Presented by,

DR. SASIKUMAR.T.P.
1ST YR PG STUDENT
DEPT OF PROSTHODONTICS
 
“A COMPARATIVE EVALUATION OF DIMENSIONAL
ACCURACY OF CASTS RESULTING FROM PUTTY–WASH
ADDITION SILICONE IMPRESSIONS MADE USING DIFFERENT
IMPRESSION TECHNIQUES“- AN INVITRO STUDY.

Guided by

DR.K. KAMALAKANTH SHENOY. M.D.S DR. SANATH SHETTY. M.D.S

PROFESSOR AND HEAD PROFFESSOR AND GUIDE
DEPT. OF PROSTHODONTICS DEPT. OF PROSTHODONTICS
 NEED FOR THE STUDY:
 Accuracy of an impression is very critical for the
success of any prosthesis. This accuracy largely depends on
the impression techniques and also the inherent quality of
the impression material to record finer details. It is also a
great advantage if the impression maintains the accuracy for
a period of time.
 The addition silicone impression materials have been
reported to be the most accurate and dimensionally stable
with the combination of excellent physical properties and
handling characteristics.1
For the purpose of fabricating precise fitting prosthesis,
like cast partial dentures, fixed partial dentures, implant
prosthesis, etc, an accurate gypsum cast, reproduced from an
accurate and dimensionally stable impression is a basic
prerequisite.
 Accuracy of gypsum casts indirectly depends on factors
like - type of impression material, impression techniques,
thickness of wash material (light-body) and time of pour.
Putty-wash technique has been recommended for
addition silicone impression materials. It can be made as a
one-step or a two-step technique. Advantages of the one-step
technique include reduced chairside time and saving on the
consumption of lightbody. An advantage of the putty-wash
two-step impression technique is that the impression of the
teeth can be captured with the wash material (lightbody).
 Some researchers claim that impression materials
have improved to such an extent that accuracy may be
controlled more with technique than by the material itself.
Whereas others reported that impression technique does
not affect the accuracy2,3.
 Undesirable dimensional changes and stone model
inaccuracies which resulted from excessive or uncontrolled
thickness of the wash impression material have been
reported,4,5.
 Delay in the pour of impression is of interest clinically,
because delayed pouring of cast is often desired. Accuracy
of the gypsum casts are also influenced by the time of pour6.

A lot of research has gone into investigating, as to

which brand of impression material is the most accurate.
 Very little studies have been done to assess the
accuracy of the various techniques involved in making
impressions and also the ideal time interval after which
casts could be poured to achieve optimum accuracy.
 So the evaluation of dimensional accuracy of cast
made form addition silicone impression using one step and
two step putty/wash technique with different wash (light-
body) thickness at different time intervals are subjected in
this study.
6.2. REVIEW OF LITERATURE
In one study6, accuracy of four types of rubber impression materials compared
with time of pour and a repeat pour of models was done indirectly by measuring the
seven dimensions on the improved stone models recovered from the impression of
the master model. They reported that there was little change in dimensions among
abutment preparations for all materials, for all time of pour, with a repeat pouring.
The vertical dimensions of stone posts were, in general shorter than the standard for
all materials, with the addition silicone demonstrating the smallest changes. The
addition silicone and condensation silicone demonstrated the best recovery from
under cuts and the least change in dimensions between the initial and second pour
of an impression. The addition silicone and polyether were the least affected with
delays of 1, 4 and 24 hours in pouring the impression.
 A study7 was conducted on accuracy of addition silicones as a function of
technique. They investigated four addition silicone impression material and one
condensation impression material with 3 techniques, ie, putty wash, single mix and double
mix. They concluded that the same accuracy was achieved with all techniques (ie, putty
wash, single mix and double mix) when addition silicones were used, where as the putty
wash technique produced the most accurate results for the condensation silicone.
A study2 was done to compare the accuracy of one –step putty –wash with two
step putty –wash impression techniques. Five addition silicone impression materials were
tested. A stainless steel model containing two full crown abutment preparations was used
as the positive control. Five replications of one-step and two- step putty- wash impression
of the master model were made for each test material. Accuracy of the material was
assessed by measuring six dimensions on stone dies poured from impressions of the master
model and concluded that accuracy of addition silicone impression material is affected
more by material than technique.
 In another study3 putty-wash one-step and two-step techniques for making
addition silicone impression were carried out. The results indicated that the interabutment
distances increased slightly compared with the control for both the techniques. Though
statistically significant differences in accuracy can be found between the techniques, these
were not of sufficient magnitude to warrant the strong recommendation of one technique
over the other. Neither techniques resulted in dies that deviated sufficiently from the master
model to cause clinically important difficulties in the fit of castings.
A study4 was done on three putty–wash impression techniques 1) one step putty-
wash impression 2) two-step with 2mm relief for wash material 3) two-step putty with poly
ethylene spacer. The accuracy was assessed by measuring the dimensions on stone dies
poured from impression of the master model. The study concluded that two–step 2mm
putty wash impression technique was most accurate in dimensions when compare to either
techniques because the controlled wash bulk compensates for the shrinkage of the putty
material.
 A study5 was carried out to determine effect of wash bulk
on the accuracy of polyvinyl siloxane putty-wash impressions.
Variations in the bulk of wash in a putty wash impression
technique can result in dimensional changes proportional to the
thickness of the wash material during setting. So to determine the
amount of wash necessary to achieve accurate stone models while
using a two-step putty- wash impression technique with poly vinyl
siloxane impression material, wash thickness of 1mm, 2mm and
3mm are subjected to study. The conclusion of the study was, wash
thickness of 1 to 2mm are most accurate for fabrication of stone
dies when using polyvinyl siloxane impression material with the
two –step putty-wash impression technique.
 AIM OF THE STUDY

