Zinc Oxide Eugenol Impression Paste Classification

Type I Type II

• hard paste • soft paste

• final set: within • final set: 15 min
10 min

Setting Reaction
• It is a rigid, non-elastic material used in taking
impression of the mouth. chemical reaction (irreversible)
• irreversible, inelastic impression material 1. ZnO + H2O ---> Zn (OH)2
• ideal for making impressions of edentulous jaw
structures or soft tissue 2. Zn(OH)2 + 2HE --- > ZnE + 2H2O
• KINDS: (base) (acid) (salt) (water)
1. ZOE IMPRESSION MATERIAL
2. ZOE CEMENT (Eugenol) (Zinc Eugenolate)
3. ZOE FILLING MATERIAL PERIODONTAL PACK Factors Affecting the Setting Time
COMPOSITION shorten (decrease) setting time
➢ Eugenol (12-15%) • humidity and temperature
➢ Rosin (50%) • adding a small amount of zinc acetate or
additional accelerator or a drop of water in the
➢ Zinc Acetate/MgCl (accelerator) 5% paste before mixing
➢ Fillers (Kaolin) 20% • extending the mixing time

➢ Resinous Balsam (10%) prolong (increase) setting time

➢ Other substitutes for eugenol likecarboxylic • use of a cool spatula and mixing slab
acid, chlorothymol
CHARACTERISTICS/PROPERTIES:
➢ Zinc Oxide (87%)
❖ quite satisfactory dimensional stability
➢ Inert Oils(plasticizers) (13%) ❖ no significant dimensional change subsequent to
hardening
➢ Gum Rosin (Inc. ST and Cohesion) ❖ shrinkage less than 0.1%
❖ good reproduction of oral structure details
Dispensed in 2 tubes: ❖ chief disadvantage - possible stinging or burning
sensation
Tube no. 1 - base
Tube no.2 – accelerator
/ catalyst ❖ Hard setting

• Zinc oxide • Oil of cloves or ❖ Free flowing impression paste

• Vegetable or eugenol
❖ Used when the oral tissues are very yielding,
mineral oil • Gum or flabby and are not firmly attached to the
polymerized underlying bone.
rosin
• Filler ❖ Short mixing and setting time
• Lanolin
❖ Bacteriostatic and antiseptic property
• Resinous balsam
• Accelerator ❖ Good insulators
solution (CaCl2)
and color ❖ Very Low viscosity
❖ Irreversible chemical change
 ❖ Well tolerated by patients
❖ Soluble in water
❖ Low dimensional change
OTHER USES of ZOE:
❖ Cementing and insulating medium
Upper and Lower Impression using ZOE
❖ Temporary filling material
❖ Root canal filling material
ELASTOMERIC RUBBER IMPRESSION MATERIAL
❖ Surgical dressing
• Elastomers are a group of synthetic polymer-
❖ Temporary relining material for dentures based impression materials that have the elastic
properties of natural rubber.
❖ Bite Registration
• Chemically, there are three types of elastomers:
MANIPULATION polysulfide, polyether and silicone
(condensation and addition). The composition
and characteristics of each elastomeric
impression material will be discussed in this
lesson.
• A non-aqueous synthetic rubber-based material
AKA Rubber impression material
o Mixed with a stainlesssteel spatula on a glass • a group of flexible chemical polymers that are
slab or mixing pad provided by the either chemically or physically cross-linked;
manufacturer. generally, they can be easily stretched and
o Mixing time: 45-60 seconds rapidly recover their original dimensions when
o Working time: 3-5 minutes applied stresses are released
o Maybe increased or decreased by temperature
Characteristics:
and humidity
• Biocompatible
• Viscous enough to be contained on the tray
• Fluid enough to adapt to oral tissues
• Tear Strength: Resistant to distortion or tearing
when removed From the mouth
• Dimensionally stable
• Cost effective
• Shelf life 1-2 yrs.
TYPES:

• POLYSULPHIDE (1950)
The Final Impression
• Condensation SILICONE (1950)
• The final impression records the exact contours
of the denture-bearing area and delineates the • POLYETHER (1960)
extent and shape of the denture borders
• Addition SILICONE (1970)
POLYSULFIDE
• 1ST Elastomeric impression material
• Aka Mercaptan
 • Supplied in tubes: Base/Accelerator pastes
• Consistencies: Light Body (syringe/wash)
Medium Body (regular)
Heavy Body
Composition:
COMPOSITION:
• Base paste:
• Base Paste:
1. Poysulphide 80-85% (undergo cross linking to
1. Polydimethyl siloxane
form rubber) 2. Inert filler (cristobalite, talc, starch, silica)
2. Plasticizer (di n butyl phthalate)
– gives body/controls viscosity
3. Inert fillers 16-18% (chalk/titanium dioxide)
• Catalyst Paste/Liquid:
• Catalyst paste:
1. Alkyl silica – Tetra ethyl silicate
1. 60-68% PbO2.other alternative oxidizing agents
2. Tin cpd – Dibutyl tin dilaurate/tin octoate –
2. 0.5% Sulphur
catalyst.
3. Inert oils – paraffin type/d-n-butyl phthalate
SETTING REACTION

• Lead dioxide + Polysulfide polymer

• Polysulfide + Water
• Reaction yields water as a by-product

CHARACTERISTICS

advantages disadvantages
• Long working • Requires custom PROPERTIES:
time tray
• High tear • Stretching leads • Working time: 2.5-4.0 mins.
resistance to distortion • Setting time: 6-8 mins.
• Margins easily • Compatible with • Tear Strength: 2300-2600 N/m
seen stone
• Contraction: 0.38-0.60% in 24 hrs.
• Moderate cost • Stains clothing
• Stiffer and harder than polysuphide
• Obnoxious odor
• Clean and pleasant
• Pour within 1
hour • Good working time
• Good for margins
PROPERTIES: • Hydrophobic.

• Working time: 4-7 mins. Disadvantages:

• Setting time: 7-10 mins. • High polymerization shrinkage
• Tear strength: 2500-7000 N/m • Volatile alcohol product
• Dimensional stability: 0.40-0.45% contraction at • Low tear strength
24 hrs. due to loss of polymerization by product
• Has to be poured immediately
like water.
CONDENSATION SILICONE
ADDITION SILICONE
• First type of silicone impression material Aka
Conventional silicone • Aka Polyvinyl siloxane or vinyl siloxane
• Supplied in Tubes:
• Supplied in Tubes: Base paste/Accelerator paste
1. Base and Accelerator pastes
or liquid Putty is supplied in jars.
2. Jars: Putty
Consistencies: • COMPLICATIONS WITH LATEX GLOVES
• Sulphur contamination inhibits setting
• Light (Syringe/wash)
• Failure of the material to polymerize
• Medium Body (regular)
• Separation of tray from the impression material
• Heavy Body
• OTHERS: May cause retardation
• Putty
• AlSO4 and Ferric sulfate (gingival retraction
COMPOSITION cord)
• Residues from acrylics, methacrylates and
Base Paste:
petroleum jelly
❖ Poly (methyl hydrogen siloxane)
POLYETHER
❖ Other siloxane prepolymers
❖ Fillers - 35-75% Colloidal silica – controls • First elastomer developed primarily to function
viscosity as an impression material
• Supplied in Tubes: Base/Accelerator Pastes
Third tube containing thinner may be supplied
• an elastomeric impression material of ethylene
oxide and tetra-hydrofluro copolymers that
polymerizes under the influence of an aromatic
ester.

Accelerator Paste:
❖ Di vinyl polysiloxane prepolymers
❖ Platinum salt (chloroplatinic acid) - catalyst
❖ Palladium – hydrogen absorber
❖ Retarders PROPERTIES:
❖ Fillers
• Working time: 3 mins.
PROPERTIES: • Setting time: 6 mins. (Short setting time)
• Working time: 2-4 mins. • Tear strength: 1800-4800 N/m
• Setting time: 4-6.5 mins. • Contraction: 0.19-0.24% least amount of
distortion
• Contraction: 0.14-0.17%
• Pseudo plastic
• Tear strength: 1500-4300 N/m
• Biocompatibility – may cause allergy: Contact
• Exhibits lowest permanent distortion
dermatitis
• Pseudo plastic
• Automix available
• Highly accurate
• Dimensional stability is high COMPOSITION:
• Auto mix available
Base Paste:
Disadvantages:
❖ Imine terminated prepolymer
• Hydrophobic ❖ Inert filler (silica)
• Expensive ❖ Plasticizer – phthalate - aids mixing
• Hydrogen gas evaluation in some materials Catalyst Paste:
• Hydrophilic formulations imbibe moisture
• Sulfur contamination by latex gloves ❖ Ester derivative of aromatic sulphonic acid
❖ Inert filler (silica)
PRECAUTIONS:
 ❖ Plasticizer – phthalate Pameijer CH. A one-step putty-wash impression
technique utilizing vinyl polysiloxanes. Quintessence Int
Setting Reaction Dent Dig. 1983 Aug; 14 (8): 861-3.
• Polyether + Sulfonate ester --> Cross linked
rubber
• Working time: 3 mins
• Setting time: 6 mins
Characteristics

