IMPRESSION TECHNIQUES IN FIXED

PARTIAL DENTURE

Dr. Shalini Joshi, MDS

Professor
Dept of Prosthodontics & Implantology
AME’s Dental College & Hospital,
IMPRESSION TECHNIQUES IN FIXED

PARTIAL DENTURE
 Impression
GPT-8

• Impression : a negative likeness or copy

in reverse of the surface of an object; an
imprint of the teeth and adjacent
structures for use in dentistry.
 Considerations for
Precision Impression Taking
• Before Impression Taking (Extra-oral):
- Easy to mix
- Long working time
• During Impression Taking (Intra-oral):
- Hydrophilic
- Ability to flow around preparation without slumping
- Detail-capturing
- Snap set
- Good taste & odor
• Upon Removal from Mouth:
- Easy to remove
- High tear strength
- Good recovery from deformation

• After Impression Taking (Storage):

- Dimensional stability
- Easy to read
- Can be disinfected
• During Pouring:
- Compatibility with gypsum
- Reproduction of details (ADA Specification 19: 20
microns)

- Ability for multiple pouring

 CLASSIFICATION OF IMPRESSION MATERIAL
Nonelastic Elastic

Hydrocolloids Synthetic elastomers

Waxes, gums, resins
Polysulphides
Agar-Agar
Plaster of paris
Condensation-silicone
Zinc oxide eugenol Alginate (Type I silicone)

Impression compound Polyether

Addition silicone
Eugenol-free paste (Type II silicone)
 ELASTOMERIC IMPRESSION MATERIALS
Depending on viscosity
Light body
Medium body / regular body
Heavy body
Putty
Depending on elastic properties and dimensional change
ADA specification No. 19
Type I elastomeric impression material
Type II elastomeric impression material
Type III elastomeric impression material
Reversible hydrocolloid (Agar-Agar) :
Introduced by Sears 1937
First elastic impression material
Longest continuous use
Ingredients :
Agar (Organic hydrophillic colloid )  8-15%
Water  > 80-85%
Borax
Potassium sulphate
Available as :
Tray material
Syringe material
 Hydrocolloid conditioning with three baths : liquefying, storage and tempering

Tubes and cartridges of hydrocolloid Tubes and cartridges of hydrocolloid

placed in liquefying bath transferred from liquefying bath to storage
bath
 Tray filled with impression Blunt needle is attached to
material placed in liquefying impression syringe
bath

Cartridge of liquefied hydrocolloid Cartridge of impression material

is removed from storage bath is loaded into syringe
Irreversible hydrocolloid (Alginate) :
During World War II
Salt of alginic acid (anhydro d mannuronic acid)
Ingredient :
Sodium / potassium triethanolamine alginate
Calcium sulphate
Sodium triphospate
Diatomaceous earth

• Dust free alginate

• Chromatic indicator
 ELASTOMERIC IMPRESSION MATERIALS
Accuracy / Detail capture :
ADA No. 19 fine detail of 25m
PVS impression material  best
Reversible hydrocolloid  least
Reproduction of fine detail of gypsum die materials  50 m
Lower the viscosity  Increased fine detail
Putty material  reported fine detail of 75m
Tear strength:
Measures the resistance to fracture of an elastomeric material
subjected to tensile force acting perpendicular to a surface flaw.
Point of consideration  Interproximal, subgingival areas
 Slot and groove

Polymerized material Torn material during

in the gingival crevice removal
Difficult to remove the impression from patient mouth

Custom tray with an adequate bulk of material in the area 3 times

the depth of undercut.

Undercut due to tilted teeth

Use of rigid impression material
• Dual arch impression to compensate for the - tray flexibility
- To provide rigidity (Polyether,
 Hydrophilic group Hydrophobic group
Polysuphide
Hydrocolloids
C – silicone
Polyether A – silicone (PVS)

