Dimensional stability of contemporary irreversible hydrocolloids: Humidor versus wet tissue storage

Digital Analysis of the Dimensional Change Of an Irreversible Hydrocolloid Impression Material (Alginate) with Varying Storage Times

AIM

The aim of this study was to digitally measure the dimensional changes in an irreversible hydrocolloid impression material (alginate) resulting from varying storage times under optimal storage conditions.

MATERIALS AND METHODS

A single type V dental stone control cast was used to make 25 alginate impressions using perforated stock trays. The impressions were randomly assigned into five groups of five samples each (n=5 per group) with varying storage times: Group 1, poured at 15 minutes; Group 2, poured at one hour; Group 3, poured at 24 hours (one day); Group 4, poured at 72 hours (three days); Group 5, poured at 168 hours (seven days). All impressions were stored in sealed Ziploc® plastic bags with a wet paper towel (100% relative humidity) at room temperature and stored according to the assigned group storage times. All impressions were poured in type V dental stone according to the manufacturer's instructions. The casts were scanned with a digital 3D desktop scanner and saved as electronic stereolithography (.stl) files. Each .stl file of the scanned casts were superimposed on the .stl file of the control cast using Geomagic® Control X™ software. Three preselected fixed comparison measuring points (CMP) on each cast were compared to the control cast. Point one (CMP1) was on the midfacial surface of central incisor. Point two (CMP2) and point three (CMP3) were on the mesiobuccal proximal marginal ridge areas of third molars. The discrepancies between the files at each point were analysed with colour maps, and quantified (Table 1). The tolerance was set at ±10μm. CMP scores were analysed using one-way analysis of variance (ANOVA) and Kruskal-Wallis (K-W) non-parametric H tests.

RESULTS

Average gap distances across groups ranged from 0.04mm (seven-day group) to 0.06mm (one hour and 24-hour groups). Colour maps indicated increased dimensional change with increased storage time up to one day. After three days, shrinkage up to 139μm was measured. ANOVA results for CMP1 (F[4,20] = 1.65, p = 0.020) and CMP3 (F[4,20] = 0.44, p = -0.78) were not statistically significant. Similarly, K-W results for CMP2 were not significant (χ²= 3.62, p = 0.46).

CONCLUSIONS

Under optimal storage conditions, there were no significant dimensional changes in casts poured from alginate up to seven days.

Extended-pour and conventional alginates: effect of storage time on dimensional accuracy and maintenance of details

Objective:

This study aimed to evaluate the dimensional stability and maintenance of details of conventional and high stability alginates up to 5-day storage.

Methods:

Two types of alginates were selected (n=10) for this study, conventional (Hydrogum) and high stability alginates (Hydrogum 5), which were produced with the aid of a cylindrical metal block and a ring-shaped metal mold (Specifications 18, 19, and 25, ANSI/ADA). Ten images were obtained from the molds for the dimensional stability test, which were taken immediately after their production and at each different storage periods (15 min, 24 h, 48 h, 72 h, 96 h, and 120 h) by a digital camera. The specimens were kept hermetically sealed in plastic bags (23°C) and then used to obtain 140 (n=70) dental stone models, used in the detail reproduction test, in which the angular accuracy of three grooves (20 µm, 50 µm, and 75 µm) was observed at each period. The details reproduction accuracy was classified using a predetermined score classification. Measurements of dimensional changes were made in the Corel DRAW X6 program. The data were submitted to the Student’s t-test (α?#8197;= 0.05).

Results:

A statistically significant difference concerning the size of the matrix was observed after 24h for both alginates, and a statistically significant negative linear dimensional change (contraction) was verified after 24 h of storage (1.52% for the high stability alginate, and 1.32% for the conventional alginate). The high stability alginate kept the full details for 72 hours, while the conventional alginate, for 24 h. Both alginates reproduced the 75 µm groove at all storage periods.

Conclusion:

Impressions made with both alginates presented satisfactory clinical results when the alginates were immediately poured.

Evaluating the stability of extended-pour alginate impression materials by using an optical scanning and digital method

STATEMENT OF PROBLEM

The dimensional stability of alginate dental impressions is a key factor for the reliability of delayed gypsum pouring and digital scanning. However, studies of the dimensional stability of alginates with conventional methods that consider the dimensional variations of large impressions are lacking.

PURPOSE

The purpose of this in vitro study was to investigate and compare 2 digital methods for the analysis of dimensional stability of large impressions made with 5 different extended-pour alginates and to assess dimensional stability up to 5 days.

MATERIAL AND METHODS

Impressions of a simplified master maxillary model were made with Alginoplast, Blueprint, Hydrogum 5, Orthoprint, and Phase Plus and then analyzed at different time points. Digital scans of the alginate impression surfaces were obtained with a desktop scanner and analyzed by evaluating the linear measurements between reference points and by using a novel method that consists of the analysis of the entire scanned surface to evaluate the expansion and contraction of the impressions.

