous mixing e.g. Alginate (figure of 8 motions) B) mechanical mixing VI) based on the tray used for impression A) stock tray i) types of tray a) rim locked perforated e.g. Alginate Elastomers b) water cooled e.g. Agar
  • 3. c) plastic e.g. Orthodontic tray ii) based on type of perforation a) perforated e.g. Alginate Elastomers • putty wash impression b) non perforated e.g. Impression compound B) special tray i) base plate wax e.g. Zoe impression paste medium body ii) resin.
  • 4. IDEAL REQIUREMENTS OF IMPRESSION MATERIAL 1. have a pleasant taste & odor 2. not contain toxic or irritant constituents. 3. adequate shelf life for requirements of storage & distribution. 4. economically commensurate with the results obtained. 5. easy to use with the minimum of equipment. 6. setting characteristics that meet clinical requirements. 7. satisfactory consistency texture. 8. readily wets oral tissues 9. elastic properties with freedom from permanent deformation after strain. 10. adequate strength so it will not break or tear on removal from the mouth. 11. dimensional stability over temp. & humidity ranges normally found in clinical & lab. Procedures for a period long enough to permit the production of a cast or die. 12. compatibility with cast & die materials. 13. accuracy in clinical use. 14. readily disinfected without loss of accuracy. 15. no release of gas or other by products during the setting of the impression or cast & die materials.
  • 5. IMPRESSION COMPOUND It is a rigid, reversible impression material which sets by physical change. Classification: Acc to ADA sp. No.3: Type I: low fusing compound – green stick compound. medium fusing compound – impression compound. Type II: high fusing compound – tray compound. Supplied as: 1. as sticks, cakes, & cones. 2. colors – green, brown, red. Applications: Type I: For making primary impressions. For individual tooth impression For peripheral tracing or border moulding. To check undercuts in inlay preparation. Type II: To make a special tray. Requirements of an ideal impression compound: 1. harden at or little above mouth temp. 2. be plastic at a temp. not injurious or harmful to oral tissues. 3. not containing irritating or toxic ingredients. 4. harden uniformly when cooled without distortion. 5. have a consistency when softened which will allow it to reproduce fine details. 6. be cohesive but not adhesive. 7. not undergo permanent deformation or fracture while withdrawing the impression from the mouth. 8. be dimensionally stable after removal from mouth & during storage. 9. exhibit a smooth glossy surface after flaming. 10. withstand trimming with sharp knife without flaking or chipping after hardening. Composition Rosin 30 Copal resin 30 Carbuna wax 10 Stearic acid 5 Talc 25 Coloring agent app.
  • 6. Properties: Thermal properties i) thermal conductivity: has low thermal conductivity. Significance: • during softening of the material , the outside will soften first & inside last. So to ensure uniform softening the material should be kept immersed for a long time in water bath. • the layer adjacent to the mouth tissue swill remain soft. Therefore Its imp to cool the compound thoroughly before removing the impression. ii) Coefficient of linear expansion. (CTE) high CTE , 0.3% acceptable. iii) Flow high fusing compounds – < 2% at 37 .C & < 70-85 % at 45.C low fusing compounds - < 3% at 37 C & < 80-85% at 45 C impression compound to be manipulated at least 8 .C for adequate flow. iv) Glass transition temp • it is the temp. at which the material loses its hardness or brittleness on heating or forms a rigid mass. • App. 39.C • Material removed from the mouth after glass transition temp. is reached. v) Fusion Temp. • it’s the temp. at which the impression compound becomes plastic. • Its 43.5.C vi) Dimensional stability. • Poor dimensional stability. • To prevent distortion pour the cast within 1 hr. vii) surface detail reproduction less because of high viscosity & low flow. Manipulation Sticks Small amt. softened over flame Cakes Softened in a thermostatically controlled water bath.
