CONTENTS

INTRODUCTION 01

REVIEW OF LITERATURE 03

MATERIAL AND METHODS 11

TABELS 18

RESULTS 36

DISCUSSION 41

SUMMARY AND CONCLUSION 45

BIBLIOGRAPHY

ANNEXURE
 LIST OF TABLES AND GRAPHS

Sl. No. TITLE

Chart – 1 NAME OF THE MATERIALS
USED AND NAME OF
MANUFACTURER

Table – I HOWS MEASUREMENT OF

FRASA MASTER MODEL AND
THEIR MEAN VALUES

Table- II to V SHOWS MEAN VALUE AND

STANDARD DEVIATION,
MEAN VALUE DIFFRENCE
OF EACH BRAND OF MATERIAL
FROM THE MASTER MODEL
OF REFERENCES MARKING
A-B, B-C, AND D-A RESPECTIVELY

Table- VI to IX SHOWS MEAN VALUE AND

STANDARD DEVIATION, MEAN
VALUE DIFFRENCE OF EACH
GROUP FROM THE MASTER
MODEL OF REFERENCES MARKING
A-B, B-C, AND D-A RESPECTIVELY
Graph I to IV SHOW THE DISCREPANCIES OF
EAC BRAND OF MATERIAL
FOR REEFRENCE
MARKING A-B, B-C, C-D AND D-A
RESPECTIVELY FROM THE
MASTER MODEL

Graph V to VIII SHOW THE DISCREPANCIES

OF EACH GROUP OF FOR
REFERENCE MARKING A-B,
B-C, C-D AND D-A
RESPECTIVELY FROM THE
MASTER MODEL

Graph IX SHOW THE COMPARATIVE

PERCENTAGE DIFFERENCE OF
ALL GROUPS FOR REFRENCE
MARKING A-B, B-C, C-D AND D-A
 ILLUSTRATIONS
SL. NO. TITLE
Fig. 1 SCHEMATIC REPRESENTATION OF MASTER
MODEL SHOWING THE REFERENCE POINTS

Photo 1 ALGINATES USED IN THE STUDY

Photo 2 IMPROVED ALGINATES USED IN

THE STUDY

Photo 3 ELASTOMERS USED IN THE STUDY

Photo 4 OCCLUSAL VIEW OF FRASACO

DENTULOUS MASTER MODEL

Photo 5 FARASACO MODEL MOUNTED ON

THE PHANTOM HEAD

Photo 6 ARMAMENTARIUM USED IN THE STUDY

Photo 7 IMPRESSIONS MADE OF GROUP I

AND II MATERIALS

Photo 8 IMPRESSIONS MADE OF GROUP

III MATERIALS
Photo 9 OCCLUSAL VIEW OF THE CAST

Photo 10 CASTS PRODUCED FROM DIFFERENT

IMPRESSION MATERIALS
Photo 11 CASTS ON THE STUDY TABLE OF THE
PROFILE PROJECTOR MICROSCOPE

Photo 12 PROFILE PROJECTOR MICROSCOPE

USED FOR THE STUDY
 1
Introduction
Partial edentulism is one of the commonest
prosthodontic problems; we come across. This
condition is usually treated by means of removable or
fixed prosthesis. Since the introduction of Alginate in
the year 1947, it is one of the most commonly used
impression material in recording the partial
edentulous conditions. But the studies have shown
that the alginates are not dimensionally stable and
accurate enough to be used as an impression
material for fixed partial denture cases. When it
comes to its accuracy and dimensional stability,
elastomers are proved to be superior than that the
alginates and they are the most preferred impression
materials in partial edentulous conditions. From the
last couple of years, to overcome the deficiencies of
alginates, various companies have come out with the
improvised alginate (Chromatic alginate) which they
claim to be equivalent to the elastomers and can be
used in crown and bridge cases. Since they claim
that improvised alginates are equivalent in quality
and dimensional accuracy as compared to elastomer,
this study has been planned with the following:-

2
 Aims and Objectives:

1. To compare the dimensional accuracy of alginates with that

of improved alginates.