RESULTS

The first method revealed that the dimensional changes did not exceed 0.5%, with the exception of Phase Plus at day 3 (-0.6 ±0.7%), and the average dimensional variation was always lower than or equal to 0.2 mm. Blueprint was the most stable material (-0.2 ±0.6%). The second method revealed dimensional variations always lower than 0.03 mm and confirmed Blueprint as the best performing material (0.001 ±0.006 mm) and Phase Plus the worst (-0.019 ±0.006 mm).

CONCLUSIONS

Both the methods used to evaluate alginate stability showed that the analyzed materials remain stable over time; the dimensional variations showed a similar trend, with differences in the absolute values depending on the applied method. Linear measurements are affected by the operator and choice of reference points; however, by evaluating the average variations of the entire structure surfaces, local variations should be minimized. The evaluation of the average variations with the second method offers the advantage of a rapid visual representation of these variations.

Accuracy of intraoral scans in the mixed dentition: a prospective non-randomized comparative clinical trial

OBJECTIVE

In-vivo accuracy of intraoral scans of complete mixed dentitions of patients in active treatment have not yet been investigated. The aim was to test the hypothesis that dimensional differences between intraoral scans and conventional alginate impressions in the mixed dentition are clinically irrelevant.

METHODS

Trial design: Prospective non-randomized comparative clinical trial. Based on sample size calculation 44 evaluable mixed dentition jaws of patients in active orthodontic treatment were included. Each patient received an alginate impression following an intraoral scan (TRIOS® Ortho). Plaster cast was fabricated and scanned with an external scanner (ATOS-SO®). Both STL datasets were analyzed with the 3D inspection and mesh processing software GOM Inspect®. Statistical analysis comprised sample size calculation, t-test as well as nonparametric tests.

RESULTS

The absolute mean difference between digital plaster casts and intraoral scans is 0.022 mm ± 0.027 mm (median 0.015 mm). The obtained measurements are in the range of comparable studies on full arch permanent dentitions. Gender, the size of the jaw represented by the dentition stage and upper respectively lower jaw, as well the malocclusion have no effect on the total deviations between digital plaster casts and intraoral scans. Detectable impression errors were bubbles in fissures and marginal ridges as well as incomplete alginate flow and detachment from the tray. Detectable scanning errors were incomplete distal surface of the most distal molar.

CONCLUSION

Dimensional differences between intraoral scans and conventional alginate impressions in the mixed dentition are clinically irrelevant for orthodontic purposes. In all clinical situations of active treatment in the mixed dentition, the intraoral scans are more detailed and less error-prone.

Surface Detail Reproduction and Dimensional Stability of Contemporary Irreversible Hydrocolloid Alternatives after Immediate and Delayed Pouring

Purpose

To overcome the poor dimensional stability of irreversible hydrocolloids, alternative materials were introduced. The dimensional changes of these alternatives after delayed pouring are not well studied and documented in the literature. The purpose of the study is to evaluate and compare the surface detail reproduction and dimensional stability of two irreversible hydrocolloid alternatives with an extended-pour irreversible hydrocolloid at different time intervals.

Materials and Methods

All testing were performed according to the ANSI/ADA specification number 18 for surface detail reproduction and specification number 19 for dimensional change. The test materials used in this study were newer irreversible hydrocolloid alternatives such as AlgiNot FS, Algin-X Ultra FS, and Kromopan 100 which is an extended pour irreversible hydrocolloid as control. The surface detail reproduction was evaluated using stereomicroscope. The dimensional change after storage period of 1 h, 24 h, and 120 h was assessed and compared between the test materials and control. The data were analyzed using one-way ANOVA and post hoc Bonferroni test.

Results

Statistically significant results (P < 0.001) were seen when mean scores of the tested materials were compared with respect to reproduction of 22 μm line from the metal block. Kromopan 100 showed statistically significant differences between different time intervals (P < 0.001) and exhibited more dimensional change. Algin-X Ultra FS proved to be more accurate and dimensionally stable.

Conclusions

Newer irreversible hydrocolloid alternative impression materials were more accurate in surface detail reproduction and exhibited minimal dimensional change after storage period of 1 h, 24 h, and 120 h than extended-pour irreversible hydrocolloid impression material.

Precision of guided scanning procedures for full-arch digital impressions in vivo

PURPOSE

System-specific scanning strategies have been shown to influence the accuracy of full-arch digital impressions. Special guided scanning procedures have been implemented for specific intraoral scanning systems with special regard to the digital orthodontic workflow. The aim of this study was to evaluate the precision of guided scanning procedures compared to conventional impression techniques in vivo.

METHOD

Two intraoral scanning systems with implemented full-arch guided scanning procedures (Cerec Omnicam Ortho; Ormco Lythos) were included along with one conventional impression technique with irreversible hydrocolloid material (alginate). Full-arch impressions were taken three times each from 5 participants (n = 15). Impressions were then compared within the test groups using a point-to-surface distance method after best-fit model matching (OraCheck). Precision was calculated using the (90-10%)/2 quantile and statistical analysis with one-way repeated measures ANOVA and post hoc Bonferroni test was performed.

RESULTS

The conventional impression technique with alginate showed the lowest precision for full-arch impressions with 162.2 ± 71.3 µm. Both guided scanning procedures performed statistically significantly better than the conventional impression technique (p < 0.05). Mean values for group Cerec Omnicam Ortho were 74.5 ± 39.2 µm and for group Ormco Lythos 91.4 ± 48.8 µm.

CONCLUSIONS

The in vivo precision of guided scanning procedures exceeds conventional impression techniques with the irreversible hydrocolloid material alginate. Guided scanning procedures may be highly promising for clinical applications, especially for digital orthodontic workflows.

Cast erosion from the cleaning of debris after the use of a cast trimmer

STATEMENT OF PROBLEM

Whether using tap water to rinse off debris will make a clinical difference to the surface detail of a gypsum cast is unknown. In addition, how best to remove debris from the cast is unknown.

PURPOSE

The purpose of this in vitro study was to evaluate the efficiency of different methods of cleaning a gypsum cast after trimming and the effect of short-term exposure to tap water on the surface quality of the cast.

MATERIAL AND METHODS

A die fitting American National Standards Institute/American Dental Association specification 25 (International Standards Organization specification 6873) for dental gypsum products was embedded in a Dentoform with the machined lines positioned at the same level as the occlusal surface of the posterior teeth. A flat plate was used to ensure that the plane of occlusion for the die was at the same position as the posterior teeth. Forty polyvinyl siloxane impressions of the Dentoform were made and poured with vacuum-mixed improved Type IV dental stone. Each cast was inspected for the accurate reproduction of the lines. The base of the 2-stage pour was trimmed with a cast trimmer with water, and surface debris was removed by rinsing by hand under tap water for 10 seconds, by brushing the cast with a soft toothbrush for 10 seconds, or by resoaking the cast and using a soft camel hair brush in slurry water for 10 seconds. The amount of debris was evaluated on a scale of 1 to 4, and the quality of the 20-μm line was evaluated on a scale of 1 to 4 under ×15 magnification. The nonparametric Kruskal-Wallis ranks test was used to identify significant differences among the different cleaning methods (α=.05).

RESULTS

Results of the Kruskal-Wallis and Kruskal-Wallis Z-value tests demonstrated that all cleaning methods produced cleaner casts than were observed for uncleansed controls (P<.001), but no differences in debris removal were found among the different cleaning methods (.065≤P≤.901). The ability to see the quality of a 20-μm line (P=.974) was not statistically different among the groups.

CONCLUSIONS

Rinsing the cast under flowing tap water and brushing, or hand washing under flowing tap water, or using a soft camel hair brush in slurry water for 10 seconds had no noticeable effects on the quality of a 20-μm line, and all 3 methods resulted in a clean cast.

Evaluation of digital dental models obtained from dental cone-beam computed tomography scan of alginate impressions

OBJECTIVE

To investigate the dimensional accuracy of digital dental models obtained from the dental cone-beam computed tomography (CBCT) scan of alginate impressions according to the time elapse when the impressions are stored under ambient conditions.

METHODS

Alginate impressions were obtained from 20 adults using 3 different alginate materials, 2 traditional alginate materials (Alginoplast and Cavex Impressional) and 1 extended-pour alginate material (Cavex ColorChange). The impressions were stored under ambient conditions, and scanned by CBCT immediately after the impressions were taken, and then at 1 hour intervals for 6 hours. After reconstructing three-dimensional digital dental models, the models were measured and the data were analyzed to determine dimensional changes according to the elapsed time. The changes within the measurement error were regarded as clinically acceptable in this study.

RESULTS

All measurements showed a decreasing tendency with an increase in the elapsed time after the impressions. Although the extended-pour alginate exhibited a less decreasing tendency than the other 2 materials, there were no statistically significant differences between the materials. Changes above the measurement error occurred between the time points of 3 and 4 hours after the impressions.

CONCLUSIONS

The results of this study indicate that digital dental models can be obtained simply from a CBCT scan of alginate impressions without sending them to a remote laboratory. However, when the impressions are not stored under special conditions, they should be scanned immediately, or at least within 2 to 3 hours after the impressions are taken.