  • 7. Precautions: o prolonged immersion in a water bath is not indicated o overheating In water makes the compound sticky & difficult to handle. o avoid incorporating water while kneading. Advantages: 1. cheap 2. reusable 3. does not produce irritation to the patient 4. impression can be remodified & resoftned again till an accurate impression is obtained. 5. Disadvantages: 1. difficult to record details accurately. 2. Soft tissues are compressed due to pressure applied while taking the impression. 3. Distortion. 4. Difficult to remove undercuts. 5. Does not have an pleasant taste. 6. Can be uncomfortable in patients because of the rigidity.
  • 8. ZINC OXIDE EUGENOL PASTE Introduction  Produce a rigid impression.  High degree of accuracy & good surface reproduction of details.  Is irreversible, sets by chemical change. Classification: ADA specification No. 16 Type I or hard Type II or soft Available as In paste form in 2 tubes Base paste (white) Accelerator/ reactor/catalyst paste (red) Composition: Base Paste: Zinc oxide 87 % Olive oil /linseed oil 13% Accelerator paste: Oil of cloves 12% Gum or polymerized rosin 50% Filler (silica type) : 20% Lanolin 3% Resinous balsam 10% Accelerator solution 5% Setting Reaction : ZnO + H2O  Zn (OH)2 Zn (OH)2 + 2HE  ZnE2+ 2 H2O Manipulation: • Dispense equal length of the 2 pastes. Variation in length alters setting time. • Paper pad is used as a mixing slab & a stiff stainless steel spatula with an 8-10 cm blade should be used. • Mixing is done for 30-40 sec. until no color streaks in the mix & a uniform consistency is obtained.
  • 9. Setting time: Initial setting time final setting time Type I 3-6 min. 10 min. Type II 3-6 min 15 min. Factors controlling setting time: Decreasing setting time: • Small amt. of zinc acetate • Accelerators • Small drop of water mixed in the paste containing eugenol • Increasing the mixing time. • Increasing accelerator paste while mixing. Increasing setting time: • Cooling the spatula & mixing slab • Addition of inert oils & waxes during mixing to reduce hardness like: olive oil. • Increasing base paste while mixing. Properties: i) consistency & flow  thick consistency compress the tissues. ii) dimensional stability  quite satisfactory,  less than 0.1 % shrinkage occurs during hardening. iii) reproduction of details • good. Biologic considerations: Some patients experience burning sensation in the mouth due to eugenol & can also cause tissue irritation. This maybe overcome by using a non eugenol paste.
  • 10. Uses: 1. cementing & insulating medium 2. temporary filling 3. root canal filling material 4. surgical pack in periodontal surgical procedures. 5. bite registration pastes 6. temporary relining material for dentures. 7. impression material for edentulous patients. Advantages: 1. Good dimensional stability 2. good detail reproduction 3. impression surface can be modified by adding in deficient areas 4. easy to manipulate 5. long working time, so border moulding can be done while relining dentures. Disadvantages 1. burning sensation due to eugenol. 2. messy to work with 3. sticks to skin & instruments , difficult to clean. 4. rigid so tends to break off in areas of undercuts.
