Virtual

FEBRUARY 2002

Vinylpolysiloxane Impression System

Scientic Prole

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Table of Contents
Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Requirements of an Ideal Impression Material . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Vinylpolysiloxanes Chemistry and Setting Reaction. . . . . . . . . . . . . . . . . . . . . . . . . 6 Currently Available Vinylpolysiloxanes and their Respective Manufacturers . . . . . . . 7 Viscosity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Working and SettingTimes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Reproduction of Detail. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Hydrophilicity and Contact Angles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Moisture Displacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Wetting of Set Material Laboratory Signicance . . . . . . . . . . . . . . . . . . . . . . . 13 Wetting of Hard and Soft Tissues Clinical Signicance . . . . . . . . . . . . . . . . . . 14 Hardness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Readability, Color Combinations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Elastic Recovery; Permanent Deformation and Tear Strength (Tensile Strength). . . . . . 18 Tear/Tensile Strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Elastic Recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Dimensional Stability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Flexibility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Impression Trays and Adhesives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Disinfection of Virtual Impressions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Compatibility with Die Materials. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Gloves and the Inhibition of Polymerization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Impression Techniques with Vinylpolysiloxanes. . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

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Virtual Impression Material Scientic Documentation Summary

Vinylpolysiloxane* impression materials have applications in a variety of indirect procedures in prosthodontic and restorative dentistry. Favorable handling properties, good patient acceptance and excellent physical properties have resulted in their popularity in the modern dental practice. In this scientic review, the chemistry and important physical properties of vinylpolysiloxanes in general and Virtual specically are summarized, and relevant clinical questions regarding the hydrophilic nature (wettability), favorable color combinations, tray adhesives, disinfection, and glove-induced polymerization inhibition are addressed. The importance of the impressioning procedure and subsequent laboratory fabrication is evident in that no nal restoration is more accurate than the impression and the cast from which it is made. *Note: The terms vinylpolysiloxane (VPS), polyvinylsiloxane, and addition reaction silicones all refer to the same category of impression materials and are used interchangeably throughout the literature and within the dental profession.

General
Impression materials are used to make an accurate replica of the oral tissues (both hard and soft). The area involved may vary from a single tooth to the whole dentition or in some situations an impression may be made of an edentulous mouth. The impression provides a negative reproduction of the tissues and by lling it with dental stone or other model material, a positive cast is made which can be removed when the stone has set. Good impressions are dependent on proper technique as well as optimal material characteristics of the impression material.

Requirements of an Ideal Impression Material

No dimensional change during polymerization No dimensional change during storage Suitable working and setting times Adequate detail reproduction Good tear strength Easy to mix Compatible with die and model materials Non-toxic and non-irritating Acceptable scent and taste Long shelf life Requires minimal equipment for use

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Impressions represent key communication devices between the clinician and the laboratory, as each party utilizes the impression as the most important component of the restorative and fabrication procedures.

For Clinicians, impressions should:

Record accurately the details of hard and soft tissue Be able to be read easily to determine if/when a retake is necessary Disinfect without loss of detail or accuracy Maintain stability during shipping and permit delay of pouring Be able to be poured immediately if necessary study models Work in a variety of trays Work in a variety of clinical situations Be easy to remove from the mouth Provide patient comfort, no uncomfortable taste, or odor

For Laboratories, impressions should:

Record details slightly beyond preparation margins to ensure emergence prole and soft tissue landmarks Disinfect without loss of detail or accuracy Be able to be poured multiple times without loss of detail Be able to be stored without loss of detail

There are generally six categories of elastomeric impression materials commonly used in dentistry:
1. 2. 3. 4. 5. 6. Condenstation Silicones Irreversible Hydrocolloid (alginate) Reversible Hydrocolloid Polysulde (rubber base) Polyether Vinylpolysiloxane (addition reaction silicones)

Vinylpolysiloxane is the one most often used and provides the ideal combination of physical properties and handling for most crown and bridge impression techniques. They have achieved a high level of dentist, technician, and patient acceptance as they are clean, odorless and tasteless. Virtual is a vinylpolysiloxane impression material. In general all vinylpolysiloxanes have similar characteristics and physical properties, they work when placed with accepted techniques. Differences that are detectable and preferred by clinicians include; viscosity, ease of mixing, mouth removal times, cost, and readability.