• Works in wet environment • Resistant to wetting (repelled by

(blood and saliva) hemorrhage or tissue fluids)
• Readily wettable by the gypsum • Not readily wettable by the gypsum
• Use of extrinsic /topical surfactant
• Dilute solution of soap.
• “Spray on” surfactant (debubblizer spray)
• To lower the surface tension (decreases contact angle)
 CONTAMINATION
Inhibition of polymerization of PVS impression material.
Direct inhibition
• Direct contact with latex gloves
• Impression are made with rubber dam in place
Mechanism of inhibition  Element sulphur react with
chloroplatinic acid catalyst present in PVS impression material.
Element sulphur  Zinc diethyl dithiocarbamate (preservative/
vulcanizing accelerator)
Indirect inhibition
Indirect contact of tooth and periodontal tissues during tooth
preparation and gingival displacement procedure.
Limited to small isolated areas
 Unpolymerized material remain
adherent to prepared tooth surface

•Contaminated surface will be slippery and sticky to touch

Clinical consideration :
Use of non latex gloves – Vinyl gloves
– Polyethene gloves
Avoid touching the tooth preparation and gingival areas
Avoid handling retraction cord with gloved hands.
Sulfur concentration 0.005%  total inhibition of polymerization
of PVS
 TRAY SELECTION AND PREPARATION OF THE TRAY
• Tray should be rigid.
• Dimensionally stable.
• Resist the deformation (loading heavy body material).
• Provides the space for optimal thickness.
Plastic vs metal stock trays
Tray should be 2-3mm thick to ensure sufficient rigidity.
Incorporation of stops
 Guide the clinician for positive seating
 Three widely spaced stops
 Non functional cusp of unprepared teeth, edentulous areas
or the palate.
Tin foil or aluminium foil should be used over the wax spacer to
prevent decrease in adhesive bond
Adhesion of the impression material to the tray
For accurate impression  proper adherence to the tray
Tray adhesive composition and mechanism of action
– poly dimethyl siloxane and ethyl silicate.
Hydrated silica forms from ethyl silicate to create physical bond
with tray and poly dimethyl siloxane bonds with rubber.
Bond strength of adhesive
Proper dry time  wet adhesive act as a lubricant
Adequate mixing and loading :
Earlier materials  base and catalyst tubes

Present materials  cartridges with mixing tips

 Gun like dispenser

Automixing system :
• Lesser inherent voids
• Extend the essential working time
• Reduced waste
• Uniformity in proportioning
 ELECTRIC MACHINE DEVICE
(Dynamic Mechanical Mixer)

Provides uniform mix with touch of a button

Far fewer voids in the set elastomers
 AGAR IMPRESSION TECHNIQUE
Armamentarium :

Tray and syringe

material
Water cooled trays Conditioning unit
Procedure :

Tray material Syringe material Loaded tray in

tempering bath
 Dentate arch is Water cooling tubes Completed
flooded with water connected to seated impression
tray

Disadvantages –
• Dimensionally unstable / distortion during gelation
• Initial expenditure for instruments
• Multiple pouring is not possible
 ALGINATE IMPRESSION TECHNIQUE
Clinical interest :
Recording the dentition opposing a planned prosthesis
(non working cast)
For the study cast / diagnostic cast – diagnostic wax up
– mock preparations
For matrix – interim restoration (temporization)

CLINICAL CONSIDERATIONS

TRAY SELECTION

Perforated metal / rigid plastic trays

TRAY MODIFICATION

 With tray compound

 Wax – non rigid
– distortion
TRAY ADHESIVE
Perforations – insufficient
To prevent detachment of
impression
(Distortion of the cast)
Extend 2-3 mm outer surface

Loading the tray

Sectional placement Wet gloved finger

 MOUTH PREPARATION

Rinsing with water

Pre packing palatal vault

Blocking – large interdental spaces under the contact points

(with wax)
 TRIMMING AND HANDLING THE IMPRESSION

Removal of unsupported alginate Should not be placed firm surface

(anterio-posterior distortion)

“Holding tree” Rinsing with water Completely recorded

(saliva / blood / food debris) trimmed impression
 HYDROCOLLOID LAMINATE TECHNIQUE
ALGINATE – AGAR METHOD
Suggested by Schwartz in (1951)

Prepared tooth Injection of reversible Stock tray with chilled

surfaces hydrocolloid alginate

Combined alginate –agar impression Master cast

Critical to success  bond between agar and alginate
Advantages :
• Satisfactory surface reproduction
• Good wettability (smooth, dense model)
• Simple conditioning (no tempering bath / water cooled trays)
• More economical
Disadvantages :
• The bond between agar and alginate is not sound
• Higher viscosity alginate displaces agar hydrocolloid
PUTTY WASH IMPRESSION TECHNIQUES
(Stock tray impression technique)
One stage or one step putty wash impression
(Simultaneous technique / squash technique / twin mix technique)
In this technique putty and wash are recorded simultaneously
Disadvantage :
Difficult to control thickness of wash material
Higher viscosity material displaces the wash material
- Critical areas captured in putty rather than light body