  • 11. ALGINATE Introduction: • Comes from the term ‘algin’ coined by Scottish chemist. • It is an elastic irreversible hydrocolloid because its sets by chemical reaction. Types: Type I fast setting : 1-2 min. Type II normal setting : 2-4.5 min. Available as : 1. bulk powder 2. preweighed packages 3. color changes alginates: violet during mixing, pink when ready to be seated white when set Composition: Ester salts of alginic acid(sodium or potassium or triethanolamine alginate) 15% Calcium sulphate (reactor) 16% Zinc oxide 4% Potassium titanium fluoride 3% Diatomaceous earth 60% Sodium phosphate 2% Coloring & flavoring agents traces Setting reaction: 2 Na3PO4 + 3 CaSO4  Ca3(PO4)2 + 3Na2SO4 Setting Time: Type I (fast set) : 1-2min Type II (normal) : 2-4.5 min. Control Of gelation time: • Under control by manufacturers: o By the amt of retarder added during manufacturing. • Under Control of clinicians o by altering the W:P ratio
  • 12. o by changing the mixing time. o by altering the temp. of water o increase in temp. decreases gelation time & vice versa. o Premature gelation causes distortion in the impression & it is rendered useless. o Prolonged gelation time is tedious for both pt. & the dentist. Manipulation : aerate the powder by inverting the can several times. This ensures uniform distribution of the filler before mixing. The top of the can should be taken off carefully to prevent the silica particles from being inhaled. The proper W/P ratio as pacified by the manufacturer should be used measured quantity of water and powder are added in the rubber bowl & mixing is started, with a stirring motion to wet the powder with water. Once its moistened rapid spatulation by swiping or stropping against the side of the bowl is done. A vigorous figure eight motion is used. Mixing time: Working time For fast set alginate 45 sec. 1 ¼ min. For normal set alginate 60 sec. 2 min Properties: i) taste & odor • pleasant ii) flexibility • lower w/p ratio results in lower flexibility. iii) elasticity & elastic recovery highly elastic, permanent deformation less if the impression is removed from the mouth quickly. iv) reproduction of the surface detail • lower than agar. v) strength • compressive strength : 5000-8000 gm/cm2 • tear strength : 350-700 gm/cm2 vi) dimensional stability. Poor
  • 13. Biologic properties: • Silica present in the dust which rises from the can after fluffing alginate powder is a health hazard. • Dustless alginate is also present in the market which contain glycol. Uses: 1. for making primary impression of edentulous patients with undercut ridges. 2. for preliminary impressions for complete dentures. 3. for making impressions for dentulous pts. For construction of study models & temporary removable prosthesis. 4. for making impression for orthodontic study models. 5. used for making impressions for the preparation of mouth protectors for athletes. 6. used as duplicating material. Advantages: 1. ease of mixing & manipulation. 2. no elaborate equipment required. 3. material is elastic & comes out easily from undercuts. 4. economical 5. impression can be removed easily & has pleasant taste & odor, so comfortable for the patient. 6. Disadvantages: 1. can’t be electroplated. 2. poor tear strength especially in thin sections. 3. dimensional stability is poor. 4. distortion may occur if tray is shifted during setting. 5. cant be refined. Types of failures: 1. defects: a. improper mixing b. prolonged mixing c. undue gelation d. w/p ratio is too low. 2. tearing: a. inadequate bulk b. moisture contamination c. premature removal from mouth d. prolonged mixing
  • 14. 3. external bubbles: a. undue gelation preventing flow b. air incorporated during mixing 4. irregularly shaped voids: a. moisture 5. rough or chalky stone model: a. inadequate cleaning of the impression b. excess water left in impression c. premature removal of model. 6. distortion: a. impression not poured immediately