• advantages • disadvantages
• Fast-setting • Stiff, high
• Automix modulus
dispense • Bitter taste
• Least • Need to block
hydrophobic undercuts
• Margins easily • Absorbs water
seen • Leaches
• Good stability components
• High cost

DISADVANTAGES:

• Very stiff set material

• Short working time
• Imbibition
• Allergic hypersensitivity in some cases
Ways of Mixing:

• Manual / Hand mixing

• Static – use of cartridge
• Dynamic Mechanical mixing – use of machine

Techniques in the Manipulation

• One Step Technique

• Two Step Technique
With the 1-step procedure, Low viscosity impression
material is injected around the prepared tooth or teeth
Then the putty impression material is immediately
placed intra orally and the materials polymerize
simultaneously.
➢ Simultaneous / Squash Technique
IMPRESSION COMPOUND
Introduction:
• A successful dental restoration is mainly
dependent on the accuracy of the dental
impressions.
• An impression is an imprint or negative replica.
There are several impression techniques
developed to produce duplications as accurate as
possible.
• The accuracy of an impression depends on the
materials used for impression making as well as
the techniques.
• Impression compound is one of the oldest dental
impression materials. It can be described as
rigid, reversible impression material which sets
by physical change.
• Impression compound is usually used for taking
primary impressions of the edentulous ridge
prior to the construction of a custom-made
impression tray for complete dentures.
• Impression compound is also available in sticks
of various colors indicating different softening
temperature ranges.
• Impression compound is used to take a negative
replica or an Impression of the Edentulous Oral
Cavity in a process called primary impression.
• Impression Compound is a material composed of
fatty acids, shellac, glycerine, and filler used as a
primary impression material. When heated in a
water bath at about 65°C (149°F) it becomes
plastic and can be moulded in an impression tray
and inserted in the mouth.
• The material becomes fairly rigid on cooling to
mouth temperature and has low material flow at
room temperature. It has a low thermal
expansion coefficient so that there is minimal
dimensional change as the impression is cooled
from mouth temperature and it does not adhere
to moist oral tissue.
COMPOSITION
• Waxes are straight - chain hydrocarbons of the
general formula CH3 (CH2) n CH3, where n is
between 15 and 42. They are characteristically
tasteless, odourless, colourless and greasy to the
touch. Waxes used in impression compound
include beeswax and colophony.
• Plasticizers - the waxes and resin, if used on
their own, would tend to produce a brittle
material with a tendency towards tackiness.
• The brittleness is overcome by the addition of
plasticizers, such as gutta percha and now, more
commonly, stearic acid.
• Fillers - to overcome the tackiness, control the
degree of flow and minimize shrinkage due to
thermal contraction, a filler is added. Commonly
used fillers are calcium carbonate and limestone.
The fillers also improve the rigidity of this
impression material.
TYPES
Type I
• ◦ For making primary impressions
• ◦ For individual tooth impression
• ◦ For peripheral tracing or border moulding
• ◦ To check undercuts in inlay preparation
• ◦ Has high flow property
Type II
1. To make a special tray
2. More rigid
3. Cake – for full arch impression (preliminary)
4. Sticks
• Green - material with lowest fusing of the
modeling compound.
• Red and Gray - sticks have higher and broader
working range than do the cakes of like color so
they may be flamed without harming the
material.
• Gray - material in stick form is preferred by
some dentist for border molding because of its
contrasting lighter color.
CHARACTERISTICS
1. When heated in a water bath at about 65ºC
(149ºF) it becomes plastic and can be moulded
in an impression tray and inserted in the mouth.
2. Material becomes fairly rigid on cooling to
mouth temperature and has low material flow at
room temperature.
3. It has a low-thermal expansion coefficient so
that there is minimal dimensional change as the
impression is cooled from mouth temperature
and it does not adhere to moist oral tissue.
4. The material is are reversible type material
which means, it can be reused or softened using
heat for a limited period of time to capture the
perfect impression.
5. It’s is a rigid, reversible impression material
which sets by physical change.
MANIPULATION zinc oxide– eugenol to provide the surface
detail.
• Sticks: Small amount softened over flame ✓ The coefficient of thermal expansion of resins
• Cakes: Sofetened in a thermostatically and waxes is very high, as indicated in, and are
controlled waterbath highly non-linear within the temperature range
• Moist heat method of dental interest Shrinkage is in the order of