Setting distortion of the putty add to over all distortion of

impression
 TWO STAGE OR TWO STEP PUTTY WASH
TECHNIQUE

Two step unspaced impression technique

Preoperative putty impression is recorded
Preset putty impression is relined with thin layer of wash

Two step spaced impression technique

Preoperative putty impression is made
Space for the light body wash material is provided to reline
the putty
 Putty impression with polyethene spacer sheet and
then wash

• Spacer prevents the penetration of the putty into the interproximal

areas
Gauging away the putty impression to provide space and
then wash

Scalpel to create space

 PUTTY SCRAPER / SCOOP

Sluices / escape channels are cut  excess material to escape

PVS putty impression as custom tray with 2 mm space

Putty material is used to fabricate a custom tray

With a two layer of base plate wax over the
diagnostic cast as a 2 mm space
 DISADVANTAGES
• Distortion during seating the putty.

Pressure while seating the putty Compression of impression

Elastic recovery Shorter narrower die

 INJECTION MOULDED PUTTY WASH TECHNIQUE
Brian Millar (2001)

Preoperative full arch putty impression

Drilling the hole through the tray perforation

Cut away gingival margin region and buccal

escape channel

Putty is reinserted and light body

is injected through the hole
 Injection moulded
impression

Advantage :
• Can be used with single arch or dual arch trays
• Suited for recording of multiple prepared teeth
• Economical
• Can be used to repair impressions
 DUAL PHASE IMPRESSION TECHNIQUE
(Multiple mix technique, laminate single impression
technique, custom tray impression technique)
Two consistencies
• Light body syringe material
(wash type)
Heavy body – tray material
• Tray material will force the light
body material into the gingival
sulci and preparation detail
Custom tray with 2 – 3 mm space
ADVANTAGES
Uniform thickness of impression material (2-3 mm)
Viscosities of 2 materials reduces drags and improves the blending of
2 phases.
Good marginal definition.
No distortion due to recoiling of plastic tray and putty.
Less impression material is required.

DISADVANTAGES
Construction of custom tray (time / cost)
Differential shrinkage
 Monophase impression technique
(Single viscosity technique)

•Medium viscosity – polyether or addition silicone

•Used as both tray material and syringe material
•Custom tray with 3 mm spacer
Depends on pseudoplastic property

DISADVANTAGES
•Reduced ability to flow into intra coronal features and gingival
crevice
•Greater amount of polymerization shrinkage compared to heavy body
•Surface reproduction may not be as good as light body material
 BAND / TUBE IMPRESSION TECHNIQUES
Impression techniques in this category
• The original copper band and modeling compound
• Variety of copper tube and elastomer combination
• Tube impression with acrylic resin and elastomer combination
Characteristics
Rigid carrier for the impression material
(buried/embedded in final impression)
Registration of finish line is achieved in carrier
Carrier is designed to extend slightly apical to finish line

Sulcular extension of tube  “Displacement of

gingiva”
Retraction less impression or cordless procedures
 THE ORIGINAL COPPER BAND AND MODELING COMPOUND

2mm wider Extend 1 mm beyond the

finish line

Heavy PVS – final impression

Compound plug
Putty PVS – pick up
 TUBE IMPRESSION WITH ACRYLIC RESIN
AND ELASTOMER COMBINATION
MH Goldfogel et al (1989)

Prepared tooth with final Aluminium tube trimming / adaptation

finish line

Acrylic resin tube with recorded

Tube with acrylic resin
finish line
Tube is relieved for Relieved tube with Polysufide wash
wash space vent hole impression
(0.5mm)
Vent hole