  • 15. ELASTOMERIC IMPRESSION MATERIALS • basically synthetic rubbers. • Initially they were called rubber impression materials. • Currently known as non aqueous elastomeric dental impression materials. Classification: ( Based on chemical composition) 1. polyether 2. polysulfide 3. silicones.  Addition  Condensation . POLYSULFIDE ELASTOMERIC IMPRESSION MATERIAL • First elastomeric impression material to be introduced. • also known as mercaptan / thymol Supplied as Base paste (white) Accelerator (brown/grey) Available in 3 viscosities: Light bodied Medium bodied Heavy bodied Composition: Base paste: Liquid polysulfide polymer 80-85% Inert fillers (titanium oxide, zinc sulfate, silica) 16-18% Reactor Paste: Lead dioxide 60-69% Dibutyl phthalate 30-35% Sulfur 3% Other substances (like magnesium stearate) 2% and deodorants Setting reaction: HS - R - SH ----------PbO2 + S----> HS - R- S – S – R - SH + H2O Properties:
  • 16. 1) setting time – 5-8 min. • colder climate increases setting time. • Drop of water accelerates the reaction. 2) excellent detail reproduction. 3) dimensional stability • curing shrinkage – 0.45% due to continued reaction. • Shrinkage due to loss of byproduct. 4) permanent deformation – 3-5% • highest amongst elastomers. 5) high tear strength – 7000gm/cm2 6) good flexibility of 7%, allows elastic recovery of the material. 7) hydrophobic- tissue should be thoroughly dried before making the impression. 8) can be electroplated with copper. Advantages: 1. long working time. 2. proven accuracy 3. high tear resistance. 4. inexpensive to use 5. less hydrophobic 6. longer shelf life. Disadvantages: 1. must be poured with dental stone immediately. 2. potential for significant distortion. 3. odor is offensive. 4. messy & stains clothes. 5. second pour is less accurate. CONDENSATION SILICONES • It was the first type of silicone impression material. • Also known as conventional silicones. • Setting occurs in room temp , so called as RTV silicones. Composition: Base paste 1. Polydimethyl siloxane (hydroxy terminated) 2.Colloidal silica or micro sized metal oxide filler putty viscosity – 60-70% medium viscosity – 35-75 % low viscosity – 5-15% 3. color pigments accelerator paste 1. alkyl silicate (ortho ethyl silicate)
  • 17. 2. stannous octate 3. inert filler. Setting reaction: Dimethyl orthoethyl silicone ethyl + ----STANNOUS OCTATE----- > + Siloxane silicate rubber alcohol Properties: 1. Setting time – 8-9 min. Mixing time – 45 sec. 2. excellent detail reproduction 3. dimensional stability – high curing shrinkage. 4. permanent deformation – 1-3 % 5. tear strength – 3000gm/cm 6. stffer & harder than polysulfide material. 7. hydrophobic 8. can be electroplated with silver & copper. 9. shelf life - 2 yrs. Advantages: 1. adequate working & setting timer. 2. pleasant odor & no staining. 3. adequate tear strength 4. better elastic properties on removal. 5. less distortion on removal. Disadvantages: 1. adequate accuracy if poured immediately. 2. poor dimensional stability. 3. potential for significant distortion. 4. putty-wash method is technique sensitive. 5. slightly more expensive. ADITION SILICONES • Introduced after condensation silicones • Have better properties than condensation silicones. • Also known as poly vinyl siloxane.
  • 18. Composition: Base paste 1) poly(methyl hydrogen siloxane) 2) other siloxane prepolymers 3) fillers • putty viscosity – 60-70 % • medium viscosity – 35-75 % • low viscosity – 5-15% accelerator paste 1. divnyl polysiloxane 2. inert oils & fillers 3. platinum salt 4. palladium 5. retarders 6. fillers. Setting reaction: Poly vinyl siloxane + silane siloxane -----Pt ,Salt -----> silicone rubber Properties: 1. setting time: - 5.9 min. mixing time - 45 sec 2. excellent surface detail reproduction. 3. highest dimensional stability amongst elastomers 4. lowest curing shrinkage – 0.17 % 5. good tear strength – 3000gm/cm 6. extremely hydrophobic 7. low flexibility 8. electroplated with copper & silver. 9. shelf life - 1-2 yrs. Advantages: 1. short setting time 2. adequate tear strength 3. extremely high accuracy 4. minimal distortion on removal 5. dimensionally stable even after 1 week 6. if hydrophilic, good compatibility with gypsum. Disadvantages: 1. hydrogen gas may cause dimensional change.