✓ Water bath 50-70% 1.5%, and is due to the thermal contraction from
✓ Because of poor thermal conductivity/ poor heat mouth to room temperature
transfer, the outer surface softens while the inner ✓ Impression compound is muco-compressive, as
surface remains hard it is the most viscous of the impression materials
✓ Homogenously soft in and out used. This can present particular problems in
those patients who have a flabby mandibular
• Dry Heat method ridge.
✓ Open flame ✓ Compo is rigid once cooled and therefore cannot
✓ Important ingredients are lost during melting be used to record undercuts. It has a high
✓ Overheating –sparks indicate that some viscosity, so reproduction of surface detail is not
components (plasticizers) are leached out very good. However, the reproduction can be
✓ If during heating, the modelling compound isn’t improved by reheating the surface of the
shiny, plasticizers are lost already impression material after taking the first
✓ It should never be softened at temperatures impression and then reseating it in the patient’s
much above 132ºF. mouth.
✓ Neither it nor any other modeling plastic should
be immersed in the water bath for an indefinite
period.
✓ It should be dipped and kneaded until soft and
subjected to no more heat than necessary before
the tray is loaded and it is placed in the mouth.
✓ Then it may be flamed with an alcohol torch for
the purpose of border molding, but it should
always be tempered by being dipped back into
the water bath before its return to avoid burning
the patient.
✓ The modeling plastic then may be chilled using
water spray before removal from the mouth,
although this is not necessary if care is used in
removing the impression.
✓ During sectional flaming and border molding,
the modeling plastic should be chilled in iced
water after each removal from the mouth; then it
may be trimmed with a sharp knife without
danger of fracture or distortion.
PROPERTIES
✓ Poor thermal conductivity ◦ Dimensional
change; shrinks at 0.3-0.4%
✓ Detailed and accurate impression
✓ Good flow property
✓ Even then, the surface detail is not as good as
can be achieved with virtually all of the other
impression materials. It is therefore better to use
compo as a simple and quick means of
producing a special tray, and then use a wash of
HYDROCOLLOIDS
Introduction:
• Hydrocolloids are elastic materials composed of
colloidal gels. They are high molecular weight
hydrophilic polymers which contain polar or
charged functional groups, rendering them
soluble in water. It has several uses.
• In Dentistry, we use hydrocolloid as an
impression material. They were the first flexible
materials available to dentists. They are elastic
enough drawn to undercuts without significant
deformation, easy to use and inexpensive.
Definition of Terms:
1. Colloids - Any solution in which the unit of
the solute are sufficiently large so that it will not
dialyze through a suitable membrane.
2. Dispersed Phase / Dispersed
Discussion:
Particles - Particles in a solution.
3. Dispersion Phase / Dispersed
Medium - solution containing a suspension of
particles.
4. Suspension - The dispersed phase and the
dispersion medium are not of like phase.
5. Emulsion - The dispersed phase is of the same
phase as of the dispersion medium.
6. Hydrophilic – Tendency to demonstrate a
strong affinity for water.
7. Hydrophobic – Tendency to demonstrate a
strong aversion to water.
8. Hydrocolloid – (agar) a colloid that contains
water as the dispersion phase.
9. Reversible Hydrocolloid – Agar impression
material.
10. Irreversible Hydrocolloid – Alginate
impression material.
11. Gelation - The transformation from a
hydrocolloid sol to gel.
12. Gelation time – The time needed to transform
sol to gel.
13. Gelation Temperature - the temperature in
which the sol is transformed into gel.
14. Liquefaction - The transformation from gel to
sol.
15. Liquefaction Time- time needed to transform
gel to sol
16. Liquefaction Temperature - the temperature at
which the gel is transformed to sol at a higher
temperature. (60-70C)
17. Hysteresis - the difference between gelation
and liquefaction temperature.
18. Imbibition – Process of water sorption.
19. Syneresis – expression of fluid onto the surface
of gel structures.
20. Setting time – The elapsed time from the start
of mixing until the impression material becomes
firm enough to resist permanent deformation.
21. Working time - The total time from the start of
mixing to the final time at which an impression
tray can be fully seated without distortion.
• Hydrocolloid impression materials in dentistry
are based on colloidal suspensions of
polysaccharides in water. A colloidal suspension
that behaves neither as a solution nor as a true
suspension. The colloidal suspension lies
somewhere between these two extremes, no
