IMPRESSION TECHNIQUES AND MATERIALS USED FOR FIXED PARTIAL

DENTURE FABRICATION: A SURVEY AMONG GENERAL DENTAL PRACTIONER

AND SPECIALIST IN SINDH.

1
IMRAN SAMEJO, BDS, FCPS

2
IRFAN AHMED SHAIKH, BDS, FCPS

3
ERUM BEHROZ, BDS, FCPS

ABSTRACT:
The purpose of this study is to evaluate that which impression materials and techniques
are used for fixed partial denture fabrication among general dental practioner and specialist in
Sindh.
In this cross sectional study, 06 structured questionnaires regarding fixed partial denture
impression materials and techniques was prepared. Questionnaires were distributed randomly
among 150 specialist and general dental practitioner in Sindh, Pakistan.
In this study the response rate was (84%). The material of choice for diagnostic
impression was irreversible hydrocollide by specialists (91%) and general dental practitioner
(25%). Complete arch tray was most commonly used by specialist (78%) and general dental
practitioner (88%). To expose the finish line (91%) of the specialists used gingival retraction
cord with chemical and most of the general dental practitioners were not using gingival cord
(84%). The most common material of the choice for impression after tooth preparation was
additional silicon and alginate used by specialist (52%) and general dental practitioner (76%)
respectively. Type III dental stone was used by specialist (83%) and type II by general dental
practitioners (88%). Articulation of cast prior to sending laboratory by specialists and general
dental practitioners were (74%) and (18%) respectively.
Long term success of fixed partial denture is based on materials and techniques. Most of
the prosthodontist used recommended impression materials and techniques. Ideal materials and

1
Assistant Professor, Department of Prosthodontics, Sindh Institute of Oral Health Sciences,
Jinnah Sindh Medical University, Karachi, Sindh, Pakistan.
2
Assistant Professor, Department of Prosthodontics, Institute of Dentistry, Liaquat University of
Health Sciences, Jamshoro, Sindh, Pakistan.
3
Assistant Professor, Department of Orthodontics, Sindh Institute of Oral Health Sciences,
Jinnah Sindh Medical University, Karachi, Sindh, Pakistan.
techniques are not followed by general dental practitioners which may lead to compromised and
failure of final prosthesis.

Key words: Survey, fixed partial denture, impression materials, impression technique, specialist,
general dental practitioner.

INTRODUCTION:
The missing teeth can be replaced by removable partial denture, dental implant, ceramic or
metal-ceramic or ceramic fixed partial dentures and resin-bonded fixed partial dentures. 1 Dental
implants and resin bonded fixed partial denture are the most suggested treatment options, when
the nearby teeth are available in impeccable condition, ideal position with proper occlusion. 2
Nevertheless, fixed partial dentures are usually used due to their economical, substantial
durability, aesthetics, satisfactory retention and no desire for surgery. 3 Successful fixed partial
dentures in oral rehabilitation is depends on impression making and pouring. 4 Impression
materials should have proficiency to imitate soft and hard tissues around prepared and adjacent
teeth in order to gain mechanically, biologically, functionally and aesthetically satisfactory
restorations.5 There are few elements such as tooth preparation design, soft tissue management,
tray selection, impression material and techniques that influence the final impression quality. 6-8
A range of impression trays including prefabricated metal or plastic stock trays are used to
record a full or partial arch for fabrication of fixed partial dentures. 7 Conventionally, custom
trays are encouraged for fixed partial dentures. Accurate casts have been produced by custom
trays rather than stock trays as reported by most investigators. 9 Prefabricate dual arch tray is
most commonly used now a days in order to record the abutments, opposing teeth, adjacent teeth
and the maximal intercuspation for fixed partial denture. Other benefits of dual arch impression
are accurate record, patients are comfortable, less time and material is required. 10 Several elastic
impression materials have been used for fixed partial denture such as hydrocolloid, polysuphide,
condensation silicone, polyvinysiloxane and polyether.4,8,11 Alginate hydrocolloid a popular
impression material in the last years due to its low cost and easy mixing as compared to other
elastomers. Majority of professionals have not been using alginate for fixed partial denture
because of its poor dimensional stability and unsatisfactory details. 8
During impression making, one of the most challenging feature of fixed partial denture is

2
management of gingival tissues.12 Accurate record of finish line can be achieved when gingival
sulcus is widened enough in order to provide access for impression material to reach the
subgingival margins.13,14 Three principle methods are existing for soft tissue retraction including
mechanical, chemo-mechanical and electrosurgical.15-18 The chemo-mechanical technique is
doubtless the most extensively used but it is time consuming and can lead to postoperative
discomfort, inflammation and marginal recession.17

Different techniques such as single copper band system, monophase, single-step and double-step
have been accounted for making of impression for fixed partial denture. 19 Every material has its
remunerations and drawbacks Impression material is chosen by particular intraoral conditions
Though, none of these alone will guarantee an accurate impression.20

METHODOLOGY:

A cross sectional study conducted among general dental practioner( GDP) and specialist

(SP) in Sindh, Pakistan. A questionnaire was prepared and randomly distributed among 150

General dental practioner and specialist by hand, email and through post practicing in main cities

of Sindh, Pakistan. The questionnaire was comprised of six multiple choice questions pertaining

to techniques and materials used in the fabrication of fixed partial denture.

DISCUSSION:
Many surveys regarding complete denture and removable partial denture have been conducted in
Pakistan. Regarding fixed partial denture no one survey has been conducted in Pakistan.
Therefore this survey was conducted to know which materials and techniques are used by
general dental practioner and specialist regarding fixed partial denture fabrication.
In present study 91% (21) of specialists and 25% (26) of general dental practitioner are using
irreversible hydrocolloide impression material for making diagnostic impression. Most of the
general dental practitioners (75%) are not making diagnostic impression.
The most commonly used impression tray were complete arch tray which are used by specialists
(78%) and general dental practitioners (88%).
Gingival retraction cord with chemical was the choice for (91%) specialists and (16%) general
dental practitioners. This is in agreement with previous surveys conducted in india.3

3
It was found in current survey (52%) of specialists and (76%) of general dental practitioners
were used addition silicon and alginate for impression after tooth preparation respectively. These
findings are in agreement with other surveys.3,8
Amongst the specialist and general dental practitioners (83%) used type III dental stone and
(88%) type II stone for pouring impression respectively. This is in contrast with previous surveys
where (60%) prosthodontist and (53%) other practitioners used type IV and type III dental stone
respectively. This might be due to cost effectiveness or the deficient in knowledge of
practitioners.3,8
Articulation of cast is not common in general dental practitioners (18%), but most of the
specialists (74%) articulated the cast prior sending to laboratory.

CONCLUSION:
Long term success of fixed partial denture is based on materials and techniques. Most of the
prosthodontist used recommended impression materials and techniques. Ideal materials and
techniques are not followed by general dental practitioners which lead to compromised and
failure of final prosthesis.

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5.

Author’s contribution:
1. Dr. Imran Samejo: Principal Investigator, Concept of paper, data collection and
write.
2. Dr. Irfan Ahmed Shaikh: Data collection and Critical Review of manuscript, analysis &
discussion.
3. Dr. Erum Behroz: Data collection, result compilation, analysis & discussion.