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Vinylpolysiloxanes Chemistry and Setting Reaction

The vinylpolysiloxane impression materials are addition reaction silicone elastomers which were rst introduced in the 1970s. Since that time and especially in the past decade, these materials have gained in their acceptance and account for a large share of the impression material market. Vinylpolysiloxanes are synthetic polymers whose chemical makeup includes alternating atoms of silicon and oxygen and are presented in the form of two pastes (a base and a catalyst) which are most often auto dispensed from a dual cartridge, and mixed in equal quantities for use. One paste contains a polydimethylsiloxane polymer in which some terminal methyl groups are replaced by hydrogen (silane groups). The other paste contains a pre-polymer in which some terminal methyl groups are replaced by vinyl groups. This paste also contains a chloroplatinic acid catalyst. Once mixed in equal proportions, an addition reaction occurs between the hydrogen (silane) and vinyl groups of the respective pastes and cross linking occurs to form a silicone rubber. There is minimal dimensional change during this polymerization and there are no by-products. The base and catalyst pastes also contain llers. Amorphous silica or uorocarbons are used as llers to add bulk and improve the properties of the paste. The ller is also silanated to increase the bond strength between ller and polymer, which better allows it to function as a cross-linker. Coloring agents are added to distinguish the base and catalyst pastes and to aid evaluation of mixing. With Virtual, improved readability is the result. Intrinsic surfactants have also been added to negate the hydrophobicity of these materials and improve wettability. Compared to other elastomeric impression systems, Vinylpolysiloxanes offer: High accuracy Excellent dimensional stability Good elastic recovery - recovery from undercuts Accurate recording of ne detail High tear strength Impervious to uid absorption Adequate working time Fast recovery from deformation No odor or taste (unless purposely incorporated) patient friendly Easy to remove from the mouth Stable; can be poured up to two weeks after taking impression Stable in disinfecting/immersion protocols

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Variable viscosities Variable setting times Ease of use good handling characteristics Compatible with various die materials

Negative features of Vinylpolysiloxanes may include; Innately hydrophobic/relatively moisture intolerant require surfactants to pour in the laboratory Require separate adhesive for adhesion to impression tray Sulfur in latex (gloves) or ferric and aluminum sulfate used as clinical homeostasis, can inhibit setting

Currently Available Vinylpolysiloxanes and Their Respective Manufacturers1

Access Afnity Aquasil Reprosil Capture Splash & Splash Halftime Exaex Exafast Examix Flexitime Correct Plus WaterMark Perfectim Take 1 Extrude Imprint Imprint II Express Position Penta Quick Dimension Penta Cinch Honigum Star VPS
1

Centrix Clinicians Choice Dentsply/Caulk Dentsply/Caulk Glidewell Direct Discus Dental GC America GC America GC America Heraeus Kulzer Jeneric/Pentron Jeneric/Pentron J Morita Kerr/Sybron Kerr/Sybron 3M/Espe 3M/Espe 3M/Espe 3M/Espe 3M/Espe Parkell DMG/Zenith Danville Materials

Trademarks are not registered trademarks of Ivoclar Vivadent, Inc.

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Viscosity
International Standards Organizations (ISO) and the American Dental Association (ADA) have dened categories for the nonaqueous elastomeric impression materials which are not based on chemistry, but on 24-hour dimensional change following setting and certain elastic properties (maximum permanent deformation and maximum ow in compression) and are related to viscosity. Example Material Light Body Medium Body Heavy Body Putty ISO Specication 4823 Type 3 - Low Consistency Type 2 - Medium Consistency Type 1 - High Consistency Type 0 - Very High Consistency ADA Specications 19 Type 1 - Low Viscosity Type 1 - Medium Viscosity Type 1 - High Viscosity Type 1 - Very High Viscosity

Vinylpolysiloxanes are available in viscosities ranging from very low (for syringing or wash use), to medium, high and very high (putty). The viscosity of the material increases with the proportion of ller present. Viscosity is also affected by the shear force placed on the material. The mixed base and catalyst pastes exhibit a decrease in their relative viscosities in response to high shear stresses. This is termed shear thinning. This is why Virtual Monophase, a medium body impression material can possess sufcient viscosity to avoid excess ow if loaded into an impression tray, yet it can also exhibit an apparent lowered viscosity suitable for intrasulcular placement, when it is expressed through an impression syringe tip.

