Fourth year class Prosthodontics

Prosthodontics Dr.
[Link]
MohammedAbdulaziz

Lec#: 5

Impression materials and techniques for RPD

1. Rigid materials:
 Plaster of paries
 Metallic oxide paste (zinc oxide eugenol impression material).
2. Thermoplastics materials:
 Modeling plastic.
 Impression wax &resin.
3. Elastic materials:
 Hydrocolloid :
 Reversible hydrocolloid (Agar-Agar)
 Irreversible hydrocolloid( alginate)
 Elastomers:
 Mercaptan rubber base impression material (polysulfide)
 Silicon impression material:
a. Condensation reaction silicon
b. Addition reaction silicon
 Polyether impression.

Rigid materials :

Although rigid material may be capable of recording tooth and tissue detail
accurately, they cannot be removed from the mouth accurately and without fracture
and reassembly.

1. Plaster of paries:

This material with introduction of elastic impression material has been completely
replaced by elastic impression material.

2. Metallic oxide paste:

Which usually some form of zinc oxide eugenol combination those are not used as
primary impression materials &should never be used for impression that include
the remaining natural teeth also they are not be used in stock impression tray.

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Fourth year class Prosthodontics
Prosthodontics Dr.
[Link]
MohammedAbdulaziz

Metallic oxide pastes are manufactured with a wide variation of consistencies most
of them are dispensed from two tubes; this enables the dentist to dispense and mix
the correct proportion from each tube on a mixing slab.

Metallic oxide paste can be used as :

 Secondary impression material for CD &for extension base edentulous ridge

areas of RPD.
 It can be used with custom acrylic impression tray (special tray) which has
being properly designed &attached to the partial denture framework.
 Also it can be used as impression for relining distal extension denture bases.

Thermoplastic materials :

It cannot record minute details accurately because they undergo permanent

distortion during withdrawal from tooth &tissue undercuts.

1- Modeling plastic (modeling compound):

The most commonly used modeling plastic is the red material in cake form and the
green stick form for use in the border molding impression materials. It is generally
used only as means of building up the underside of the denture before recording
the tissue with some secondary impression material. A common error in the use of
modeling plastic is that it is often subjected to higher temperatures than intended
by the manufacturer. It then becomes too soft and loses some of its favorable
working characteristics & the material becomes brittle and unpredictable. Also,
there is the ever-present danger of burning the patient when the temperature used
in softening the modeling plastic is too high.

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Fourth year class Prosthodontics
Prosthodontics Dr.
[Link]
MohammedAbdulaziz

2- Impression wax and resin:

It is used in recording the edentulous area also it may be used to correct the borders
of impression made of more rigid material.

Elastic materials :

They are the only one that can be withdrawn from tooth &tissue undercuts without
permanent distortion &are therefore most generally used for making impression for
RPD, immediate denture, crown &bridge, &fixed partial denture when tooth &soft
tissue undercut &surface details must be recorded with accuracy.

1- Hydrocolloids:
- Reversible hydrocolloid( agar-agar)

a. Which are fluid at high temperature and gel on reduction in temperature.

b. The preparation of agar hydrocolloid for clinical use requires careful control
and moderately expensive apparatus. It needs special types of tray (contain
tube to of water to cooled the impression materials).
c. Agar hydrocolloid impressions are dimensionally unstable on standing; thus
models should be made as soon as possible after the impression is taken.
d. Complaints sometimes arise from patients as a result of thermal shock to the
teeth, producing pain and discomfort. This situation can arise from the heat
from the impression material when introduced into the mouth or the
comparatively low temperatures attained during cooling of the impression to
obtain a set gel.
e. It's used as impression material for fixed restoration.

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Fourth year class Prosthodontics
Prosthodontics Dr.
[Link]
MohammedAbdulaziz

f. They demonstrate acceptable accuracy when properly used.

g. The border control of impression made with this material is difficult.

- Irreversible Hydrocolloid (alginate)

a. Used for making diagnostic cast, orthodontic cast and master cast for RPD.
b. These material have a low strength provide less surface details than other
material.
c. Dimensionally unstable, it can be used in the presence of moister, it is
hydrophilic.
d. Have a good taste &odor and nontoxic.

2- Elastomers:

A. Mercaptan rubber base impression material (Polysulfide):

1. It can be used for RPD impression especially for altered cast impression.
2. The accuracy of Mercaptan rubber base impression material exceeds that of
properly made irreversibly hydrocolloid impression; beside that the impression
with the hydrocolloid impression material need certain precaution that must be
taken to avoid distortion of the impression.
3. Other advantages over hydrocolloid impression material in that the surface of an
artificial stone poured against them is of a smoother &harder than one poured
against a hydrocolloid material.