solid particles can be detected and yet the
mixture does not behave as a simple solution.
The molecules of the colloid remain dispersed
by nature of the fact that they carry small
electrical charges and repel one another within
the dispersing medium. When the fluid medium
of the colloid is water it is normally referred to
as a hydrocolloid.
• Dental hydrocolloid impression materials exist
in two forms: sol or gel form. In the sol form,
they are fluid with low viscosity and there is a
random arrangement of the polysaccharide
chains. In the gel form, the materials are more
viscous and may develop elastic properties if the
long polysaccharide chains become aligned.
Alignment of the polysaccharide chains
as fibrils which enclose the fluid phase normally
causes the gel to develop a consistency similar to
that of jelly. The greater the concentration of
fibrils within the gel the stronger the jelly
structure will be. This point is best illustrated by
consideration of the properties of commercial,
flavoured gelatin (jelly). The material which is
initially purchased is a fairly strong gel but after
dilution with water the resulting gel is much
weaker. This is relevant to dental hydrocolloids
since the strength of the gel is important and
 depends on the concentration of polysaccharide
material dispersed in the aqueous phase.
• The conversion from sol to gel forms the basis
of the setting of the hydrocolloid impression
materials. The products are introduced into the
patient’s mouth while in the fluid, sol form.
When conversion to gel is complete, and elastic
properties have been developed, the impression
is removed.
Factors which affect Gel Strength
1. Brush heap density or concentration
2. Temperature of reversible gel
3. Addition of certain modifiers
Two Dimensional Changes
• Imbibition– The absorption of water into
the surface of the gel causing swelling.
• Syneresis – The evaporation of water from
the surface of the gel causing shrinkage.
TWO TYPES OF HYDROCOLLOIDS
✓ The formation of gel and development of elastic
properties through alignment of polysaccharide
chains may take place by one of two
mechanisms. For some materials, gel formation
is induced by cooling the sol. Chains become
aligned and are mutually attracted by Van der
Waals forces. Intermolecular hydrogen bonds
may be formed between adjacent chains,
enhancing the elasticity of the gel. On reheating
the gel, these bonds are readily destroyed and
the material reverts to the sol form. These
materials are the reversible hydrocolloids (agar).
✓ For other materials, gel formation involves the
production of strong intermolecular cross-links
between polysaccharide chains. These materials
do not require cooling in order to encourage gel
formation and once formed the gel does not
readily revert to the sol form. These materials
are the irreversible hydrocolloids (alginates).
REVERSIBLE IRREVERSIBLE
✓ Hardens by ✓ Hardens by
physical change chemical reaction
✓ Subjected to heat ✓ Not subjected to
✓ Need special heat
equipment ✓ Does not need
special
equipment
REVERSIBLE HYDROCOLLOID
• AGAR - AGAR - A polysaccharide extracted
from red seaweeds is the main active ingredient
wile water is the main constituent. (Annusavice)
• Chemical composition:
➢ is a linear complex sugar made from beta-
galactopyranose linked to 3,6-anhydro-L-
galactopyranose. Basically, it's just a
polysaccharide/carbohydrate, or complex sugar
• extracted from several types and species of
red seaweeds belonging to the
Rhodophyceae class
• These agar-containing seaweeds are called
agarophytes and the major commercial
species are Gracilaria, Gelidium, and
Pterocladia.
Raw Material:
- seaweeds are usually harvested manually by fishermen
in low depths at low tides or by diving using appropriate
equipment.
- seaweeds are placed under the sun to dry until they
reach a humidity level that is ideal for processing.
Agar:
• Has a high gel strength at low
concentrations
• low viscosity in solution
• high transparency in solution
• sharp melting/setting temperatures
• A higher temperature is needed to convert
the gel into a sol.
• The first material to set is that which is in
contact with the tray since it is cooler than
the tissues.
* Thus it is the material in contact with the tissue which
stays in the sol state for the longest time.
Exact Gelation of Agar depends on:
1. Molecular weight of agar
2. Purity of agar
3. Ratio of agar to other constituents
Composition of Reversible Hydrocolloid Impression
Material
Supplied as a gel with the following Ingredients
 PROPERTIES: DISADVANTAGES
Composition AMOUNT ACTION
• Need special equipment (water bath) and
Agar special technique
12- Gelling agent
• Thermal Discomfort
15%
Borax • Poor tear resistance
Improves • Pour immediately: Imbibition and syneresis
0.2% strength • Difficult to see margins and details
K2SO4 • Dimensional instability