2. To compare the dimensional accuracy of alginates with that

of elastomers.

3. To compare the dimensional accuracy of improved alginates

with that of elastomers.

3
 Review of Literature

BAILEY (1955) 3 recommended acrylic resin tray for

rubber base impression materials. He specified that
this tray should have a spacer of 1 to 1.5 mm over
the abutment teeth. The occlusal and incisal
surfaces of unprepared teeth should not be covered
by the spacer so that they act as stops for the tray.
Perforations should be made to provide mechanical
retention for the impression material. He believed
that an individual tray prepared in this manner
would utilize the utmost elasticity of rubber based
impression materials.

ROSENTIEL (1955) 1 6 carried out an investigation

on the dimensional accuracy with models obtained
from rubber base impression material of a stainless
steel die simulating two bridge abutment. A copper
plated replica was obtained. Control experiments
with other impression materials showed it to
compare favorably with the more reliable of the
older materials. Reversible hydrocolloids gave the
least satisfactory result.

4
 EUGENE W.SKINNER and NOEL E.HOBLIT
(1956) 1 8 studied the accuracy of hydrocolloid
impressions and for this; they constructed an
oversize model to simulate the conditions like the
human mouth for a one tooth bridge. Impressions in
hydrocolloid were obtained of the model and their
dimensions were compared with the similar
dimensions of the model. In this study the three
reversible hydrocolloids impression materials and
impression involving both types of materials were
considered and from this study they stated that the
impressions obtained with the irreversible
hydrocolloid material are equal in accuracy to
those obtained with reversible hydrocolloid
materials.

CAUL H.J. (1957) outlined the techniques that

would avoid many of the inaccuracies in the use of
alginate impression materials.

Caul suggested that:

1) Alginate mix should have a smooth creamy

consistency.

2) Pre cooling the mixing equipment and using cool

water is indicated to delay the setting time. Since,
this is a
5
 chemical reaction the working time will be
lengthened by reduction of temperature of the mix.

3) Impression should be removed with a sudden and

snap about 2-3 minutes after time of set.

4) Impression should be poured instantaneously.

5) Impression and cast should be separated one hour

after pouring.

6) Excellent accuracy can be obtained with alginates

if the material is used properly.

PHILLIPS (1958) 1 5 summarized the research on

elastomeric materials and started that factors such
as the use of minimum bulk of materials, bonding
of the impression material to the tray, adequate
time in the mouth and use of double mix technique
were essential for accuracy.

SNIPPER (1960) 1 9 studied in vivo the accuracy of

casting made with Thiokol and Silicone and
comparison drawn was that Thiokol, when
manipulated as suggested, will produce
impressions of complete dental arch as any other
elastic impression material.

6
AGARWAL N.K. et al (1970) 1 carried out a study to
determine the accurate reproducibility of alginate
impression materials. They tested three brands of
alginate under the trade name of Zelgan, Unident
and Dencer and with these alginates they made the
impression of brass metal die with a perforated
copper cap with a uniform space of 1.5 mm. Their
conclusion was that Zelgan Alginate material was
more accurate than others, if poured within 3 to 10
minutes.

JAMES A.STACKHOUSE Jr. (1975) 2 0 conducted a

study on a comparison of elastic impression
materials in relation to consistency and time
relation and he concluded that, the polyether
material compared favorably with the other in
mixing time, working time, and consistency.

1) There were no significant differences in

accuracy among all of the Elastomers when
poured within 30 minutes.
2) Dies poured immediately from the
hydrocolloids did not differ significantly from
those of the other materials poured in 30
minute.
3) The polyether was the most stable among all
the tested materials.

6
HOSES F.SAWYER et al (1976) 1 7 conducted a
study on the accuracy of casts produced from two
alginate hydrocolloids (irreversible), one
hydrocolloid (reversible) and a polyether rubber.
When compared, they concluded that the polyether
impression material produced the most accurate
casts. The hydrocolloids reversible casts were the
second most accurate, and the alginate
(irreversible hydrocolloid) produced the least
accurate casts.