B. Silicone Impression materials:

The silicone impression materials are more accurate and easier to use than the
other elastic impression materials, silicone impression materials are hydrophobic,
which can make cast formation a problem, ideally, these materials should be
poured within 1 hour.

1- Condensation reaction silicone:

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Fourth year class Prosthodontics
Prosthodontics Dr.
[Link]
MohammedAbdulaziz

Have a moderate (5 to 7 min.) working time that can be altered by adjusting the
amount of the accelerator. They have a pleasant odor, moderately high tear
strength, and excellent recovery from deformation.

2- Addition reaction silicone:

Are the most accurate of the elastic impression materials. They have less
polymerization shrinkage, low distortion, fast recovery from deformation, and
moderately high tear strength. These materials have a working time of 3 to 5 min.,
which can be easily modified with the use of retardants and temperature controls.
They are available in both hydrophilic and hydrophobic forms, have no smell or
taste, and also come in putty form. Most of the addition reaction silicones are
available in automixing devices, can be poured up to 1 week after impression
making with acceptable clinical results, and are stable in most sterilizing solutions.
Sulfur in latex gloves and in ferric and aluminum sulfate retraction solution may
inhibit polymerization.

C. Polyether impression materials

These materials have demonstrated good accuracy in clinical evaluations and are
provides good surface detail and makes them useful as a border molding material.
It should be noted, however, that these materials are not compatible with the
addition reaction silicone impression materials and should not be used to border
mold custom trays when the silicone impression materials are to be used as the
final impression material. The polyethers are also hydrophilic, which produces
good wettability for easy cast forming. The polyethers have low to moderate tear
strength and much shorter working and setting times, which can limit the
usefulness of the material.

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Fourth year class Prosthodontics
Prosthodontics Dr.
[Link]
MohammedAbdulaziz

The principal differences between reversible and irreversible

hydrocolloid are as follows :

1. Reversible hydrocolloid converts from the gel form to a solution form by the
application of heat. It can be converted to gel form by a reduction in temperature.
This physical change is reversible.

2. Irreversible hydrocolloid becomes a gel via a chemical reaction as a result of

mixing alginate powder with water. This physical changes is irreversible.

Important precautions to be observed in the handling of

hydrocolloid:

1. Impression should not be exposed to air because some dehydration will

inevitably occur &result in shrinkage.

2. Impression should not be immersed in water because some imbibition will

inevitably result with an accompanying expansion.

3. Impression should be protected from dehydration by placing it in a humid

atmosphere or wrapping it in a damp paper towel until a cast can be ,poured. To
avoid volume change, this should be done within 15 minutes after removal from
the mouth.

4. Exudates from hydrocolloid have a retarding effect on the chemical reaction of

gypsum products and results in a chalky cast surface. This can be prevented by
pouring the cast immediately or by first impression in a solution of accelerator if
an accelerator is not including in formula.

Step by step procedure for making an impression:

1. Select a suitable, sterilize a rim-lock or perforated impression tray that's large
enough to provide 4-5mm thickness of the impression material.
2. Build-up the palatal pen maxillary impression tray with wax or modeling plastic
to ensure even distribution of impression material to prevent material from
slumping away from palatal surface also if gelation occurs next to the tissues the

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Fourth year class Prosthodontics
Prosthodontics Dr.
[Link]
MohammedAbdulaziz

deeper portion is still fluid, a distorted impression of the palate may result, which
cannot be detected in the finished impression. This can result in major connector of
finished casting not being in contact with under lying tissue. The maxillary tray has
to be extended posteriorly to include the tuberosities &vibrating line region of the
palate. Such anextension also aid in correctly orienting the tray in the patient
mouth when the impression is made.

3. The lingual flange of the mandibular tray may need to be lengthen with wax in
the retromylohyiod area also wax may need to be added inside the distolingual
flange to prevent the tissue of the floor of mouth from rising inside the tray.

4. Place the patient in an upright position, with the involved; arch nearly parallel to
the floor.

5. When irreversible hydrocolloid is used, place the measured amount of water (at
700 F)in a clean, dry rubber mixing bowl (600 ml capacity). Add the correct
measure of powder. Spatulate rapidly against the side of the bowl with a short, stiff
spatula. This should be accomplished in less than 1 min. The patient should rinse
his or her mouth with cool water to eliminate excess saliva while the impression
material is being mixed &the tray is being loaded.