  • 19. 2. hydrophobic & hence requires a very dry field. 3. expensive. POLYETHER IMPRESION MATERIAL • Introduced in Germany in late 1960’s • 1st Elastomers to be developed as impression material. Composition: Base Paste: 1. imine terminated polymer(polyether) 2. colloidal silica 3. glycol ether or phthalate Accelerator Paste: 1. alkyl aromatic sulfonate 2. colloidal silica 3. plasticizers ( glycoether ) Setting Reaction: polyether + sulfonic ester ---- cross linked rubber. Properties: 1. setting time: 8.3 min. mixing time – 30 sec. 2. dimensional stability is good. 3. decreased flexibility – 3% 4. hydrophilic 5. activator paste can produce allergy if handled frequently. 6. tear strength – 3000gm/cm 7. shelf life > 2 yrs. Advantages: 1. short working & setting time 2. proven accuracy 3. adequate tear strength 4. hydrophilic 5. long shelf life 6. less distortion on removal 7. good dimensional stability. Disadvantages: 1. stiffness requires blocking of undercuts 2. slightly more expensive
  • 20. 3. multiple casts can’t be poured due to stiffness of the material. Manipulation of Elastomers: Manipulation of two paste systems • equal length of base & activator paste are taken. • Paper pad with graduations is provided by manufacturer. • Pastes are mixed till no streaks are present. • Tray coated with tray adhesive. Uniform two-layer coat is applied & allowed to dry. • The mixed material can either be taken in a syringe or loaded directly in the tray. Manipulation of Putty Material: • Putty dispenser is supplied with scoops for dispensing. • Activator may be a liquid or paste. • Putty material is taken in a scoop & the activator is added. Usually the activator is of different color. • It is kneaded till no streaks are present. • Putty material is used with stock trays.
  • 21. IMPRESSION TECHNIQUES Impression can be classified as : 1. depending on the theories of impression making: a. mucostatic/passive impression. b. Mucocompressive/functional impression c. Selective pressure impression. 2. depending on the technique: a. open mouth technique b. closed- mouth technique 3. hand manipulation for functional movements: a. border moulding 4. depending of the type of tray: a. stock tray impression b. custom tray impression 5. depending on the purpose of the impression : a. diagnostic impression b. primary impression c. secondary impression 6. depending on the material used: a. reversible hydrocolloid impression b. irreversible hydrocolloid impression c. modeling plastic impression d. plaster impression e. wax impression f. silicone impression g. Thiokol rubber impression.
  • 22. MUCOSTATIC / PASSIVE IMPRESSION • Proposed by Richardson • Impression is made with the oral mucous membrane & the jaws in a normal relaxed condition. • Border moulding not done. • Impression material – impression plaster • Retention due to interfacial surface tension. • Taken with an oversized tray. • Denture closely adapted to the denture bearing area but has poor peripheral seal. Therefore these dentures have good stability but poor retention. MUCOCOMPRESSIVE/ IMPRESSION • Given by Carole Jones • Records oral tissues in a functional & displaced form. • Imp. Material – imp. Compound , waxes , soft liners. • Dentures don’t get displaced due to tissue rebound at rest. • During function, the constant pressure exerted onto soft tissues limit the blood circulation leading to residual ridge resorption. SELECTIVE PRESSURE TECHNIQUE • Given by Boucher. • Impression made to extend over as much denture bearing area as possible without interfering with the limiting str. At function at rest. • Forces acting on the denture are confined to the stress bearing areas. • Relief is given by using wax in the special tray, which is removed before impression making. FOR ELASTOMERS: PUTTY WASH/RELINE TECHNIQUE • Combination of putty & light body impression are used. • Putty material forms the bulk & supports light bodied material • Light bodied material records fine details. o Single mix technique o Multiple mix technique o Triple tray/ double arch technique
  • 23.  Single mix technique  Equal lengths of base paste & accelerator paste are taken.  Both putty & light bodied material are simultaneously mixed.  The syringe material is then injected into prepared area of impression, tray seated over it, material allowed to set.  Multiple Mix Technique  Material loaded on the stock tray & primary impression taken with putty material. Relief with cellophane spacer given.  Light bodied material mixed & filled in the space provided in the impression, syringe material is injected into the impression area.  Putty impression is then seated over it & held till it sets.  Triple tray technique  Uses a special tray having a plastic frame with a thin mesh work.  Material loaded into either side of the tray.  Patient asked to occlude into the tray between the arches.  Impression records the teeth in both impression arches.