Virtual Impression System is available in the following viscosities and Types (according to ISO 4823 and ADA specications 19):
Virtual Extra Light Body Light Body Monophase Heavy Body Putty Viscosity Extra Low Low Medium High Very High Color Beige Beige Blue Blue Blue Type (ISO4823) Type 3 Type 3 Type 2 Type 1 Type 0 Type
(ADA spec 19)

Type 1 Type 1 Type 1 Type 1 Type 1

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Working and Setting Times

Modern vinylpolysiloxanes have a working time of approximately two minutes and a setting time of anywhere from two to six minutes (fast vs. regular set). Although Virtual maintains an adequate working time for even large cases*, the setting time is initiated once the tray material has been inserted into the mouth, thereby reducing the overall sum of the working and setting time for the impression. Once inserted in the mouth, all Virtual vinylpolysiloxane impression materials set within 41/2 minutes when using the regular set materials, or 21/2 minutes when using the fast set materials regardless of the working times. The Intraoral set time is the minimum time the material needs to be in place in the oral environment. Reducing the overall time results in less distortion during the seating and setting, minimizes patient or tray movement and improves patient comfort. The working time is measured from the start of mixing, during which it is possible to manipulate (mix & place) the impression material without an adverse effect on its properties. Working time comprises mixing, manipulation, and placement time. Virtual Extra Light Body Working Time Regular Fast Regular Fast Regular Fast Regular Fast Regular Fast Intraoral Set time
(minutes)

3:00 1:45 2:35 1:35 2:35 1:35 2:05 1:15 1:25 1:15

4:30 2:30 4:30 2:30 4:30 2:30 4:30 2:30 4:30 2:30

Light Body

Monophase

Heavy Body

Putty

*Occasionally, situations will present which require extended working times (full mouth or implant impressions). The most convenient and widely advocated method for extending working time of vinylpolysiloxanes is to refrigerate the impression material before mixing.

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Reproduction of Detail
Surface Detail is the ability of an impression material to reproduce intricacies on the surface of an object and is necessary to achieve good marginal t of nal restoration. Vinylpolysiloxanes are currently considered to reproduce the greatest detail of all the impression materials. The international standard for dental elastomeric impression materials1 states that a type III (light body) impression material must reproduce a line 0.020 mm (20 microns) in width. With the exception of the very high viscosity putty materials, all vinylpolysiloxanes (light, medium and heavy body) achieve this.

Note: Smooth preparations reproduce better with all impression materials and die stones. Material Type Type 3 LowViscisity Type 2 Medium Viscosity Type 1 High Viscosity Type 0 Very High Viscosity Internal Data Virtual VPS Material Extra Light Body Light Body Monophase Heavy Body Putty Detail Reproduction () Required (ISO-4823) 20 20 50 50 75 Detail Reproduction () of Virtual VPS Materials 20 20 20 20 50

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Hydrophilicity and Contact Angles

Another aspect of importance for impression materials is whether they are hydrophilic, or not; that is whether they have an afnity for water. The thought is that if the material is slightly hydrophilic, saliva may be displaced upon recording the impression. A study measuring the moisture displacement of various vinylpolysiloxane materials demonstrated that Virtual Extra Light Body and Virtual Light Body displaced the most moisture when simulating clinical conditions.

