Dimensional stability of a polyvinylsiloxane impression material following ethylene oxide and steam autoclave sterilization

Evaluation of efficacy of Aloe Vera as a Disinfectant by Immersion and Spray methods on Irreversible Hydrocolloid Impression Material and its Effect on the Dimensional Stability of Resultant Gypsum Cast - An in Vitro Study

The need to use a natural alternative for disinfecting dental impression materials, which should be biocompatible and effective, led us to evaluate the efficacy of Aloe vera as a disinfectant by immersion and spray method on alginate impression material and its effect on the dimensional stability of the resultant gypsum cast.

The efficacy of the disinfection procedures against Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans was evaluated by determining the number of colony-forming units (CFU) recovered after disinfection of alginate discs inoculated with 1x106 CFU for defined intervals with aloe vera solution (99.96%). Dimensional stability was determined from the mean percentage deviation of three measurements that were taken between the fixed points on the casts using a traveling microscope and compared with corresponding measurements from the master model and controls. Statistical analysis of data was determined by analysis of variance.

We found out that there is a mean percentage reduction in colony count of S. aureus, P. aeruginosa, and C. albicans after 3 minutes of immersion in aloe vera and after 3 minutes spray disinfection. Complete elimination of all the microorganism cells after 7 min immersion and spray disinfection. There was a statistically significant difference in the increase of the mean anteroposterior (AP) and cross arch (CA) dimension after 3 and 7 minutes immersion in aloe vera.

Spraying with aloe vera for 7 minutes was proved to be the most effective disinfection procedure without altering dimensional stability.

Comparative evaluation of elastic recovery of three different elastomeric impression materials on chemical disinfection and autoclaving: An in vitro study

Aim:

The aim of the study was to investigate the effect of disinfection and steam autoclaving on the elastic recovery of three different elastomeric impression materials.

Settings and Design:

In vivo - comparative study.

Materials and Methods:

Ninety dumbbell-shaped specimens of commercially available two addition-cured silicones (AFFINIS and AQUASIL) and one condensation-cured silicone (SPEEDEX) impression materials were prepared and treated with chemical disinfectant and steam autoclaving. Specimens were seal packed and sent to laboratory for testing elastic recovery. After the specimen had been pulled to failure, the broken parts were fitted back together, and the distance between the marks was measured using an electronic Vernier caliper.

Statistical Analysis Used:

one-way analysis of variance test and Tukey post hoc test for multiple comparisons.

Results:

The result showed significant difference in elastic recovery of AFFINIS when it was disinfected and steam autoclaved whereas elastic recovery showed no significant difference when SPEEDEX and AQUASIL were disinfected and steam autoclaved. Similarly, results were alike when AFFINIS, SPEEDEX, and AQUASIL were compared on disinfection. However, significant difference was noted on steam autoclaving, highest being the mean value of AFFINIS.

Conclusion:

Within the limitations of this in vitro study, conclusion was made that the elastic recovery of AFFINIS was the least which improved with disinfection and autoclaving. Elastic recovery of SPEEDEX and AQUASIL was similar. However, all the three materials used in the study can be safely sterilized after clinical use and before being sent to the laboratory without significantly affecting their elastic recovery.

Comparative evaluation of dimensional stability of impression materials from developing countries and developed countries after disinfection with different immersion disinfectant systems and ultraviolet chamber

Objectives

It was to analyse and compare the effect of different disinfectant systems on the dimensional stability of commonly used irreversible hydrocolloid and addition silicone impression materials from developing countries as compared to materials from developed countries.

Material and methods

Disinfectant systems used were glutaraldehyde, sodium hypochlorite and ultraviolet chamber. The stability after disinfection of commonly used alginate and addition silicone of native origin (Algin-Gum & Ad-Sil) was compared with similar impression materials from developed countries (Vignette and Aquasil) and results compared. A CAD/CAM manufactured stainless steel die simulating maxilla with four metal studs at canine and molar region was used. Impressions were made and disinfected after rinsing and drying and casts poured. The cross arch distance, interabutment distance and the occluso-gingival length of the studs was measured under traveling microscope and observations were recorded and compared. ANOVA test and Bonferroni test was applied.