Aluminium tube
Acrylic resin
Relieves space with wash

Prepared tooth

Gingival tissue
Over impression with
embedded tube

Cross section of impression tube

Disadvantage :
Band adaptation and trimming  time consuming
trauma and haemorrhage
Copper band and impression compound
Distortion of the compound
Rigid nature – fracturing of dies
Replaced with band and elastomers techniques
Softer band / tubes – flexing distortion
Elastic deformation of elastomers which may reversed when
impression is removed
Advantage :
Mechanical displacement of gingiva  Clean and complete
impression
 DUAL ARCH IMPRESSION TECHNIQUE
(Double bite, dual quad tray, closed bite, triple tray
technique, accu-bite)
Introduced by Wilson and Werrin (1983)
Maximum
Captures the – prepared teeth intercuspation position
opposing arch (MIP)
Indications interocclusal articulation
One or two units bounded by intact and
opposed dentition
Patient cooperation – S/be able to close in MIP
Stable, reproducible MIP
Space for connector bar behind the last molars
(quadrant trays)
 DUAL ARCH IMPRESSION TRAYS

Metal trays

Plastic trays

Complete arch impression tray

 DUAL ARCH IMPRESSION TECHNIQUES

One step technique

Low or medium viscosity impression material (for syringe
material)
Bite registration material or heavy body material (tray material)
1. Prepare tooth
2. Verify that patient can close with tray in mouth.
3. Check the patient can close repeatedly into MIP
4. Adhesive on side of tray-not on gauze
5. Mix heavy body & load tray
6. Mix light body & load syringe. Start timing
7. Inject light body and have patient close in ICP
8. Orient and seat the tray ask the patient to close in MIP (check
the reference teeth
9. Remove impression and inspect for completeness
• Two step technique :
– Preoperative impression (putty / bite registration
material)
– Second impression syringe ( light / monophase)
– Limitation : Depends on patient ability to bite into
same MIP
 TWO STAGE LAMINAR IMPRESSION TECHNIQUE

Developed by Dr. Gary Schoenrock (1989)

Laminar flow  the way the fluid under pressure flows within the
constricted space
Required preoperative double arch impression (bite registration
material)
 Ditching around gingival margin To enlarge exit hole

Seated Tip placed in Impression flows out

Preliminary impression mesial hole of distal hole

Completed impression
Advantage :
Light body material engulfs the tooth without creating
compressive forces
Residue (blood, etc) flushed out of the exit hole.
 FLAWS RELATED TO IMPRESSION TECHNIQUE
Visible flaws :
Finish line not visible  Inadequate gingival displacement
• Gingival inflammation and bleeding
 Delay impression for 10 days
 Papillary injection of LA
 Microbrush soaked in ferric / aluminium sulfate
• Crevicular fluid and heamorrhage

Poor moisture Dry field

control
Air bubbles / voids in critical areas
Mixing
Syringing
 Keep syringe tip in expressed
material
 Start syringing from distal
interproximal area (distoligual)
 Fill the base of grooves, boxes first
Tray loading and tray seating
Drags
Reason :
Poor flow of putty
Premature syringe of impression material
Poor bond between the tray and syringe material
Unset / unpolymerized impression material  contamination

INVISIBLE FLAWS
Tray and impression recoil
Permanent deformation
Detachment of impression from the trays
 DISINFECTIONS OF IMPRESSIONS
• To prevent exposure and cross infection
• Disinfection before poring the cast.

Disinfection methods :
• Spray-on disinfectants
• Immersion of impression in chemical disinfectant (Submerged /
soaking)

Types of chemical disinfectant used :

• Chlorine compounds
• Synthetic phenolic compounds
• Glutaraldehyde
• Idophores
• Combination of phenols and alcohols
Hydrophilic impression material  hydrocolloids, polyether
should be sprayed rather than immersion.
Idophore sprays, sodium hypochlorite sprays (1:10 ratio).
Agar (reversible hydrocolloid)  10 min immersion in 2%
alakaline glutaraldehyde  more than 20 min affects the
dimensional stability and surface detail.
Alginate (irreversible hydrocolloid)  Westerholm et al (1992)
full strength (5.25%) sodium hypochlorite spray.
Polysulphide and condensation silicone immersion in sodium
hypochlorite, glutaraldehyde 10-30min.
FAQ………

What is the difference between of the diagnostic and

elastomeric impression?

How do you make FPD impressions?

How is reversible hydrocolloid used for impressions?

What is monophase impression technique?

What are the advantages of putty reline technique for fixed

partial denture impressions?

What is irrreversible hydrocolloid used for?

What is dual impression technique?