Moisture Displacement

Moisture Displacement
Meniscus Diameter, Relative Units
Meniscus Diameter, Relative Units
5 5.0 5.5 5 5.0 5.5 4 4.0 4.5 4 4.0 4.5 3 3.0 3.5 3 3.5 3.0 2 2.5 2.0 2 2.5 2.0 1 1.5 1.0 1 1.5 1.0 0 0 0 Virtual XL Virtual L Express Express Splash L Splash L Reg XL Aquasil XL Aquasil L

Moisture Displacement

B. Norling, PhD, University of Texas Health Science Center, San Antonio

An extracted human third molar was mounted in acrylic resin in a PVC ring with the crown exposed. Right angle grooves 1.5mm wide by 1.5mm deep were milled mesio-distally along the facial and lingual surfaces using a water- cooled FG-57 bur in a high-speed handpiece. For ten replicates of each of six impression materials, the tooth was immersed in deionized water and removed, leaving the adherent water in the grooves and an impression made. After curing, the impressions were sectioned bucco-lingually and photographed at 45 magnication using a digital camera on an Olympus zoom microscope. The photographs were imported into Corel Draw and magnied 2x. A circle was drawn which matched the radius of the meniscus where the impression material had failed to displace water from the tooth surface. These circle diameters were analyzed by ANOVA and post hoc multiple comparison tests and compared with previously measured contact angles (slurry) by correlation analysis. Radii were analyzed by ANOVA and StudentNeuman-Keuls multiple comparison test. Note lower number values higher displacement. The materials fell into three statistical subsets, p<0.05. Both viscosities of Virtual displaced moisture better than any of the others, although they shared a statistical subset with the 3M Express Materials.

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The correlation between contact angle (slurry) and moisture displacement was examined by plotting the two variables against one another. There was no relationship between the two variables. Indeed, the materials with the best moisture displacement also had the highest contact angles (slurry). The results of these evaluations conrm previous results which suggest that there is little if any correlation between contact angles (slurry) and moisture displacement for vinylpolysiloxanes. Moisture displacement is probably a much more clinically relevant consideration to take into account when selecting an impression material or system than simply measuring static contact angles. However, when discussing the wetting characteristics (contact angles) of impression materials, it is important to distinguish between the ability of the material to ow around the soft and hard tissues of the mouth, and the ability of the set impression material to be wet by a gypsum slurry or water.

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Wetting of Set Material Laboratory Signicance

The wetting of a solid by a liquid can be measured by the contact angle. A contact angle of 0 degrees indicates complete wetting (more hydrophilic). The larger the contact angle, the lower the ability to wet (more hydrophobic). Good wetting means good adaptation of the liquid to the surface of the solid, which ensures improved detail reproduction by the impression material. The traditional method of determining the wetting ability of an impression material is to measure the contact angle of a drop of water or a drop of slurry (stone mixed with water) on the set impression material. This contact angle is what is reported in most manufacturers literature as the true indication of the hydrophilic nature of an impression material. This technique of measuring a contact angle of water on a set impression material does not directly or indirectly relate to what actually happens when an impression is taken in the oral cavity at best it represents what happens when an impression is poured in the laboratory water or a water slurry against set impression material.

Contact Angles, Water

30 Second Contact Angle, Degrees

Contact Angles, Water

Contact Angles, Water
100 80 60 40 20 0
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Video Contact Angle Measurement of Impression Materials on Various Substrates. Sorensen JA. J Dent Res #80. 2001.

Fresh at samples of each impression material were fabricated with the natural gloss obtained by pressing the material against a microscope slide. For each material, 10 drops of water were left after falling on the surface. The drops were of a standardized volume of 7 micro liters.

Although the contact angles of the Virtual impression materials are relatively high in comparison to others, numerous clinical and laboratory eld tests and evaluations conrmed excellent pourability of the impressions and high quality of the models. The resultant restorations and t were considered ideal.

Imprint, Impregum, Exafast, Dimension, Honigum, Splash, Take 1 and Aquasil are not registered trademarks of Ivoclar Vivadent, Inc.

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Wetting of Hard and Soft Tissues Clinical Signicance

The ability of a material to wet a preparation or the hard/soft tissues is directly related to the force of application, the speed of application and the weight of the material and possibly now related to the material itself. Part of the composition of Virtual is a non-ionic surfactant of nonylphenoxypolyethanol homologues which is homogeneously distributed throughout the material. Once it is mixed, the surfactant quickly migrates from its homogeneous position to all outer surfaces of the dispensed material creating an active hydroactivated surface. Literally, due to this migration, the surface of the impression materials become more hydrophilic (and the inside portion more hydrophobic) as it is dispensed and placed either in a tray or directly intraorally. Two independent studies conrm Virtuals unique wetting of the various hard (dentin) and soft (gingival) tissues.