JEAN – PIERR STAUFFER et al (1979) 2 1 studied

the accuracy of six elastic impression materials
used for complete arch fixed partial dentures and
for this, four types of impression materials were
used. The accuracy was evaluated by visual
comparison and indirect measurement methods and
from this study they concluded that:

1) None of the tested materials allow safe

finishing of a complete arch fixed partial
denture on a cast poured from one single
master impression.
2) All of the tested materials can be used for
impressions for a complete arch fixed partial
denture.

7
EAMES W.B et al (1979) 8 studied the effect of bulk
on the accuracy of elastomeric impression
materials Impression trays were fabricated
providing 2, 4 and 6 mm spacer to determine the
stability and accuracy of nine elastomeric
impression materials on a simulated full crown A
preparation steel die and from this study they
stated that space of 2 mm produced the most
accurate impressions for all of the materials tested.

EAMS W.B et al (1979) 9 studied accuracy and

dimensional stability of elastomeric impression
materials in relation to making of impression in a
heat processed tray, with a space of 2.4mm for
impression material and from the study they stated
that the impressions should be poured as soon as
possible. When poured immediately, many of the
available materials exhibit similar characteristics of
stability.

OLA HANSSON and JAN EKLUND (1984) 1 3

studied the dimensional accuracy of three new
alginate with that of two agar hydrocolloids and one
additional silicone in relation to different stock
trays and stated that new alginates were as
accurate as other impression materials in most
clinical conditions and further stated that the use of
perforated and non- perforated metal stock tray
8
will cause inaccuracy. However when used in
severe undercut area they stated that alginate were
inferior to elastomers in accuracy.

CHANG CHI LIN et al (1988) 1 4 conducted a study

on the accuracy of Impression materials. The
materials selected for study were polyether, vinyl
Polysiloxane, polysulfide, reversible hydrocolloids,
irreversible hydrocolloid and irreversible reversible
hydrocolloid combination. They concluded that the
polyether gave the most accurate result, the
second accurate was vinyl polysiloxanes followed
by polysulfide and irreversible reversible
hydrocolloids and least accurate was irreversible
hydrocolloids.

P.A.ODMAN, T.M JENT (1988) 1 2 conducted a study

on the accuracy of impression materials in a semi-
clinical model. The materials selected for this study
were irreversible hydrocolloid, reversible
hydrocolloid and addition and condensation
silicone and they stated that all tested materials
seemed acceptable for clinical use in crown and
short span bridge work.

GEORGIA S.DOVNIS et al (1991) 7 conducted a

study to compare the Marginal fit of complete arch
fixed prosthesis under simulated clinical
9
conditions. Prostheses were made on casts
constructed from three commonly used impression
materials; Polyether, Polyvinyl siloxane (Medium
viscosity and putty wash) and Reversible
hydrocolloids. A maxillary dentoform with four
abutment teeth was used as the master cast and
six impressions were made with each material.
Individual casting for each abutment was made on
the stone casts. The abutment castings were luted
together on the cast to provide a complete arch
fixed partial denture using a ticonium framework
and acrylic resin. The marginal fit of the abutment
casting was measured on the master cast before
and after the prostheses were luted together and
they stated that the polyether and both addition
and condensation silicone impression materials
were significantly more accurate than the
reversible hydrocolloid in both situations. All of the
single castings were clinically acceptable, but the
luted restorations made from reversible
hydrocolloids were not.

ANDERS ERIKSSON et al (1996) 2 studied

irreversible hydrocolloids used for crown and
bridge impressions and stated that all the
irreversible hydrocolloids, hydrocolloids if correctly
treated before pouring with compatible gypsum,
could reproduce details of 20 mm and further
10
stated that detail reproduction did not improve with
the use of 2% potassium sulfate solution, compared
to water or if the impression were poured “dry”. In
general, the alginate stabilizer produced casts with
significantly Better detail reproduction and surface
structure and they also stated that an irreversible
hydrocolloids impression should not come into
contact with any liquid within the first 15 minutes.

KENNETH J.ANUSAVICE (1999) 3 stated that the

most of the alginate impression materials are not
capable of reproducing the finer details that one
observed with elastomeric impression materials. To
improve the accuracy of the alginates, the
surfactants can be used but addition of a layer of
solution over the surface of the impression also
obscures the accuracy.