Results

An increase in the interabutment and cross arch distance and decrease in occluso-gingival height was seen in the casts obtained. Glutaraldehyde immersion showed variation in the interabutment and cross arch distance for all materials studied. Ultraviolet chamber and sodium hypochlorite produced best results. Dimensional stability of impression materials like Vignette, Algin-Gum & Aquasil was found to within clinically acceptable limits after disinfection while maximum deviation was seen with Algin-Gum.

Conclusion

Evaluated materials can be safely disinfected with sodium hypochlorite and ultraviolet chamber. Addition silicone of native origin is at par with impression materials from developed countries but same cannot be said about alginate.

Comprehensive Review and Comparison of the Disinfection Techniques Currently Available in the Literature

The goal of disinfection in the dental office is to prevent the spread of infection from one patient to another and maintain the safety of the dental care providers. Prevention of cross infection has significant effect on infection control. The standard procedure of rinsing impressions under tap water immediately after removal from the mouth eliminates microorganisms along with saliva and blood. A broad search on published literature was done using the keywords impression materials, disinfection method, and sterilization of dental impression from 1980 to 2016 in Medline, Google Scholar, the internet, and textbooks. This article critically analyzes the various published methods of dental impression disinfection in dentistry.

Preliminary SEM Observations on the Surface of Elastomeric Impression Materials after Immersion or Ozone Disinfection

INTRODUCTION

Surface integrity of dental elastomeric impression materials that are subjected to disinfection is of major importance for the quality of the final prosthetic restorations.

AIM

The aim of this qualitative Scanning Electronic Microscopy (SEM) study was to reveal the effects of immersion or ozone disinfection on the surface of four dental elastomeric impression materials.

MATERIALS AND METHODS

Four dental elastomeric impression material brands were used (two vinyl polysiloxane silicones, one polyether, and one vinyl polyether silicone). Total of 32 specimens were fabricated, eight from each impression material. Specimens were immersion (0.525% sodium hypochlorite solution or 0.3% benzalkonium chloride solution) or ozone disinfected or served as controls and examined with SEM.

RESULTS

Surface degradation was observed on several speci-mens disinfected with 0.525% sodium hypochlorite solution. Similar wavy-wrinkling surface structures were observed in almost all specimens, when treated either with 0.3% benzalkonium chloride solution or ozone.

CONCLUSION

The SEM images obtained from this study revealed that both immersion disinfectants and ozone show similar impression material surface alterations. Ozone seems to be non-inferior as compared to immersion disinfectants, but superior as to environmental protection.

Effect of disinfection and sterilization on the tensile strength, surface roughness, and wettability of elastomers

AIM

The aim of the present study was to evaluate the effect of chemical disinfection, autoclave, and microwave sterilization on some of the key properties of elastomers.

METHODS

Five polyvinylsiloxane elastomeric impression materials were evaluated. Forty samples were fabricated from each material. The samples were randomly selected and assigned to four experimental groups with 50 samples each: group I, control; group II,chemical disinfection; group III, autoclave sterilization; and group IV, microwave sterilization. The differences in the mean values were contrasted and compared with the control group and analyzed using two-way analysis of variance (P < 0.05).

RESULTS

The results showed that chemical disinfection and autoclave sterilization had no significant effect on the tensile strength and surface roughness, whereas microwave sterilization showed a statistically-significant reduction in tensile strength, and an increase in surface roughness. None of the disinfection and sterilization techniques had a significant effect on wettability. However, autoclave and microwave sterilization resulted in an increase in hydrophilicity of all the materials tested.

CONCLUSION

Chemical disinfection and autoclave sterilization had no statistically-significant effect on the tested properties of elastomers, thus autoclave sterilization can be considered as an alternative and an effective mode of disinfection and sterilization to eliminate all forms of disease causing microorganisms from dental impressions.