6. In placing the material in the tray, avoid entrapping air. Have the first layer of
material lock through the perforations of the tray or rim-lock to prevent any
possible dislodgment after gelation.

7. After loading the tray, remove the gauze with the topical anesthetic and quickly
place (rub) some of the impression material on any critical areas using your finger
(areas such as rest preparations and abutment teeth). If a maxillary impression is
being made, place the material in the highest aspect of the palate and over the
rugae.

8. Use a mouth mirror or index finger to retract the cheek on the side away from
you as the tray is rotated into the mouth from the near side.

9. Seat the tray first on the side away from you, next on the anterior area, while
reflecting the lip, and then on the near side, with the mouth mirror or finger for
cheek retraction. Finally, make sure that the lip is draping naturally over the tray.

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Fourth year class Prosthodontics
Prosthodontics Dr.
[Link]
MohammedAbdulaziz

10. Be careful not to seat the tray too deeply, leaving room for a thickness of
material over the occlusal and incisal surfaces.

11. Hold the tray immobile for 3 minutes with light finger pressure over the left
and right premolar areas. To avoid internal stresses in the finished impression, do
not allow the tray to move during gelation. Any movement of the tray during
gelation will produce an inaccurate impression. Don not allow the patient or the
assistant to hold thetray in position, some movement of the tray will be inevitable
during the transfer and the impression will probably be inaccurate. Do not remove
the impression from the mouth until the impression material has completely set.

12. After releasing the surface tension, remove the impression quickly in line with
the long axis of the teeth to avoid tearing or other distortion.

13. Rinse the impression free of saliva with slurry water,or dust it with plaster, and
rinse gently then examine it critically& finally cover it immediately with a damp
paper towel.

14. A cast should be poured immediately into a disinfected hydrocolloid

impression to avoid dimensional changes and syneresis. A delay should not exceed
a15 min.

The palatal pen max. impression tray, The lengthen lingual flange of the mand.
tray.

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Fourth year class Prosthodontics
Prosthodontics Dr.
[Link]
MohammedAbdulaziz

Step by step procedure for making a stone cast from a

hydrocolloid impression

1. Have the measured dental stone at hand, along with the designated quantity of
room temperature water, as recommended by the manufacturer. A clean 600-mL
rubber mixing bowl, a stiff spatula, and a vibrator complete the preparations.

2. First, pour the measure of water into the mixing bowl and then add the measure
of stone. Spatulate thoroughly for 1 min., remembering that a weak and porous
stone cast may result from insufficient spatulation. Mechanical spatulation under
vacuum is preferred. After any spatulation other than in a vacuum, place the
mixing bowl on the vibrator and knead the material to permit the escape of any
trapped air.

3. After removing the impression from the damp towel, gently shake out surplus
moisture and hold the impression over the vibrator, impression side up, with only
the handle of the tray contacting the vibrator. The impression material must not be
placed in contact with the vibrator because of possible distortion of the impression.

4. With a small spatula, add the first cast material to the distal area away from you.
Allow this first material to be vibrated around the arch from tooth to tooth toward
the anterior part of the impression . Continue to add small increments of material at
this same distal area, with each portion of added stone pushing the mass ahead of
it. This avoids the entrapment of air. The weight of the material causes any excess
water to be pushed around the arch and to be expelled ultimately at the opposite
end of the impression. Discard this fluid material. When the impressions of all
teeth have been filled, continue to add artificial stone in larger portions until the
impression is completely filled.

5. The filled impression should be placed on a supporting Jig &the base of the cast
can be completed with the same mix of stone. The base of the cast should be 16 to
18 mm (2/3 to3/4 inch) at its thinnest portion and should be extended beyond the
borders of the impression so that buccal, labial, and lingual borders will be
recorded correctly in the finished cast.

6. As soon as the cast material has developed sufficient body, trim the excess from
the sides of the cast. Wrap the impression and cast in a wet paper towel, or place it

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Fourth year class Prosthodontics
Prosthodontics Dr.
[Link]
MohammedAbdulaziz

in a humidor, until the initial set of the stone has taken place. The impression is
thus prevented from losing water by evaporation, which might deprive the cast
material of sufficient water for crystallization. Chalky cast surfaces around the
teeth are often the result of the hydrocolloid’s acting as a sponge and robbing the
cast material of its necessary water for crystallization.