JOSEPH NISSAN et al (2000) 1 1 studied the

accuracy of three putty wash impression
techniques using the polyvinyl siloxane impression
material and they concluded that the polyvinyl
siloxane, 2 step, 2 mm relief putty wash impression
technique was the most accurate for fabricating
stone dies.

11
Materials and Methods
1. ARMAMENTARIUM USED IN THE STUDY

 Frasaco dentulous model

 Maxillary metallic dentulous perforated stock

tray(Coe Tray)

 Water dispensing cup

 Alginate dispensing scoop

 Rubber bowl

 Curved stainless steel mixing spatula

 Straight stainless steel mixing spatula

 Auto mixing gun for elastomers

 Base former

 Vibrator

 Profile Projector Microscope

12
2. MATERIALS USED IN THE STUDY
 For this study, the materials used were grouped as
follows;
1. Group I: Alginate

a. Zelgan ( Dentsply India)

b. Alginoplast ( Heraeus and Kulzer Holland)

2. Group II: Improved alginate

a. Litochrom (LASCOD – Italy)

b. Cavex (Cavex “Holland”)

3. Group III: Elastomer

a. Putty consistency elastomer (3M, India,

Reprosil, India)
b. Light body elastomer (3M, India, Reprosil,
India)

4. Tray adhesive (3M, Reprosil, India)

5. Die stone Type IV (Kalabahi, Karson, Mumbai)

6. Dental plaster Type II (Kalabahi, Karson,

Mumbai)

13
 The present in-vitro study was carried out in the
Department of Prosthodontics, Bapuji Dental
College and Hospital, Davangere, India.

Material and method followed in this study has been

discussed under the following headings.

1. Preparation of the master model (Frasaco Model)

2. Selection of the stock tray for alginates and

elastomer.

3. Making impressions of the master model using

alginates, improved alginates and elastomers.

4. Pouring the cast

5. Measurement of the distance between reference

points

MATERIALS AND METHOD:

1) Preparation of Master Model:

The Frasaco maxillary dentulous model was

selected and reference markings of 1 mm in
diameter were made on the buccal cusp of first
pre-molars and mesio-buccal cusp of the first molar
using round diamond bur. These makings were
14
 made on 14, 24, 26 & 16 and were named as A, B,
C, & D respectively. The distance between the
above markings were measured with a “profile
projector microscope” and kept as a standard
value.

2) Selection of the stock tray;

The maxillary perforated stock tray (Coe tray) was
selected with a uniform space of 4-6 mm between
the tray and the master model to make impression
with alginate improved alginate and elastomer.

3) Making impression of the master model using

various impression materials.

The Frasaco model was mounted on the phantom

head and using each group, 14 impressions were
made.

Making Alginate Impression:

Manufacturer’s instructions were strictly followed
regarding the water: Powder ration and the
manipulation of Alginates Uniformly mixed
irreversible hydrocolloids were made, loaded onto
the selected perforated stock tray and the
impressions were made of the master model
mounted on the phantom. After 5 minutes (3

15
minutes setting time + 2 minutes waiting
time),13Materials and Methods impressions were
removed from the master model and checked for
the accuracy, seven impressions were made using
each brand and a total of 14 impressions were
obtained. Acceptable impressions were poured with
die stone Type IV.

Making Improved Alginate Impression:

Similar to the Alginate impressions, 14 impressions
of group II were made, 7 of each brand were
obtained and poured with die stone, Type IV.

Making Elastomeric Impression:

On the selected stock tray, the respective tray
adhesive was applied onto the tissue surface and 2
mm at the border of the stock tray. Then the tray
was air dried the room temperature for 10 minutes.
Putty consistency base and catalyst were taken
according to manufacturers instruction and mixed
till the uniform colour was obtained and loaded
onto the selected stock tray and on this the
polyethylene sheet was applied as a spacer and
impression was made. After this the polyethylene
sheet was removed and light body was loaded onto
the putty using auto mixing gun and tray was again
seated onto the model and impression was made,
similar 14 impressions were made, seven of each
16
 brand and were checked for presence of voids and
acceptable impressions were poured with die stone
Type IV.