Contact Angles, Human Dentin

(Lower values indicate better wetability)

Contact Angles, Human Dentin Contact Angles, Human Dentin

100

Degrees

90 80 70 60 50

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Video Contact Angle Measurement of Impression Materials on Various Substrates. Sorensen JA. J Dent Res #80. 2001.

Freshly extracted human teeth were embedded in methacrylate and trimmed to expose dentin. Drops of impression materials were delivered over moist surfaces. The contact angle was measured in the VCA Optima Machine. An average between the left angle and the right angle was calculated and documented. A total of ten drops per surface were made for each material.

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Contact Angles, Wet Gingiva

(Lower values indicate better wetability)

Contact Angles, Wet Gingiva

60 50

Contact Angles, Wet Gingiva

Degrees

40 30 20 10 0
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Video Contact Angle Measurement of Impression Materials on Various Substrates. Sorensen JA. J Dent Res #80. 2001.

Freshly collected samples of fresh bovine intraoral mucosa were collected in a full thickness form. Drops of impression materials were delivered over wet and dry gingival surfaces. The contact angle was measured in the VCA Optima Machine. An average between the left angle and the right angle was calculated. A total of ten drops per surface were made for each material. All impression materials had a better (lower) contact angle when placed on wet gingiva than when placed on dry.

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Hardness
The relative hardness of elastic materials such as rubber or soft plastics can be determined with an instrument called a Shore A durometer. If the indenter completely penetrates the sample, a reading of 0 is obtained, and if no penetration occurs, a reading of 100 results. The reading is dimensionless.

Shore Hardness

Shore A Shore AHardness Hardness

100 90 80 70 60 50 40 30 20 10 0 Virtual XLV Internal data Virtual LV Virtual Mono Virtual Heavy Aquasil LV Take 1 Wash Take 1 Tray

Clinically it is desirable to have increasing hardness from wash to tray to provide support for the nal impression. The results demonstrate an increasing hardness of the various viscosities of the Virtual line of impression materials from Extra Light Body Wash to the Heavy Body Tray material.

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Readability, Color Combinations

During development of the Virtual VPS Impression System numerous independent focus groups comprised of general practitioners, prosthodontists and laboratory technicians were held to determine the ideal color combination of impression materials. Although most other competitive systems include a variety of color combinations (see chart below) it was determined that an optimized combination of a beige (tan) and blue facilitated the best reading of the margins and was the most accepted color combination. This is a signicant advantage for both the clinician (determining chair-side if an impression needs to be retaken) and for the technician (seeing the margins to pour). This color combination stands to reason as blue is commonly known as a relaxing and cool color while beige is the color of most dental stones, which consistently are used in dental laboratories and provides for easy reading of the margins. The following are possible color combinations within impression systems combining equal set times (fast and regular set) with low and higher viscosity materials. Monophase impressions are also included as a single color:

Virtual (Ivoclar Vivadent, Inc.) Beige/Blue Blue Splash (Discus Dental) Yellow/Sky Blue Yellow/Purple Mint Green/Sky Blue Mint Green/Purple Sky Blue Aquasil (Dentsply/Caulk) Orange/Purple Orange/Green Aqua Green/Purple

Imprint II (3M/ESPE) Yellow-Green/Mauve Lavender/Bluish-Green Yellow/Mauve Orange/Bluish-Green Take 1 (Kerr/Sybron) Orange/Blue Orange/Purple Orange/Light Green Light Green Impregum (3M/ESPE) Purple Aqua Green/Green Purple

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Elastic Recovery; Permanent Deformation and Tear Strength (Tensile Strength)

During the stretching of an impression material (similar to removing from an undercut, sulcus) the material will go through three phases; Elastic Recovery, it will stretch to a point that if the pressure is released it will bounce back to the original dimension. Then, it is stretched to a point of no return meaning that as it is stretched and released it doesnt go back to the original dimension; rather it will be distorted or stretched Permanent Deformation. Following this stage, it can be stretched so much that it breaks or tears marking the Tensile/Tear Strength. Virtual is an ideal material because it has a high elastic recovery; a very short or no permanent deformation stage and high tear strength. Rather than distort at the highest stress it tears so the dentist immediately knows that they may have to retake the impression which avoids nding out later due to the distortion at permanent distortion.