To evaluate the dimensional accuracy of casts resulting

from addition silicone impressions made from 1 step
putty/wash and 2 step putty/wash impression techniques.
SOURCE OF THE DATA
 150 impressions of the stainless steel master
die will be made from EXPRESS TMXT (3M
ESPE) penta putty VPS impression material
using PENTAMIXTM ( 3M ESPE ) automatic
mixing unit and EXPRESSTM XT (3M ESPE)
light body VPS impression material using
auto mix syringe.
 These 150 impressions will be poured with ELITE

ROCKTM Type IV die stone from ZhermackR to

procure 150 stone dies.

 TRAVELING MICROSCOPE will be used for

measuring the interabutment distance and

occlusogingival distance on these 150 stone dies.

METHOD OF COLLECTION OF DATA

Fabrication of stainless steel die :

 A machined standard stainless steel die which
will be the control for all measurements will be
fabricated to simulate two full crown fixed partial
denture abutment preparations.
 The dimensional details6 are as follows :
 1. Distance between the abutment preparations : 30 mm
 2. Gingival diameter of the abutment preparations : 10 mm
 3. Occlusogingival height of the abutment preparations : 10 mm
 4. Occlusogingival taper of the abutment preparations : 60
 5. Platform thickness : 5mm
 Reference lines will be inscribed on the occlusal
and axial surfaces of the abutment preparations for
the purpose of measurements. A cross marking will
be made at the centre of the occlusal surface of the
abutment preparations for the purpose of measuring
the interabutment distance of the stone dies.
 Circumferential reference lines will be made on
axial surface of abutment preparation 1mm short of
the occlusal surface and base. A vertical line will be
inscribed along occlusogingival direction joining
the two circumferential lines. This will be used for
assessing the occlusogingival dimension of the
stone dies.
Fabrication of the impression tray:

A perforated stainless steel tray with a handle

will be fabricated of 2mm thickness. A clearance
of 4mm is provided for the putty material between
the abutment and the inner surface of the tray.8, 9
Fabrication of spacers for the wash material :
 a. Thickness of stainless steel spacer :2mm
 b. Thickness of stainless steel spacer :1mm
 c. Polyethylene spacer :50microns(approx)
Impression making :
Group 1: One –step putty/wash technique:
 Perforated tray will be loaded with putty from the
PENTAMIXTM. Simultaneously the light body will
be injected onto the stainless steel dies using automix
syringe.
  The tray will be seated onto the dies with a gentle
finger
pressure. After the material has set, the impression will
be gently removed from the die.
 30 impressions will be thus made using this technique.
These 30 impressions will again be subgrouped into 5,
each subgroup containing 6 impressions. Each subgroup
will be poured with Type IV die stone at 5 different time
intervals.
Group 2-A : Two –step putty /wash technique
without spacer:
Perforated tray will be loaded with putty from the
PENTAMIX.TM. Then the tray will be seated onto the die
with gentle finger pressure.
After the putty impression material sets, impression will
be carefully removed and loaded with the light body from
the automix syringe. The tray is again seated back onto
the die.
 After the set of the light body, the impression will be
gently removed from the die.
 30 impressions will be thus made using this technique.
These 30 impressions will again be subgrouped into 5,
each subgroup containing 6 impressions. Each subgroup
will be poured with Type IV die stone at 5 different time
intervals.
 Group 2-B: Two –step putty/ wash technique using
polyethylene spacer:
 A polyethylene spacer will be closely adapted on the
abutment preparations.
 Perforated tray will be loaded with the putty from the
PENTAMIXTM. Then the tray will be seated onto the die
with gentle finger pressure. After the material has set, the
impression will be removed from the die.
 The polyethylene spacer is then removed from the
impression and the light body from the automix syringe is
loaded in the impression. The tray will be then reinserted
onto the die.
 Once the lightbody is set the impression will be gently removed from the die.
 30 impressions will be thus made using this technique. These 30 impressions will
again be subgrouped into 5, each subgroup containing 6 impressions. Each
subgroup will be poured with Type IV die stone at 5 different time intervals.
 Group2-C: Two -step putty/wash technique using 1mm thick metal
spacer:

 A 1mm thick metal spacer will be placed on the abutment

preparations.
 Perforated tray will be loaded with the putty from the
PENTAMIXTM. This tray will then be seated onto the die with
gentle finger pressure. After the material has set, the impression
will be removed along with the metal spacer.
 The metal spacer will be separated from the impression and
light body from the auto mix syringe will be loaded into the
tray. This tray will be then seated onto the die.
 Once the material has set, the impression will be gently
removed from the die. 30 impressions will be thus made
using this technique.
 These 30 impressions will again be subgrouped into 5,
each subgroup containing 6 impressions. Each subgroup
will be poured with Type IV die stone at 5 different time
intervals.
Group 2-D: Two –step putty/wash technique using 2mm thick
metal spacer:
 A 2mm thick metal spacer will be placed on the abutment
preparations.
 Perforated tray will be loaded with the putty from the
PENTAMIXTM. This tray will be then seated onto the die with gentle
finger pressure. After the material has set, the impression will be
removed along with the metal spacer.
 The metal spacer will be separated from the impression and light
body from the auto mix syringe will be loaded into the tray. This
tray will be then seated onto the die.
 Once the material has set, the impression will be gently
removed from the die. 30 impressions will be thus made
using this technique.
 These 30 impressions will again be subgrouped into 5,
each subgroup containing 6 impressions. Each subgroup
will be poured with Type IV die stone at 5 different time
intervals.
5) Preparation of stone dies :

The 5 subgroups(consisting of 6 impressions) of Group

1, Group 2-A, Group 2-B, Group 2-C and Group 2-D will
be poured with type IV dental stone at time intervals of 0
hour, 1 hour, 6 hours, 24 hours and 48 hours respectively.
Assessment of accuracy :

  The dimensional accuracy of impression will be determined by

measuring the
 a) The interabutment dimension and
 b) The occlusogingival dimension of the recovered stone dies
using a traveling microscope capable of measuring dimensions up
to 0.001mm.
 The results thus obtained will be compare with stainless steel
master die and then tabulated and subjected to statistical analysis
using TWO WAY ANOVA test.
LIST OF REFERENCES
 
 1) Craig RG. Review of dental impression materials. Adv Dent Res 1988; 2:51-64.
 2) Shirley H.hung, John H.Purk, Daniel E.Tira, J.David Eick. Accuracy of one – step
versus two- step putty wash addition silicone impression technique.J PROSTHET DENT .
1992;67:583-58.
 3) ) Badr Idris, Frank Houston ,and Noel Claffey. Comparison of the dimensional accuracy of
one and two step techniques with the use of putty /wash addition silicone impression materials.
J PROSTHET DENT. 1995;74:535-41.
 4) Joseph Nissan, Tamar Brosh, and David Assif. Accuracy of three polyvinyl siloxane
putty-wash impression techniques. J PROSTHET DENT. 2000;83:161-165.
 5) J,Nissan,M.Gross, A.ahifman and A.Assif..Effect of wash bulk on the accuracy of
polyvinyl siloxne putty-wash impressions. Journal of oral rehabilitation 2002;29:357-
361.
 6) Glen H.Johnson ,and Robert G.Craig .Accuracy of four types of
rubber impression materials compared with time of pour and a repeat
pour of models. J PROSTHET DENT. 1985;53:484-490.
 7) Glen H.Johnson ,and Robert G.Craig .Accuracy of addition
silicones as a function of technique. J PROSTHET
DENT.1986;55:197-203
 8) Reisbick, M . H., and Matyas, J. The accuracy of highly filled
elastomeric impression materials. J PROSTHET DENT.1975; 33 : 67.
 9) Asgar, K.: Elastic impressions materials. Dent Clin North Am .
1971;15: 81.