1-2% IRREVERSIBLE HYDROCOLLOID (ALGINATE)

Alkyl Provides
benzoates good
surfaces on ➢ A casting material made from kelp used for
0.1% making the negative impression of the teeth.
gypsum
Water This is the same material used by dentists.
models/dies
85%
• A material from a natural substance
Preservative extracted from certain brown seaweed.
• The substance is called anhydro-B-d-
mannuronic acid or alginic acid.
Dispersion
Medium PROPERTIES: ADVANTAGES:

• Easy to manipulate
Trace amount of coloring and flavoring agents • Comfortable for the patient
• Clean and pleasant
• Does not need special equipment
*Other fillers: Diatomaceous earth, clay, silica, wax,
rubber and similar inert powders are used to control • Inexpensive
• Long shelf life
strength, viscosity and rigidity.
*Thymol and glycerin may be added that acts as PROPERTIES: DISADVANTAGES:
bactericidal agent and plasticizer.
• Not Accurate/Rough
• Tears easily
• Pour immediately: Undergo imbibition and
syneresis
• Can retard setting of gypsum

COMPOSITION WEIGHT FUNCTION

%

PROPERTIES: ADVANTAGES 15
Potassium Soluble
• Inexpensive Alginate 16 alginate
• Odorless
• Nontoxic; Non-irritant, Non-staining CaSO4 4 Reactor
• Slow setting time
• Adequate shelf life 3
• Easy to pour into stone Zinc Oxide
Filler
• Good surface detail 60
particles
• Accurate and pleasant
• Reusable and easily sterilized by an aqueous Potassium 2
solution of hypochlorite Titanium
Fluoride Gypsum
Hardener
 ROUGH / CHALKY Inadequate cleaning of
Diatomaceous Filler Particles STONE MODEL the impression
Earth Improper manipulation of
Retarder stone
Premature removal of the
Sodium
impression
Phosphate
Model left in the
impression too long
DISTORTION Impression not poured
immediately
• Soluble Alginates (Potassium, Sodium or
Movement of tray during
Triethanolamine alginate)
gelation
• Polyethylene glycol or propylene glycol to
Premature removal from
become “dustless” alginate
the mouth
Improper removal from
TYPES according to Setting the mouth
• Type 1 – Fast Setting – sets in 1-2 minutes
• Type 2 – Normal Setting – sets in 2-4.5
minutes Manipulation:

Methods of controlling Gelation ➢ First, prepare a proper mixture of powder and

water. Using a clean rubber bowl and spatula,
1. By altering the W/P put the water in the bowl and gradually sift the
2. By altering the mixing time powder into the water. Let it settle and then mix
3. Addition of retarders using the figure of eight motion. Mixing time of
4. By altering temperature 45 seconds to 1 minute is generally sufficient.
The result should be a smooth, creamy mixture
CAUSES OF FAILURE IN THE MANIPULATION that does not readily drip off the spatula when it
OF ALGINATE is raised from the bowl.
CAUSES CAUSE/S
GRAINY MATERIAL
Improper mixing
Prolonged mixing
Undue gelation
W/P too low
TEARING
Inadequate bulk
Moisture contamination
Premature removal from
the mouth
Prolonged mixing
EXTERNAL BUBBLES
Undue gelation
Air incorporated during
mixing

IRREGULARLY
SHAPED VOIDS Presence of moisture or
debris on tissue