Tear/Tensile Strength

Tear Strength
10 9 8 7 6 5 4 3 2 1 0 Express Express Splash L Reg L Aquasil L

Tear Strength

N/mm

Virtual XL

Splash Virtual L Aquasil XL XL

B. Norling, PhD, University of Texas Health Science Center, San Antonio

Impression materials must have sufcient strength to allow removal from a gingival sulcus without tearing. Tear energy is that energy required to sustain a tear through a material, and is of obvious importance in thin intrasulcular or interproximal areas.

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Tear/Tensile Strength Tear Strength Strength Tear

10 9 8 7 6 5 4 3 2 1 0 Virtual XL Virtual L Virtual Mono Virtual Heavy Body Aquasil LV

Internal Data

Tear Strength is dependent on many factors:

Adequacy of gingival retraction is critical since thinner areas of impression material are weaker and more likely to tear The deeper the margin the more likely the material will tear Hemorrhage can aw the impression which can act as foci for tear initiation Sharp edges on preparations can score impression materials and initiate tears Rough preparations can cause tears by increasing the resistance required to release the impression material from the surface

N/mm

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Elastic Recovery

Elastic Recovery (%) Elastic Recovery (%)

100% 90% 80% 70% 60% 50% Virtual XLV Virtual LV Virtual Mono Virtual Tray Aquasil LV Take 1 Wash Exafast NDS HB

J. Powers, Houston

Internal Data

Permanent deformation is the lack of recovery from deformation of an elastic impression or duplicating material compressed at a xed strain, usually for 30 seconds. The trend is to report percent recovery rather than permanent deformation. Therefore a material with a permanent deformation of 1% has a 99% recovery. Rapid straining tends to maximize recovery from deformation, thus the set impression should be removed from the mouth with a rapid pull (in as far as is practicable) and not stressed slowly. ADA/ANSI Standards require greater than a 96.5% Recovery from Deformation, which all viscosities of Virtual surpass. Vinylpolysiloxanes are frequently reported to be the best suited elastic impression materials because they exhibit better elastic recovery and less permanent deformation than the other elastomers. They can absorb over three times more energy up to the point of permanent deformation than other elastomers, and if elongated to over 100% (strain at tear), they rebound to only 0.6% permanent deformation.

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Dimensional Stability
The accuracy of an impression material is dependent on the dimensional stability. There are a number of possible causes for dimensional changes in elastomeric impression materials. All rubber polymers must contract slightly during polymerization as a result of reduction in spatial volume as they cross-link. Some impression materials like the polyethers are very sensitive to the moisture content of their surroundings and can absorb and then even lose water if they are placed in wet or varying humidity environments. Changes in temperature can also lead to varying changes in the nal dimensions. Vinylpolysiloxanes show the smallest dimensional changes on setting of all the elastomeric impression materials.

Linear Dimensional Change Linear Dimensional Change (%)

0.20% 0.15% 0.10% 0.05% 0.00% -0.05% -0.10% -0.15% -0.20% Internal data Virtual XL Virtual L Virtual Mono Virtual Heavy Body Virtual Putty

The majority of this shrinkage is due to continued polymerization occurring within the rst three minutes of removal of the impression from the mouth. This linear contraction is well matched to the setting expansion of modern type III and type IV die stones and results in a slightly larger replication of the preparation. Long term dimensional stability of vinylpolysiloxanes is ideal because they are not susceptible to changes in humidity, and they do not undergo any further chemical reactions or release any by-products.

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Flexibility
Strain in Compression

Strain in Compression (%) Strain in Compression (%)

14% 12% 10% 8% 6% 4% 2% 0% Virtual XL Virtual L Virtual Mono Virtual Heavy Body Aquasil LV Aquasil Rigid Take 1 Wash Exafast NDS HB

Internal Data

J.Powers, Houston

Strain in compression or exibility of an elastomeric impression or duplicating material is measured between stresses of 100 and 1000 g/sq. cm (ca. 0.01 and 0.1 MPa).