4) Pouring of the Cast:

The die stone, Type IV was hand mixed. Water
powder ratio was taken according to manufacturers’
instructions in a clean rubber bowl. With the help of
straight stainless steel spatula it was uniformly
mixed and poured into the impression on the
mechanical vibrator. After setting, the casts were
removed from the impressions and the base was
poured with dental plaster Type II.

5) Measurement of the Dimensional Accuracy:

Measurements were made between the four
reference points that are A to B, B to C, C to D and
D to A using Nikon Profile Projector Microscope,
Japan at Bapuji Institute of Engineering and
Technology, Davangere, India. The readings were
obtained and subjected to statistical analysis.

Material and Trade Name Manufacturer

Group
Group I Zelgan Dentsply India
Alginate Ltd.

Alginoplast Heraeus Kulzer,

Italy

Group II Cavex Cavex, Holland

Improved
Alginate Litochrom LASCOD, Italy

Group III 3 M 3M, India

Elastomeric
Reprosil Dentsply, India
Ltd.
17
CHART–1
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
 Results

The aim of the present study is to assess and

compare the dimensional accuracy of alginates s and
improved alginates with that of elastomer
impressions Material.

The material with their trade name and name of their

manufacturers has been shown in Chart No.1.

The distance between the reference markings were

measured to know the accuracy of difference
materials and compared with the master model
values. For this the test specimens (Casts) were
evaluated under “Profile Projector Microscope”
and the accuracy of each specimen was analyzed
statistically by;

1) Wilcoxon’s signed rank test: it was used to

compare the accuracy of different materials with the
master model.

2) One way ANOVA test: in this test, the mean

discrepancy of different materials were subjected.

37
3) Student-Newman Kaul’s test; it was used for
the simultaneous comparison between different
groups.

Tables

Table I:
It shows the measurements of the master model and
their mean value in millimeter (mm) and micrometer
(um).

Table II:
It shows the mean value and standard deviation,
mean value difference and the percentage difference
of each brand from the master-model for reference
marking A-B.

Table III:
It shows the mean value and standard deviation,
means value difference and the percentages
difference of each brand from the master model for
reference marking B-C.

Table IV:
It shows the mean value and standard deviation,
mean value difference, And the percentage
difference of each brand from the master model for
references marking C- D.
38
Table V:
It shows the mean value and standard deviation,
mean, value difference and the percentage
difference of each brand from the master model for
reference marking D-A.

The ANOVA test showed that the materials of Group

I, Group II and Group III exhibit significantly different
dimensional changes from the master – model.
Group III shows the least dimensional change
followed by Group II and the highest dimensional
change was shown by Group I from the master model
for all reference markings. The F value of ANOVA
test was significant for all reference markings in all
groups. So, to know which group differs significantly
from one and the other, Student- New Kaul’s test
was used.

The P value of Student Newman Kaul test was

significant between the groups (P<.01) and the P
value non- significant (P>.01) within the groups, so
the value of each group has been clubbed and
compared with the master-mode.

Table VI, VII, VIII, and IX shows the mean value and
standard deviation, mean value difference and the
percentage difference of each group from the master
model for the reference markings A-B, B-C, C-D and
39
D-A respectively. When the mean and standard
deviation, mean value difference and percentage
difference of each group were compared with the
master-model and statically analyzed, It showed the
followed mentioned percentage discrepancies.
Percentage discrepancies of each group from the
master model:

A-B B-C C-D D-A

Group I 3.2% 1.8% 2.4% 3.7%

Group I 1.4% 1.7% 1.0% 2.4%

Group I 0.2% 0.3% 0.2% 0.6%

So, from these values it can be revealed that the

Group III elastomers showed least discrepancies
from the master model followed by Group II improved
alginates and the highest discrepancies were seen in
Group alginate.

Graph I, II, III and IV shows the discrepancies of

each group for reference markings A-B, B-C, C-D,
and D-A respectively for the master model.