The effect of repeated immersion of gypsum cast in sodium hypochlorite and glutaraldehyde on its physical properties: An in vitro study

Background:

One method used to disinfect a dental cast is immersion in a disinfecting solution. Repeated immersion of a cast in disinfectant may affect its physical properties.

Purpose:

The purpose of this study was to evaluate the changes in dimensional accuracy and hardness of the dental casts as a result of repeated disinfection in 0.525% sodium hypochlorite and 2% glutaraldehyde solutions.

Materials and Methods:

Sixty specimens were made of type III dental stone. Twenty specimens were immersed in slurry, a supernatant solution of calcium sulfate in distilled water (control casts), 20 specimens in 0.525% sodium hypochlorite, and 20 specimens in 2% glutaraldehyde solutions for 30 min and air dried for 24 h. This process was repeated for 7 times for testing. Linear dimensional change and hardness were determined according to American National Standards Institute/American Dental Association (ANSI/ADA) standards. The data were analyzed using two-way analysis of variance.

Results:

For specimens prepared with type III stones, treatment was by immersion in slurry (group I – control casts), and by immersion in 0.525% sodium hypochlorite (group II – test group 1) and in 2% glutaraldehyde solution (group III – test group 2). The specimens treated with sodium hypochlorite and glutaraldehyde showed more linear dimensional change compared to the specimens treated in slurry. However, the difference between test casts and control casts was significant. But the difference between the two test groups was not significant. Both the test groups showed decrease in hardness of the specimens compared to that specimens in control group. But the difference between two test groups was not significant in hardness. However,the values remained close to ANSI/ADA standards.

Conclusion:

The results demonstrated that repeated immersion of type III dental stone specimens in slurry with distilled water, 0.525% sodium hypochlorite and 2% glutaraldehyde, along with drying in air, caused a significant increase in linear dimension and a significant decrease in hardness.

Evaluation of dimensional stability and accuracy of autoclavable polyvinyl siloxane impression material

Dimensionally stable autoclavable impressions will be effective in controlling the cross-infection and contamination caused by patient's saliva and other oral secretions. The accuracy of newly introduced autoclavable polyvinyl siloxane impression material was assessed for its dimensional stability and accuracy. A standard metal model (Dentoform, U-501, Columbia) was customised for impression making. The impressions were made using the newly introduced polyvinyl siloxane impression materials (AFFINIS, Coltene/Whaledent AG, 9450 Alstalten, Switzerland). Fifty impressions were made and were divided into two groups A and B of 25 each. Group A was the control sample (non-autoclaved impressions) and group B was the test sample (autoclaved impressions), which was subjected to the steam autoclave procedure at 134 °C for 18 min, casts were poured in type IV gypsum products. The customised metal model, casts obtained from control and test group were subjected to laboratory evaluation with help of a travelling microscope (×10 magnification), and digital vernier calliper (0.01 mm/10 μm accuracy). Data analysis was done using one-way ANOVA and One-Sample t test to evaluate the overall accuracy (P < 0.005). As a result, there was an average reduction of 0.016 μm in overall dimension between the test and the control group when compared with the master model, which is not statistically or clinically significant. The newly introduced polyvinyl siloxane impression material is accurate and dimensional stable for clinical use when steam autoclaved at 134 °C for 18 min.

Modified soft tissue cast for fixed partial denture: a technique

In process of fabrication of a fixed partial denture, dies are trimmed to expose margins of the preparations. The need for the soft tissue cast is quite evident as the soft tissue emergence profile that surrounds the prepared tooth is destroyed in the process of fabrication. This article describes a modified technique to fabricate the soft tissue cast for the conventional fixed partial denture. The impression made with the polyvinylsiloxane was first poured to prepare the die cast. After retrieval of the cast, the same impression was poured second time with the resin based resilient material to cover the facial and proximal gingival areas. The remaining portion of the impression was poured with the gypsum material. This technique does not require additional clinical appointment, second impression procedure, technique sensitive manipulations with impression, or cumbersome laboratory procedures. The simplicity of this technique facilitates and justifies its routine use in fabrication of the fixed partial denture.

Accuracy and stability of impression materials subjected to chemical disinfection - a literature review

Disinfection of impressions by immersion or spraying with disinfecting solutions is considered nowadays mandatory for effective infection control. The purpose of this review was to examine existing evidence on the effects that chemical disinfection may have on critical qualities of impressions, namely dimensional accuracy and stability over time. A PubMed search was conducted to include original laboratory research articles written in English, published between 1980 and 2005 in peer-reviewed journals and investigating the effect of chemical disinfection, by immersion or spraying, on the dimensional changes that the impression materials experience after setting. Studies were also sought manually, by tracing the references cited in the retrieved articles. The reports on dimensional changes of disinfected impression materials, although rather numerous, are difficult to compare and analyze because of variations of the experimental design. The investigations broadly agree that the disinfection process does not generally affect the dimensional integrity of the impressions, in spite of the statistically significant differences occasionally found. However, the immersion in the disinfecting solution encourages water absorption phenomena in the case of the so-called hydrophilic impression materials, especially after the long-term immersion. Chemical interactions between impressions and disinfectants may occur, but they do not appear to influence the dimensional behaviour of the former. The overall effect of the disinfection is influenced not only by the changes experienced by the impression per se, but also by the alterations of the acrylic tray containing the impression and of the gypsum product poured in it.

Reproducibility of sterilized rubber impressions

Impressions, dentures and other dental appliances may be contaminated with oral micro-flora or other organisms of varying pathogenicity from patient's saliva and blood. Several approaches have been tried to control the transmission of infectious organisms via dental impressions and because disinfection is less effective and has several drawbacks for impression characterization, several sterilization methods have been suggested. This study evaluated the reproducibility of rubber impressions after sterilization by different methods. Dimensional accuracy and wettability of two rubber impression materials (vinyl polysiloxane and polyether) were evaluated after sterilization by each of three well-known methods (immersion in 2% glutaraldehyde for 10 h, autoclaving and microwave radiation). Non-sterilized impressions served as control. The effect of the tray material on impression accuracy and the effect of topical surfactant on the wettability were also evaluated. One-way ANOVA with Dunnett's method was used for statistical analysis. All sterilizing methods reduced the reproducibility of rubber impressions, although not always significantly. Microwave sterilization had a small effect on both accuracy and wettability. The greater effects of the other methods could usually be overcome by using ceramic trays and by spraying impression surfaces with surfactant before pouring the gypsum mix. There was one exception: glutaraldehyde still degraded dimensional accuracy even with ceramic trays and surfactant. We conclude that a) sterilization of rubber impressions made on acrylic trays was usually associated with a degree of dimensional change; b) microwave energy seems to be a suitable technique for sterilizing rubber impressions; c) topical surfactant application helped restore wettability of sterilized impressions.

Evaluation of disinfected casts poured in gypsum with gum arabic and calcium hydroxide additives

STATEMENT OF PROBLEM

Disinfection of stone casts is an important measure for the control of cross-contamination. Many approaches have been used to disinfect stone casts, but information regarding the accuracy of the resultant casts is limited.

PURPOSE

The purpose of this in vitro study was to evaluate the dimensional accuracy, incidence of abutment fracture, and the abutment reproduction of disinfected stone casts made from elastomeric impressions and to determine the effect of gum arabic and calcium hydroxide additives on these properties.

MATERIAL AND METHODS

Two aqueous solutions of chemical disinfectants (0.525% sodium hypochlorite and 0.1% povidone iodine) were used as mixing water substitutes for 3 types of dental stone: Types III (Lab Stone), IV (Mile Stone), and V (Die Keen). These stone powders were subjected to further modification by adding 1% gum arabic and 0.132% calcium hydroxide before mixing at the manufacturer-recommended liquid/powder ratios (0.30 for Type III, 0.21 for Types IV and V, respectively). As these additives increased the fluidity of the mix, reduced liquid/powder ratios (0.26 for Type III, 0.19 for Types IV and V, respectively) were also evaluated. Unmodified stone powder mixed with water served as the control. These modifications resulted in 7 test groups for each type of stone. Mixed stones of these groups were poured into 10 putty/wash vinyl polysiloxane impressions made of a customized definitive cast. The percentage of abutments fractured at the time of releasing the resultant casts, as well as the percentages of incompletely reproduced abutments, abutments with air bubbles, and abutments with defective finish lines were compared statistically among the tested groups using the chi-square test (alpha=.05). The average dimensional deviations of the resultant cast from the definitive cast measured in mm were statistically analyzed using 1-way ANOVA (alpha=.05) followed by the Dunnett test to detect any differences among the tested groups.

RESULTS

No significant difference was found in abutment fracture or abutment defects for the different formulations of each type of stone used. The resultant casts showed no significant dimensional changes except for Type III and IV stones modified by gum arabic and calcium hydroxide additives and mixed at the recommended liquid/powder ratios.

CONCLUSION

Both 0.525% sodium hypochlorite and 0.1% povidone iodine can be used to disinfect dental gypsum with no significant effect on the dimensional accuracy and reproducibility of the resultant casts. Addition of gum arabic and calcium hydroxide to the hemihydrate powders before mixing does not aid in reducing the incidence of defective abutment reproduction.

Polyvinyl siloxane impression materials: an update on clinical use

Polyvinyl siloxane impression materials have applications in a variety of indirect procedures in prosthodontics and restorative dentistry. Favourable handling properties, good patient acceptance and excellent physical properties have resulted in their popularity in today's practice. In this review, the chemistry and important physical properties of polyvinyl siloxanes are summarized, and recent clinical questions of improved hydrophilics, tray adhesives, disinfection, and glove-induced polymerization inhibition are addressed.

Vertical distortion in distal extension ridges and palatal area of casts made by different techniques

A coordinate measurement machine with laser probe was used to measure the vertical distortion of the casts produced by use of three types of impression materials (irreversible hydrocolloid, condensation silicone, and addition silicone) and two types of trays (stock and custom trays). Results indicated that all impression groups showed positive vertical distortion (ranging from 0.00566 to 0.30299 mm) at the edentulous ridges and palatal area. The amount of the vertical distortion was greatest at the palatal area and was followed by the high edentulous ridge and the low edentulous ridge. Addition silicone, with either custom tray or stock tray, was the most accurate impression material. Condensation silicone was more accurate than irreversible hydrocolloid in custom tray impression. However, in stock tray impression the irreversible hydrocolloid was more accurate than the condensation silicone. The results suggest that, with careful manipulation, irreversible hydrocolloid with stock tray impression may provide a satisfactory cast for fabricating the framework of a distal extension removable partial denture.

The effects of sterilization on addition silicone impressions in custom and stock metal trays

Five groups of addition silicone impressions (four made in custom autopolymerizing acrylic resin trays and one in stock metal rim-lock trays) were made of a stainless-steel master die. The first group (control group) was not sterilized. The second group was sterilized in an ethylene oxide gas autoclave, the third group in a steam autoclave, and the fourth and fifth groups by immersion for 12 hours in 2% glutaraldehyde. Casts made from each sterilization group were found to be significantly different from control impressions by multivariate analysis of variance and should not be used to fabricate prostheses.

Use of a scanning laser three-dimensional digitizer to evaluate dimensional accuracy of dental impression materials

A steel die was machined to represent a dental arch with teeth prepared for complete crowns. Impressions and casts were made from the die, and critical dimensions were measured by two methods--one using micrometers and the other a scanning laser three-dimensional (3-D) digitizer. The digitizer recorded measurements were more precise than the micrometer's and virtually eliminated operator error because the acquisition of data was automatic. The digitizer could also be useful for high-precision analyses of the dimensional accuracy of dental impression materials, but the cost and complexity of the instrument makes it less desirable for low-precision work.