Strain in compression is a measurement is how much the material can be compressed. The higher the value the more "exible" the material, the lower the value, the stiffer the material. There is no ideal value (thats why ISO allows 0.8 - 20 %), it depends much more on the material and especially the technique used. For example, low value indicates low elasticity meaning that the impression might be difcult to remove (hard to move over undercuts). Yet it may be easily cut with a knife if someone is using the putty-wash technique in a two-step mode (usually in this technique you cut back some of the putty material after having taken the rst impression to allow space for the low viscosity material). Therefore, strain in compression can be viewed as another way to measure the ridgity of a material.

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Impression Trays and Adhesives

Tray spacing and tray design have often been cited as potential sources for error in impressions for xed prosthodontic impressions. The improved physical properties of vinylpolysiloxanes have diminished this concern and now the use of stock trays for impressions has become common practice for reasons of cost and convenience. Common stock trays made of polystyrene or chromium plated brass are reported to be suitably stiff to prevent exure or distortion. Whether custom or stock trays are used, another potential source of error may arise if the material is not adequately retained in the impression tray when it is removed from the mouth. The use of adhesives in impression trays has shown higher material bond strengths for vinylpolysiloxanes compared to mechanical retention. Virtuals tray adhesive is a polydimethyl siloxane and ethylsilicate. The adhesive reacts with the surface of the tray material and forms a chemical bond to the tray and to the impression material. It is recommended to wait three minutes after application of the adhesive before making the impression. This allows time for the solvent to evaporate and for the adhesive to react with the tray material. In many clinical situations, the impression tray must be tried in the mouth prior to taking the impression. This leads to saliva contamination. If the adhesive is placed prior to trying in the tray. If the tray has already been painted with adhesive, then subsequent application is recommended to maintain bond strengths.

Disinfection of Virtual Impressions

Disinfection is the inhibition or destruction of pathogens. This can be achieved by immersion of an impression into antimicrobial chemical solutions for 3 to 90 minutes depending on the agent. Sterilization is the total elimination of all micro-organisms and spores and requires immersion periods of 6 to 10 hours. Extended periods of immersion can cause distortion of the impression due to liquid uptake resulting in swelling of the material. Consequently, procedures currently used to control the transmission of pathogens from impressions tend to be disinfection and not sterilization due to concern for the accuracy of the impression. Numerous studies have tested the dimensional stability of different impression materials following immersion disinfection for greater than thirty minutes. Results show that vinylpolysiloxanes were unaffected after immersion in sodium hypochlorite, 2% glutaraldehyde, 0.5% povidone-iodine and 0.16% halogenated phenol, while polyethers (because of their moisture uptake) were signicantly unstable. It is recommended that impressions made with Virtual impression materials be submerged for 10 minutes.

Compatibility with Die Materials

Virtual is compatible with popular gypsum, epoxy resin, and polyurethane resin materials. Gypsum stones cannot reproduce detail much smaller than 20 m because their crystal size ranges from 15 to 25 m. Epoxy and polyurethane resins can reproduce detail down to 1 to 2 m making them highly compatible with the detail capture possible with vinylpolysiloxane impressions. Vinylpolysiloxanes can also be silver electroplated. This procedure can be facilitated by soaking the impressions in water for 24 hours before application of the silver powder. It is thought that this alters the concentration of surfactants in the surface layers of the impression. The ability to pour duplicate dies from one impression is highly advantageous and the removal of dies and subsequent repouring of vinylpolysiloxane impressions typically produce clinically accurate duplicate models. 23

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Gloves and the Inhibition of Polymerization

Occasionally an inhibition or retarding effect is seen on vinylpolysiloxanes when they are used in a clinical setting. This phenomenon can occur after direct contact between the impression material and latex gloves, or a region of the mucosa previously touched by latex gloves. A sulphur compound has been identied as being responsible for the retarding effect on polymerization. Zinc diethyl dithiocarbamate is an accelerator used in the manufacture of the latex gloves. It reacts with the platinum catalyst in the vinylpolysiloxane to cause a delay or total inhibition of polymerization. It is also believed that the compound can remain on a previously gloved hand. Washing hands after glove use is not recommended as a means of avoiding contamination. Interestingly, not all latex gloves will cause an inhibition of set. It has been observed that synthetic latex gloves do not produce this phenomenon, while some natural latex gloves do. Ones own testing and subsequent use of a non-retarding glove is recommended. In addition, sulfur-containing additives in retraction cord such as ferric sulfate (e.g. found in Astringedent, Ultradent) and aluminum sulfate may also produce this inhibition effect.

Impression Techniques with Vinylpolysiloxanes

Three common impression taking techniques are recommend with Virtual: the single mix, the double mix, and the putty wash. No signicant difference in accuracy between the three techniques has been found. The single-mix or Monophase technique is one in which a medium-viscosity material (Virtual Monophase) is used in both the syringe and in the custom, quadrant or stock tray. A double-mix technique uses a light-body wash material (Virtual Light Body or Extra Light Body) in the syringe and a medium or heavy body material (Virtual Heavy Body or Monophase) in the custom or stock tray. Light bodied impression material is placed in a syringe, and placed over the areas where high detail is required (e.g. over a crown preparation). the same material is then injected over the heavy bodied impression material which has been loaded into an impression tray. the tray material is then seated and sets simultaneously. The heavy-light, double-mix technique is the most popular technique with vinylpolysiloxanes in North America. The putty-wash method, can be done in one stage (simultaneous setting of putty wash, similar to the double mix technique, but using the putty material in the custom or stock tray) or in two stages where the putty sets rst and acts as a subsequent custom tray for the wash step. Often this technique is used to convert a stock metal tray into a custom tray. (i.e., take a stock tray, paint it with adhesive, and make a putty impression of a spaced diagnostic model). This tray is then used clinically to make the nal impression by syringing a light body (Virtual Light Body or Extra Light Body) material atound the prep and in the putty impression is then reseated into place.

Astringedent is not a registered trademark of Ivoclar Vivadent, Inc.

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References
1. Albers, HF. Impressions; A Text for Selection of Materials and Techniques; Alto Books. January, 1990 First Edition. 2. International Standards Organization. Dental elastomeric impression material. ISO 4823-1992. 3. Lee EA, Culp L, Friebauer W. Accurate Elastomeric Impressions: Precise Transfer for Predictable Indirect Restorations. Collaborative Techniques. Winter 2001. Montage Media. 4. Mandikos, M.N. Vinylpolysiloxane Impression Materials: An Update on Clinical Use. Australian Dental Journal 1998; 43: (6) 428-34. 5. Materials Handling and Evaluation Center (MHEC), Ivoclar Vivadent, Inc. Impression Materials Handling Report. Internal Report. 2001. 6. Miller, M. REALITY 2001, Impression Materials. REALITY Publishing Co. Vol. 15. 7. Norling BK. Report of Laboratory Tests. Ivoclar Vivadent Impression Materials. Internal Report. 2001. 8. OBrien W. Biomaterials Properties Database, University of Michigan. Updated from Dental Materials and Their Selection, 2nd ed., 1997. Quintessence Publishing. 9. Paquette JM, Sheets CG, Mastering the Impression Technique for Simple to Complex Treatments. Dentistry Today, June 2000.68-75. 10. Phillips RW. Skinners science of dental materials. 9th edition. Philadelphia: Saunders, 1991. 11. Powers J. Impression Materials UTHSC. Internal Report, 2001. 12. Ray NJ, Lecture Notes, Dental Material Science - Chapter Five; Rubber Impression Materials. UCC, 2000-2001. Internet download. 13. Shillingburg HT, Hobo S, Whitsett LD. Fundamentals of xed prosthodontics. 2nd edition. Chicago: Quintessence Publishing Co., 1981. 14. Sorensen, JA. Video Contact Angle Measurement of Impression Materials on Various Substrates. J Dent Res #80. 2001. 15. Virtual Instructions for Use and Technical Data.

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Vinylpolysiloxane Impression System

Scientic Prole

Copyright 2002 Ivoclar Vivadent, Inc.

REV. 02/2001 NA6910056