40
Graph V, VI, VII and VIII shows the discrepancies of
each group for reference markings A-B, B-C, C-D,
and D-A respectively for the master model.

Graph IX shows the comparative percentage

difference of all groups for reference markings A-B,
B-C, C-D, and D-A respectively for the master model.

41
Discussion
 For the [proper fitting of all the partial prosthesis, the
accuracy of impression materials play an important role.
From the beginning of 18th and 19th centuries, many
researches are going on to improve the accuracy of the
impression materials.

In 1937, Sears used agar –hydrocolloid as an impression

material for the first time. In 1947, the irreversible
hydrocolloids came into existence.

The advantages of alginate discussed by Skinner and

Pomes were;

i. Low cost

ii. No heat in necessary for their preparation and no

danger of burning of mouth of the patient.

iii. Sufficient fluidity prior to the time gelation.

iv. Reduced risk of trapping of air.

Caul H.J. out lined the techniques to avoid the inaccuracies

during the use of alginate impression material.

i. Alginate mix should have a smooth creamy consistency.

42
 ii. Pre cooling of the mixing equipment and using cool water
indicate to delay the setting time. Since this is the chemical
reaction, the working is lengthened by reducing the
temperature of the mix.

iii. The impression should be removed with sudden and snap

about 2-3 minutes after the time of set.

iv. The impression should be poured instantaneously.

v. The impression should be separated 1 hour after pouring.

Agarwal et al suggested that accuracy of the alginate

impression material is better if poured within 3-10 minutes.

Skinner and Carlism proved that considerable errors in the

accuracy of alginate occurred when;

i.) The alginate impression was dried with an air-burst.

ii.) The model surface was dried before the impression was
taken.

iii.) The water at room temperature was employed instead of ice

water.

Chang-Chi-Lin al at proved that irreversible hydrocolloid

was least accurate when compared with other materials. To
43
Overcome the advantages of the alginate, in the past recent
years several new materials for mixed prosthesis based on
alginate have been introduced. As the new hydrocolloids are
only minor modifications of the older ones and the
manipulation is almost same as in 1947.

Ander et. Al. conducted a study on the accuracy of new

alginates and the traditional alginates. According to them
new alginates are 2-3 time costly than traditional alginates
and they stated that this study does not indicate that the
increase prize corresponds to a similar increase in the
success of impression.

Anne Pertzfeldt et al proved from their study that the

accuracy of the blue print alginates was comparable with the
elastomers.

From the results obtained of the present study, it has been

proved that there is significant difference on the dimensional
accuracy between the alginates and the improved alginates.
In 1975, the additional polymerizing silicones were
introduced in the market. There was no by-product of the
polymerizing reaction and the material proved to be more
dimensionally stable and accurate.

It has been proved by Sawyer, Peutzfeldt, Chang-Chillin

and Anusavices that elastomers are more accurate then
alginates.
44
B.A.Linke et al proved from their study on the distortion
analysis of stone cast made from different impression
materials and they concluded that silicone impression
materials produced less inter-abutment distortion than the
irreversible hydrocolloids and they also stated that statically
significant differences exist among the different impression
materials.

From the present study it is proved that the significant

differences exist between the elastomers, alginates and
improved alginates on the accuracy of impression.

The result of this in vitro study showed that improved

alginates are better than alginates but the elastomers are the
still more accurate. So the further studies are required to co-
relate the results clinically.

45
 Summary and Conclusion
The present study was conducted to compare the
dimensional accuracy of alginates and improved
alginates with that of elastomers.

For this study, Frasaco model was prepared with four

reference markings and seven impressions were
made, totally 42 casts were prepared using different
impression materials and the distance between the
reference markings A-B, B-C, C-D, and D-A on the
casts were measured and compared with the
distance between the reference markings on the
master model.

Multi group comparison of reference markings were

analyzed by One- Way ANOVA F-test followed by
Student-Newman Kaul’s test.

Form this study is was concluded that;

1) Improved alginates were more dimensionally

accurate than alginates.

2) Elastomers were more dimensionally accurate than

alginates as well as from the improved alginates.

46
3) