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DIMENSIONAL STABILITY OF VINYLSILOXANETHER IMPRESSION MATERIAL

AFTER AUTOCLAVE STERILIZATION-AN IN VITRO STUDY.

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Dental Materials
Original Article

DIMENSIONAL STABILITY OF VINYLSILOXANETHER IMPRESSION

MATERIAL AFTER AUTOCLAVE STERILIZATION – AN IN VITRO STUDY
1
AIMAN KHAN
2
MUMTAZ-UL-ISLAM
3
TAHIR ALI KHAN
ABSTRACT
Dental impressions are often neglected in clinical practice as a source of spread of infectious
diseases. In Pakistan more than fifty percent of the clinicians do not disinfect impressions. Blood and
saliva contaminated impressions should be either disinfected or sterilized before further handling.
Aim of this study was to determine effect of autoclave sterilization on the time dependent dimension-
al stability of vinylsiloxanether impression material. Impressions of stainless steel die (ADA/ANSI
specification No. 19), were made of Vinylsiloxanether. Out of 40 specimens, half were allotted to group
A and were autoclaved at 134ºC AND 20 psi for 5 minutes. Rest of the specimens (Group B) served
as a control. Dimensional changes were calculated for two time intervals i.e. after one hour and af-
ter twenty-four hours. Samples were scanned and images were analyzed by using Adobe reader XI
(AcroRd 32) software. Paired t-test showed significant difference (p = 0.007) between readings at first
hour (-0.047%) and twenty fourth hour (0.084%) in group A. Whereas independent t-test showed no
significant difference in group A and B for both time intervals i.e. at first hour (p = 0.162) and twenty
fourth hour (p = 0.148). It was concluded that Vinylsiloxanether can be sterilized in an autoclave
without any deleterious change in dimensions.
Key Words: Vinylsiloxanether, Autoclave sterilization, Elastomers, Dimensional stability.

INTRODUCTION Therefore, microorganisms from the oral cavity are

One of the commonest procedures that can lead to
transmission of infection between patients and labo-
ratory technicians is dealing with dental impressions.
Apart from general dental practice, prosthodontic
procedures are gaining more affirmation regarding
pathogenicity of hepatitis B virus (HBV), herpes, tu-
berculosis (TB), acquired immunodeficiency syndrome
(AIDS) and pneumonia.1 Human Immunodeficiency
Virus (HIV) related oral abnormalities are present in
30-80% of the HIV-infected individuals and few of the
lesions are said to be contagious.2 HBV and HIV can
persist viably on non-living surfaces for more than a
week.3 Seventy two percent of the dental impressions
receiving at laboratories yielded growth of bacteria, with
a median number of 130 colony forming units (CFU).4
1
Aiman Khan, Assistant Professor – Science of Dental Materials,
BDS, MPhil, Sardar Begum Dental College and Hospital, Gand-
hara University, University Town, Peshawar, Pakistan
Cell: 0332-9001222 Email: khan.aimann@yahoo.com
2
Mumtaz-ul-Islam, BDS, MHR, Sardar Begum Dental College and
Hospital, Gandhara University, University Town, Peshawar, Pa-
kistan Email: drmumtazulislam@gmail.com
3
Tahir Ali Khan, Professor – Science of Dental Materials, BDS,
MDSc, MHR, Sardar Begum Dental College and Hospital, Gand-
hara University, University Town, Peshawar, Pakistan
Email: tahiralikhan1972@yahoo.com
Received for Publication: July 31, 2015
Approved: August 25, 2015
able to survive on the surface of impression material
and are thus can contaminate the cast.5-7
Rinsing with water, disinfection and sterilization
are the various methods in use for cross infection control.
Rinsing dental impressions under water is not sufficient
for the removal of pathogens.8 Disinfection of the impres-
sion materials is strongly advised by American Dental
Association (ADA) and Centres for Disease Control
(CDC).9 Disinfection methods effects the dimensional
stability of the impressions, thus it remained a subject
of interest for many researchers, who used variety of
approaches.10 Inability of disinfection procedures to
destroy bacterial spores makes autoclaving the more
desirable method for sterilization.11
Amongst the variety of impression materials avail-
able, Addition silicone (Vinyl polysiloxane) is very well
known for their excellent dimensional stability and
precise detail reproduction.12 The storage temperature
recommended by manufacturers, for dental impres-
sions is 15-23°C Where as addition silicones remained
stable at 134°C without any significant change in its
dimensions.13-17 Where as their inherent hydrophobic
nature and low tear strength are the chief drawbacks
associated with addition silicones. On the other hand
Polyether impression materials are hydrophilic and