  • 24. IMPRESSION PROCEDURES. RECORDING THE PRIMARY IMPRESSION.  TRAY SELECTION o Known as stock trays. o Can be metal / plastic, perforated or non perforated. o Available in standard sizes. o There should be 2-3 mm clearance between the stock tray & the ridge & should have 5-6 mm clearance for impression compound. o Tray should be extend over the tuberosity & the hamular notch. o If try too large – it will distort the tissue in the borders of the impression & push the tissues away from the bone. o If tray is too small – then modeling wax should be added along the posterior border of the tray. o The tray material should not react with the impression material & should not distort.  PRIMARY IMPRESSION MAKING IN MAXILLARY ARCH. o Objective – to obtain a preliminary impression that is slightly overextended along the borders. o Imp material with high viscosity preferred o Imp. Compound softened in water bath at 140.F, then kneaded. o Kneaded material rolled into a tray & rolled into a ball & placed on the tray. Using thumb the operator should spread & adapt the material allover the tray so that it app. To the ridge contour. o If alginate used then small amt. of material is placed in the post. Part of the palate & tuberosities before making the imp. o Pt. asked to sit upright & open the mouth halfway. Operator should position himself towards the side & rear of the patient. o Tray centered over the upper residual ridge by using labial frenum as a centering guide. o After proper positioning the tray is seated over the ridge by applying pressure in the first molar region, until it touches the posterior palatal seal. o Tray stabilized with a finger placed in its center
  • 25. o Borders are refined by asking the pt. to suck down into the tray, move the mandible side to side & then open wide. This record the labial & buccal vestibules & influence of coronoid process on the shape of the buccal vestibules. o Once the material has set, the cheeks & upper lip are lifted away from the borders to allow for air entry. Tray is then removed from the mouth in one motion & inspected for any deficiency. o Borders of the custom tray can be marked by  Marking the peripheral outline on the impression.  Outlining the cast o Cast is observed & then poured with dental plaster.  PRIMARY IMPRESSION MAKING IN MANDIBULAR ARCH o Choice of material – impression compound / high viscosity alginate. o Astringent mouthwash given to reduce the viscosity of the saliva. o Impression material manipulated & loaded into the tray, if alginate used then small quantity placed on the retromolar pads. o Tray should be rotated within the patients mouth in a horizontal plane until it is in the center of the residual ridge. The pt. should be asked to raise the tongue to fit into the tongue space of the impression tray. o Tray is seated gently using alternate pressure on the molar regions of either side,. o Then passive movements of peripheral musculature is done. o Once the imp. Material sets, the lips & cheek are retracted & the imp. Is removed in a single snap from the patients mouth. o Imp. Should be Checked for any errors like voids etc.
  • 26. RECORDING THE SECONDARY IMPRESSION  SECONDARY IMPRESSION MAKING IN MAXILLARY ARCH It includes: • Border Moulding • Tray preparation after border moulding • Making the wash impression • Recording the posterior palatal seal • Checking for errors in the posterior palatal seal. Border Moulding Two techniques for border moulding: 1. single step or simultaneous border moulding. 2. incremental or sectional border moulding. Single step border moulding Polyether is the material of choice. Done in single step. Incremental border moulding Greenstick compound is the material of choice. Spacer is removed just before impression making. Clinical procedure: o greenstick compound is softened over flame & added along portion of the tray, material should be tempered with warm water before placing intraorally. o Order: Labial vestibule -> buccal vestibule -> posterior palatal seal. o Passive Movements are made. o After border moulding , the moulded section is immersed in cold water. o Then the procedure is repeated for another section.
  • 27. Tray preparation after border moulding. o The wax spacer is removed to provide space for the impression material. o 0.5-1 mm of the tracing material is removed from the outer, inner & top surfaces of the border. o The material over the posterior palatal seal is not removed. o Green stick compound removed using a scalpel. o The thickness of the flanges & the border should be 2.5-3 mm. o Holes are drilled into the impression tray to allow escapement of the impression material. Making the Master / wash impression. o Material of choice – zinc oxide eugenol impression paste. o Impression material is manipulated & loaded onto the tray. The patient made to sit in an upright position. Operator stands towards the rear or the side of the patient. o Tray is placed in the patients mouth using the labial notch as a guide. o Tray is seated into position by applying alternating pressures on the right & left molar regions using index fingers. o Tray is maintained in this position by placing a finger in the palatal region of the tray, immediately anterior to the posterior palatal seal. o Passive movements are made. o After material has set, the tray is removed in a single jerk. o Impression inspected for deficiencies & voids & is repeated if necessary. Recording the posterior palatal seal. Methods used to record it are: 1. conventional approach 2. fluid wax technique. 3. arbitrary scraping of the master cast. 4. extended palatal technique. Conventional approach : o done after the wash impression is made & master cast is poured.
  • 28. o Trial base is fabricated using shellac base plate. o The patient is asked to sit in an upright position & asked to rinse his mouth. o T burnisher is used to locate the hamular notch. the full extent of the hamular notch is marked with an inedible pencil. o Posterior vibrating line is marked using a inedible pencil by asking the patient to say “ah” in a non vigorous manner. o Line marked in the hamular notch is connected with the posterior vibrating line using an inedible pencil. o Trial base inserted into the patient’s mouth so that the inedible markings are transferred to the trial base. o Trial base is seated on the master cast to transfer the markings marked in the patient’s mouth to the cast. o Trial base is trimmed till the posterior border. o Anterior vibrating line marked in the patient’s mouth with an inedible pencil & while recording it the patient should perform the valsalva maneuver. o The area between the anterior & posterior vibrating line is scraped in the master cast to a depth of 1-1.5 mm on either side of the mid palatine raphe. o The posterior border of the posterior seal should be tapered so that it blends with the palatal tissues.  SECONDARY IMPRESSION MAKING IN MANDIBULAR ARCH It includes:  Border moulding  Tray preparation after border moulding  Making the wash / master impression. Border moulding o Done by two techniques:  Single step border moulding  Incremental border moulding o Same procedure is carried out in both techniques. o Anterior portion is moulded before the posterior portion. o Labial & buccal flange is moulded first followed by the lingual flange.
  • 29. Recording the Labial & buccal flange • Labial portion moulded by moving the lip outward, upward & inward. • Buccal frenum is recorded by moving the cheek outward , upward , backward & forward, • Distobuccal sulcus is recorded by retracting the cheek & moving it upward & inward. Recording the lingual flange. • Anterior lingual flange is recorded by asking the patient to protrude his tongue out & touch the anterior part of the palate. Recording the retromolar pad • To record the distal end of the tray the patient is asked to open his mouth wide • After recording the distal end the impression is verified, if a notch is produced in the posteromedial end of the tray it indicates that the tray is overextended up to the pterygomandibular raphe. Tray preparation after border moulding o Procedure similar to maxillary impression. o Escape holes placed 10 mm apart in the alveolar ridge & retromolar pad. Making the final / master / wash impression. o Tray placement should be practiced before making the final impression. o Dry gauze should be placed in the floor of the mouth to remove the saliva & removed before making the impression. o The impression material is manipulated & loaded onto th tray. o The tray is rotated in a horizontal plane & inserted into the mouth using the anterior handle. o Tray is seated completely by applying alternating pressure over the posterior handles. o After the material is set the impression is removed & examined for any defects.
  • 30. REFERENCES:  Basic dental materials by John J. Manappallil  Textbook of dental materials by Sharmila Hussain  Boucher’s Prosthodontics Treatment for Edentulous Treatment, 9th ed.  Textbook of Prosthodontics of Deepak Nallaswamy.