7. After the cast &impression have been in the humid atmosphere for 30 min.,
separate the impression from the cast. Thirty minutes is sufficient for initial setting.
Any stone that interferes with separation from the tray must be trimmed away with
a knife.

8. Clean the impression tray immediately while the used impression material is still
elastic.

9. Trimming of the cast should be deferred until final setting has occurred.

Possible causes of an inaccurate or a weak cast of a dental arch

1. Distortion of the hydrocolloid impression :

(a) by use of an impression tray that is not rigid.

(b) by partial dislodgment from the tray.

(c) by shrinkage caused by dehydration.

(d) by expansion caused by imbibition (this will be toward the teeth and will result
in an undersized rather than oversized cast).

(e) by attempting to pour the cast with stone that has already begun to set.

2. A ratio of water to powder that is too high. Although this may not cause
volumetric changes in the size of the cast, it will result in a weak cast.

3. Improper mixing. This also results in a weak cast or one with a chalky surface.

4. Trapping of air, either in the mix or in pouring, because of insufficient vibration.

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Fourth year class Prosthodontics
Prosthodontics Dr.
[Link]
MohammedAbdulaziz

5. Soft or chalky cast surface that results from the retarding action of the
hydrocolloid or the absorption of necessary water for crystallization by the
dehydrating hydrocolloid.

6. Premature separation of the cast from the impression.

7. Failure to separate the cast from the impression for an extended period.

Technique for making individual acrylic resin impression trays

1. Outline the extent of the tray on the cast with a pencil. The tray must include all
teeth and tissues that will be involved in the removable partial denture. Adequate
space must be provide for frenal attachments. Mark the area of the posterior palatal
seal on the max. cast &cut a 1mm ×1mm groove following the line designating the
posterior extent of the tray.

2. Adapt one layer of baseplate wax over the tissue surfaces and two layers over
the teeth of the cast to serve as a spacer for impression material. The wax spacer
should be trimmed 2 to 3 mm short of the outline drawn on the diagnostic cast.
Wax covering the posterior palatal seal area should be removed so that intimate
contact of the tray and tissue in this region may serve as an aid in correctly
orienting the tray when the impression is made.

[Link] an additional layer of baseplate wax over the teeth if the impression is to
be made in irreversible hydrocolloid. This step is not necessary if the choice of
impression material is a rubber-base or silicone type of material.

4. Expose portions of the incisal edges of the central incisors to serve as anterior
stops when placing the tray in the mouth. Bevel the wax so that the completed tray
will have a guiding incline that will help position the tray on the anterior stop.

5. Paint the exposed surfaces of the cast that may be contacted by the light-
polymerized resin tray material with a model release agent (MRA) to facilitate
separation of the polymerized tray from the cast.

6. Mix the correct proportions of autopolymerizing acrylic resin (8ml of monomer

to 24ml of polymer) in a mixing paper cup. When the acrylic resin no longer string

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Fourth year class Prosthodontics
Prosthodontics Dr.
[Link]
MohammedAbdulaziz

and can be handled without adhering to the fingers, from it into a wafer , the size
and the thickness of a cake of modeling plastic or use special stone templates to
form the wafer. A wooden roller and forming block are also available dental
supply houses in kit form.

7. carefully transfer the resin wafer to position on the cast &adapt the acrylic with
the fingers, covering the wax spacer &palatal seal area &maintaining a uniform
thickness. Remove the gross excess with a sharp knife while the acrylic resin is
still soft.

8. form a handle with the excess acrylic resin. The handle should be about 11mm
(1/2 inch) wide, about 6mm (1/4 inch) thick, &about 5cm (2inches)long.

9. Attach a handle into the tray over the region of the central incisors &shape it to
extend 12mm (1/2inch) downward &2.5cm(1inch) outward. It is usually necessary
to place additional monomer on the handle &tray to provide a satisfactory union.

[Link] the polymerizing cycle is completed, remove the tray from the cast. The
wax spacer can be removed from the tray with an suitable instrument. Perfect the
borders of the tray with rotary instruments and slightly polish the external surface
of the tray.

11. Place perforations (No. 8 bur size) in the acrylic resin tray at 4.5mm (3/
16inch) intervals, with the exception of the alveolar groove areas, if an irreversible
hydrocolloid impression material is to be used.

12. The finished tray must be sanitized and tried in the mouth so that any necessary
corrections to the tray can be accomplished before the impression is made.

The End
Best Wishes

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