Pakistan Oral & Dental Journal Vol 35, No. 3 (September 2015) 535

stable materials but they are quite expensive, bitter in
taste and have high elastic modulus.18 A new elastomeric
impression material, Vinylsiloxanether was introduced
in early 2009 which combines the countenance of ad-
dition silicone and polyether impression material.19, 20
Autoclaving of elastomeric impression materials
is a new idea which will help in attaining complete
sterility, thus will lend a hand in eliminating one of the
causes of cross contamination among laboratory per-
sonnel and a standard protocol will be advised to break
the cycle of indirect transmission of infection through
dental impressions. This study will focus on the time
dependent changes in dimensions of Vinylsiloxanether
after being autoclaved. As there is lack of published
work on this material, it provides an extensive range
for further inquiry.
METHODOLOGY
A metallic test block was fabricated according to
ADA specification number19 and International Stan-
dards Organization (ISO) Standard 4823 designed for
the evaluation of Non-Aqueous, Elastomeric Dental
Impression materials.21 It consisted of three parts:
Ruled block, impression material mold and riser
(Fig 1).
Vinylsiloxanether (Identium® - Kettenbach, Ger-
many) elastomeric impression material having type 2
medium-bodied consistency and fast setting type was
used. Pre-packed Cartridge (1:1, 50ml, Identium® - Ket-
tenbach, Germany) along with the static mixing tip was
loaded into the auto mix cartridge dispenser (1:1 - 3M
ESPE). Mold was filled with mixed material extruding
from the mixing tip in a zigzag pattern, Where as the
tip remained buried in the material to avoid air entrap-
ment. It achieved in ≤ 45 seconds, i.e. the working time
recommended by manufacturer. After that mold was
covered immediately with polyethylene sheet followed
by a glass slab (weighing 75 ± 5 grams), plus a 500g
weight, was placed over it to standardize the pressure
on the impression material during setting. Assembly
was then transferred into a water bath (Zhengji HH-S4
Jiangsu, China) maintained at 32 ± 2°C (open mouth
temperature) and allowed to set. Riser was used to
remove the recorded impression from the mold. Total
40 impression specimens were prepared and divided
into two groups each containing twenty specimens
(n=20). Where α = 0.05 and power = 80. 22 Specimens
having all three lines recorded continuously for the full
length of 25 mm between cross lines were included in
the study. Where as those having air bubbles / voids
incorporated in 20µm wide line, were excluded.
Specimens of group A were washed under tap wa-
ter for 10 seconds and allowed to dry. They were then
packed in 57mm x 130mm self sealing sterilization
Pakistan Oral & Dental Journal Vol 35, No. 3 (September 2015)
Dimensional stability of vinylsiloxanether
pouches (A.R. Medicom Inc. Hong Kong) and were steam
sterilized in an autoclave (Glow Pak International,
S. No. 487, Italy) at 134ºC and 20psi for 5 minutes.23
Specimen of Group B (control group) were only washed
under tap water for 10 seconds and dried. All specimens
were stored for twenty-four hours in moisture free,
transparent polyethylene bags at room temperature
of 28 ± 2ºC.
Digital pictures of all the specimens were obtained
by using scanner (HP DeskJet 2050 J510),10 at three
time intervals i.e. soon after their making, after one
hour of intervention and after twenty-four hour storage
period. The resolution of 600dpi (dots per inch) was used.
Images were analyzed by Adobe reader XI (AcroRd 32)
software.24 Distance between the crosslines (cd and c'd')
was measured with accuracy of 0.01mm. Data obtained
were analyzed by SPSS version 16 software. A statisti-
cal tool was applied to evaluate data at 95% confidence
interval (P value ≤ 0.05). Paired student’s t-test was
applied to determine difference between mean initial
and final values of each group separately. Intergroup
comparison was done by using independent t-test.
RESULTS
Specimens of Group A showed mean dimensional
change of -0.04710% after one hour of autoclaving
and 0.08495% after twenty four hours. Group B mean
dimensional change of 0.04235% and -0.00320% was
observed for same time intervals respectively (Fig
2). Paired T test was applied to group A and B to
determine changes in linear dimensions before and
after autoclaving at one hour and twenty four hours
interval (Table 1). Percentage dimensional changes at
two different time intervals i.e. at first hour (-0.047%)
after autoclaving and at twenty fourth hour (0.084%)
showed a statistically significant difference (p =
Ruled block Impression Material Mold Riser
X Y Z
12.5
c d
A A B B C C
12.5
c' d' 38.0
2.5
5.0
30.00D
30.00D 29.97D
29.97D
3.0
0.5 CLA
31.0
3.0
6.0
Section A-A Section B-B Section C-C
Fig 1: Section A-A: Ruled block, section B-B: impres-
sion material mold, section C-C: Riser (*All measure-
ments are in milimeters)21
536
 Dimensional stability of vinylsiloxanether

0.10% between percentage dimensional changes at twenty-four

hours (p = 0.148).
0.08%

DISCUSSION
Percentage dimensional change

0.06%

0.04% Among presently available dental impression

one hour materials, the dimensional stability and accuracy of
addition silicone and polyether is widely accepted.25,26
0.02%
twenty-four hours
0.00% Vinylsiloxanether is the hybrid of addition silicone and
-0.02%
Group A Group B
polyether elastomeric impression materials; therefore
we discuss the parent components.27
-0.04%
Present study evaluated Vinylsiloxanether material
-0.06%
for time dependent linear dimensional change after
Fig 2: Percentage dimensional change in Group A & B autoclave sterilization. Dimensional change is discussed

TABLE 1: PAIRED T TEST FOR GROUP A AND B

Paired differences t df Sig. (2-

95% Confidence tailed)
Interval of the
Difference
Mean Std. devi- Std. error Lower Upper
ation mean
Group % dimensional -.132050 .196420 .043921 -.223978 -.040122 -3.007 19 .007
A change at 1hour &
24 hours
Group % dimensional .031250 .164792 .036849 -.045875 .108375 .848 19 .407
B change at 1 hour
& 24 hours
TABLE 2: INDEPENDENT T TEST FOR PERCENT DIMENSIONAL CHANGE BETWEEN GROUP A & B

Levene's Test t-test for Equality of Means

for Equality of
Variances
F Sig. t Df Sig. (2- Mean Std. 95% Confidence
tailed) differ- Error Interval of the
ence Differ- Difference
ence
Lower Upper
After Equal varianc- 1.511 .227 -1.425 38 .162 -.08945 .06278 -.21654 .03764
1 hour es assumed
After Equal varianc- 3.974 .053 1.476 38 .148 .08815 .05972 -.03274 .20904
24 es assumed
hours

0.007). Percentage dimensional changes at two dif-
ferent time intervals i.e. at first hour (0.042%) and at
twenty fourth hour (-0.003%) for control group showed
no statistically significant difference (p = 0.407).
Independent T test was applied for inter group
comparisons (Table 2). Percentage dimensional changes
at one hour were compared between group A and group
B, the difference was not statistically significant (p =
0.162). Similarly no significant difference was found
Pakistan Oral & Dental Journal Vol 35, No. 3 (September 2015)
in terms of expansion and shrinkage along with the
accuracy of samples. In this study Vinylsiloxanether
was found to be dimensionally stable after autoclaving.
Group A showed shrinkage of specimens, when
observed after one hour of autoclaving. Results were
consistent with the study of Ramakrishnaiah et al
in which the polyvinylsiloxane showed contraction
after autoclave sterilization. According to their study
shrinkage was attributed to the loss of chemical con-
537

stituents from the elastomers when subjected to high
temperature of autoclave.11 Generally polymerization
shrinkage, loss of volatile components, loss of water,
and lack of elastic recovery are considered the main
reasons for contraction in elastomeric materials.19
Specimens in Group A showed expansion after
24 hours. Nissan et al explained that this expansion
was due to the environmental factors as the polyether
material (Impregum) expanded during storage.28 Me-
gremis et al reported alteration in dimensions of an
impression material because of storage temperature
and humidity factor.29 During 24 hours storage period
average ambient humidity was 63.6%. Variations in
environmental humidity lead to loss or gain of water
by the material e.g. in polyethers due to their hydro-
philic nature, according to Mandikos et al.30 Endo and
Finger studied effect of humidity (0%, 33%, 50%, 75%,
and 100%) on the dimensional accuracy and found that
polyether materials were significantly affected by raise
in humidity level Where as addition silicones had no
adverse effects on their dimensions.31
Jacob et al noticed expansion of polyether impres-
sion material under dry condition.32 Where as Walker
et al found no expansion of polyether impressions under
moist condition.33 Therefore Jacob et al concluded that
expansion of polyether impression material appeared
to be material dependent, i.e. significant differences
in formulations were found in different polyether im-
pression materials being marketed even by the same
manufacturer.32
Following the ADA specification, the acceptable
dimensional change for non – aqueous elastomeric
impression materials is ≤0.5%.21 In our study results
of the autoclaved specimens (group A) showed shrink-
age of -0.047% after one hour of autoclaving. After
twenty-four hours of autoclaving same specimens
showed expansion of 0.085%. Ramakrishnaiah et al
noticed dimensional changes in ADA acceptable range
for polyvinylsiloxane after autoclaving at 134ºC for 5
minutes and 20 psi pressure.11 Similar results were
derived for poly vinylsiloxanether in this study.
The accuracy and dimensional stability of addition
silicones after 18 minutes autoclaving at 134ºC has been
proved by Reddy SM et al.17 Surendra et al found no
significant dimensional change after autoclaving of elas-
tomers but suggested to delay pouring for twenty-four
hours after autoclaving.34 In the light of results obtained
from experiment group A, autoclave sterilization of
vinylsiloxanether can be suggested without having any
adverse effects on dimensional stability and accuracy
of the impression recorded.
There was no statistical difference between Group
A and B at one hour and twenty-four hours. Non-sig-
Pakistan Oral & Dental Journal Vol 35, No. 3 (September 2015)
Dimensional stability of vinylsiloxanether
nificant changes in dimensions of addition silicones
were also observed after autoclaving by Xu et al17
and Surendra et al.34 The only significant difference
was found between one hour and twenty-four hours
dimensions (P=0.007) but this difference was within
the acceptable range of ADA specification as also been
previously concluded by Surendra et al.34
Purk et al found clinically significant change in
dimensions of addition silicones in comparison to poly-
ether when evaluated at different storage temperatures
e.g. -10, 24 and 66ºC.35 Corso et al studied effect of
temperature changes on the dimensional stability of
polyvinylsiloxane and polyether. Storage of both ma-
terials at 4ºC for 24 hours and then allowing them to
attain room temperature showed slight expansion which
was partly compensated by polymerization shrinkage.
Polyether impression material showed slight expansion
from 40ºC to room temperature.36
CONCLUSION
Within the limitations of this study it was concluded
that Vinylsiloxanether remained dimensionally stable
after autoclave sterilization. Though a significant
difference was found between dimensions at one
hour and twenty four-hours, but still they meet
the requirements for dimensional stability by ADA
specification number 19.
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CONTRIBUTION BY AUTHORS
1 Aiman Khan: Main author in writing.
2 Mumtaz-Ul-Islam: Data collection/discussion.
3 Tahir Ali Khan: Supervised the project.
Pakistan Oral & Dental Journal Vol 35, No. 3 (September 2015)
View publication stats
Dimensional stability of vinylsiloxanether
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