ALGINATE

Dr Avreet Sandhu

First Impressions count

CONTENTS
INTRODUCTION
DEFINITION CLASSIFICATION PROPERTIES ELASTOMERIC IMPRESSION MATERIAL IRREVERSIBLE HYDROCOLLOID ALGINATE

COMPOSITION PHYSICAL PHASES PACKING AND STORAGE

CONTENTS
MAKING OF ALGINATE IMPRESSION
TROUBLE SHOOTING

INTRODUCTION
The ability to record consistently good impressions is

both a science and an art. It is worth bearing in mind that the impression influences not only the quality of the subsequent restoration but also the technicians perception of the dentists skill.

Definition
An impression is a negative record of the tissues of

the oral cavity which constitutes the basal seat of the denture. An impression is made in a material which has plasticity and which hardens or sets while in contact with the tissue.

Classification of Impressions
Preliminary impressions Taken either by the dentist or an expanded-function dental assistant. Used to make a reproduction of the teeth and surrounding tissues. Used to make (1) diagnostic models, (2) custom trays, (3) provisional coverage, (4) orthodontic appliances, and (5) pretreatment and post-treatment records.

Classification of Impressions
Final impressions Taken by the dentist. Used to make the most accurate reproduction of the teeth and surrounding tissues. Used to make indirect restorations, partial or full dentures, and implants.

Classification of Impressions
Bite registrations Taken by the dentist or dental assistant. Make a reproduction of the occlusal relationship between the maxillary and mandibular teeth. Provide an accurate registration of the patients centric relationship between the maxillary and mandibular arches.

The Ideal Impression Material

Easy to mix and handle.
Suitable working time. Suitable setting time. Compatible with die and stone Not toxic or allergenic to the patient.

Dimensionally stable on setting.

Accurate to record the fine details of the prepared tooth Has acceptable odor and taste. Adequate strength. Adequate shelf life.

The Ideal Impression Material

Economical Ready to disinfected without loss of accuracy. Fluid or plastic when inserted into the mouth.

It must be an exact record of all the aspects of the prepared tooth

and sufficient unprepared tooth structure immediately adjacent to margins, to allow the dentist and the technician to be certain of the location and configuration of the finish line.
Other teeth and tissue surrounding the abutment tooth must be

accurately reproduced to permit proper articulation of the cast and contouring of the restoration.
It must be free from air bubbles especially in the finish line area.

 High accuracy
(very small contraction <0.5%)

Biocompatibility
Compatibility to stone High tear strength Long shelf life Pleasant color &taste

High dimensional stability High elastic recovery Ease of use Hydrophilic and Hydrophobic Proper setting time

Cost

Elastic recovery
The amount of rebound after a cylinder of material is strained 10% for 30 seconds.

98%

IMPRESSION MATERIALS
Key Properties
a. Accuracy = ability to replicate the intraoral surface details.
b. Dimensional Stability = ability to retain its absolute dimensional size over time. c. Tear Resistance = ability to resist tearing in thin sections (such as through the feather-edged material within the gingival sulcus.
Impression Tray Impression

Accuracy Dimensional Stability Tear Resistance

CLASSIFICATION SYSTEM
Based on Properties of Set Materials
Properties: Reaction: Irrev Rev Irrev Irrev Rev Irrev Irrev Irrev Irrev Set: (Chem) (Phys) (Chem) (Chem) (Phys) (Chem) (Chem) (Chem) (Chem)

Rigid:
1. 2. 3. Impression Plaster Impression Compound Zinc Oxide/ Eugenol Rigid Rigid Rigid Flexible Flexible Flexible Flexible Flexible Flexible

Water-Based Gel: 4. Alginate (Irreversible Hydrocolloid) 5. Agar-Agar (Reversible Hydrocolloid)

Elastomers: 6. Polysulfide (Rubber Base, Thiokol) 7. Silicone (Conventional, Condensation) 8. Polyether 9. Polyvinyl Siloxane (Addition Silicone)

Impression materials
Plaster Nonelastic
Impression Compound

Zinc oxide Eugenol Impression waxes

Impression material Hydrocolloids

Agar Reversible Alginate Irreversible

Polysulfides Polyethers
Condensation silicone Addition silicone

Elastic
Non-aqueous elastomers

Nonelastic Gypsum (Plaster)

Impression Compound

Zinc oxide eugenol

Impression wax

Elastomeric Impression Materials

A material that is used when an extremely accurate impression is essential. The term elastomeric means having elastic or rubberlike qualities.

Elastic Agar
Hydrocolloids

Alginate

Hydrocolloids Reversible and Irreversible

Introduced by Sears 1939

First elastic
Sears AW. Hydrocolloid impression technique for inlays and fixed

bridges.

Irreversible Hydrocolloid
Material that cannot return to a solution state after

it becomes a gel. Alginate is the irreversible hydrocolloid most widely used for preliminary impressions.

Makeup of Alginate
Potassium alginate (Alginic Acid) (12-15%) Comes from seaweed; is also used in foods such as ice cream as a thickening agent. Calcium sulfate (8-12%) Reacts with the potassium alginate to form the gel. Trisodium phosphate Added to slow down the reaction time for mixing.

Makeup of Alginate
Diatomaceous earth (70%) A filler that adds bulk to the material. Controls the stiffness of the set gel Zinc oxide Adds bulk to the material. Potassium titanium fluoride (~10%) Added so as not to interfere with the setting and surface strength. Sodium Phosphate (retarder) (2%) Coloring and flavouring agents (traces)

Physical Phases of Alginate

The first phase is a sol (as in solution). In the sol

phase, the material is in a liquid or semiliquid form. (sol: resembles a solution, but is made up of colloidal particles dispersed in a liquid) The second phase is a gel. In the gel phase, the material is semisolid, similar to a gelatin dessert. gel entangled framework of solid colloidal particles in which liquid is trapped in the interstices and held by capillary forces (Jello)

 There are 2 main reactions occur when powder

reacts with water during setting:

First rxn. provides adequate working time:

(Retarder) 2Na3PO4 + 3CaSO4 ----> Ca3(PO4)2 + 3Na2SO4

After the sodium phosphate has reacted, remaining

calcium sulfate reacts with sodium alginate to form an insoluble calcium alginate, which forms a gel with the water: H2O Na alginate + CaSO4 --------> Ca alginate + Na2SO4 (powder) (gel)

Normal set alginate Working time of 2 minutes and a setting time of up to 41/2 minutes after mixing. Fast set alginate Working time of 11/4 minutes and a setting time of 1 to 2 minutes. Def : Working time The time allowed for mixing the alginate, loading the tray, and positioning the tray in the patient's mouth. Setting time The time required for the chemical action to be completed.

Packaging and Storing of Alginate

Containers about the size of a coffee can are the

most commonly used form of packaging. Premeasured packages are more expensive, but save time by eliminating the need for measurement of the powder. Shelf life of alginate is approximately 1 year.

Fig. 46-7 Examples of packaging for alginate.

Causes for Distortion and Dimensional Change of Alginate

If an alginate impression is stored in water or in a

very wet paper towel, the alginate will absorb additional water and expand. This condition is called imbibition. If an alginate impression remains in the open air, moisture will evaporate from the material, causing it to shrink and distort. This condition is called syneresis.

ADA Specifications
<3% deformation with a 10% strain

Altering the Setting Times of Alginate

Cooler water can increase the setting time if

additional time is needed for the procedure. Warmer water can reduce or shorten the setting time of the procedure.

Water-to-Powder Ratio
An adult mandibular impression generally

requires two scoops of powder and two measures of water. An adult maxillary impression generally requires three scoops of powder and three measures of water.

Fig. 46-8 Scoop and water measure for alginate.

Taking an Alginate Impression

Explain the procedure to the patient: The material will feel cold, there is no unpleasant taste, and the material will set quickly. Breathe deeply through your nose to help you relax and be more comfortable. Use hand signals to communicate any discomfort.
Mouth Preparation Rinse and dry the patient's teeth If teeth are too dry, alginate will stick

An Acceptable Alginate Impression

The impression tray is centered over the central and

lateral incisors. There is a complete "peripheral roll," which includes all of the vestibular areas. The tray is not "overseated," which would result in exposure of areas of the impression tray. The impression is free from tears or voids. There is sharp anatomic detail of all teeth and soft tissues. The retromolar area, lingual frenum, tongue space, and mylohyoid ridge are reproduced in the mandibular impression. The hard palate and tuberosities are recorded in the maxillary impression.

Trouble Shooting
Inadequate working or setting time:
temperature of the water, incomplete spatulation W/P too low improper storage of alginate powder

Distortion: Tray movement during gelation or removed from mouth prematurely weight of tray compressing or distorting alginate impression not poured up immediately Tearing: removing impression from mouth before adequately set thin mixes (high W/P ratio) presence of undercuts (blocking out these areas before an impression may help) inadequate amount of impression material in tray (avoided by minimum 3 mm of impression material between tray and oral tissues) Loss of detail: removed from mouth prematurely

 Consistency: preset mix is too thin or thick The W/P ratio is incorrect (avoid by fluffing powder before measuring; do not overfill powder dispenser) inadequate mixing (avoided by vigorous spatulation and mixing for recommended time) using hot water: grainy and prematurely thick mix
Dimensional change: delay in pouring alginate impression stored in air: results in distorted, undersized cast due to alginate impressions losing water when stored in air Porosity: whipping air into the mix during spatulation (proper mixing: after initial wetting of powder by the water, mix alginate so as to squeeze the material between the spatula blade and the side of the rubber bowl) Poor stone surface (of cast) set gypsum remaining in contact with the alginate for too long a period of time

Stock tray

Rim lock tray

Perforated tray

Stock tray
Special tray (Custom tray)

Nonelastic Plaster

Impression Compound

Zinc oxide eugenol

Impression wax

Elastic Agar
Hydrocolloids

Alginate

Non-aqueous elastomers

Polysulfides Polyethers
Condensation silicone Addition silicone

Elastic Agar
Hydrocolloids

Alginate Polysulfides

Polyethers
Non-aqueous elastomers

Condensation silicone

Addition silicone

(Ideal Properties)

High accuracy
(very small contraction <0.5%)

Biocompatibility
Compatibility to stone High tear strength Long shelf life Pleasant color &taste

High dimensional stability High elastic recovery Ease of use Hydrophilic and Hydrophobic Proper setting time

Cost

 Irreversible Hydrocolloids (Alginate) Diagnostic Casts:

Disinfection of Impression Materials

Soak 10 min in Gluteraldehyde

Final Impressions: Dip in Gluteraldehyde ,rinse in sterile water, dip again let stand under damp gauze 10 min Spray with Sodium Hypochlorite rinse, spray again & let stand under damp gauze 10 min

Reversible Hydrocolloid

Dip in Gluteraldehyde ,rinse in sterile water, dip again let stand under damp gauze 10 min Spray with Sodium Hypochlorite rinse, spray again & let stand under damp gauze 10 min

Addition reaction Silicones

In Gluteraldehyde 1 hr., Rinse sterile water Soak in fresh solution Gluteraldehyde 10 min

Zinc oxide eugenol

Soak in Gluteraldehyde 10 min

Silicone Impressions

Soak for 10 min Gluteraldehyde

Polyether Impressions

Dip in Gluteraldehyde ,rinse in sterile water, dip again let stand under damp gauze 10 min

Fundamentals of Removable Partial Dentures 2nd Ed. CP Owen

Tray Selection Criteria

Feel comfortable to the patient. Extends slightly beyond the facial surfaces of the

teeth. Extends approximately 2 to 3 mm beyond the third molar, retromolar, or tuberosity area of the arch. Is sufficiently deep to allow 2 to 3 mm of material between the tray and incisal or occlusal edges of the teeth.

Characteristics of Impression Trays

Quadrant tray
Covers one half of the arch.

Section tray
Covers the anterior portion of the arch.

Full arch tray

Covers the entire arch.

Perforated tray
Holes in the tray create a mechanical lock to hold the

material in place. Smooth tray Interior of the tray is painted or sprayed with an adhesive to hold the impression material.

Impression Trays
Must be sufficiently rigid to: Carry the impression material into the oral cavity. Hold the material in close proximity to the teeth. Avoid breaking during removal. Prevent warping of the completed impression.

Table 46-1 Types of Stock Trays

Fig. 46-3 Examples of quadrant, section, and full-arch impression trays.

Basic Impression Technique

1. 2. 3. 4. 5. 6. 7.

The material selected depends upon the dentists preference and the type of impression required for the procedure. The dentist prepares the tooth or teeth for the impression. The light-bodied material is prepared and loaded into the syringe and transferred to the dentist. The dentist places the light-bodied material over and around the prepared teeth and onto the surrounding tissues. The heavy-bodied material is prepared and loaded into the tray and transferred to the dentist. When the impression material has reached final set, the impression is removed and inspected for accuracy. The impression is disinfected, placed in a biohazard bag, labeled, and readied for the laboratory technician.

REFERENCES
Skinners Science of Dental Materials
Dental Materials and Their Selection (William J.

OBrien)
Introduction to dental materials (Richard Van Noort) Science of Dental Materials Phillips 11th Ed. Mr. Robert Seghi Alginate Impression Materials

(alginate lecture 2006.ppt)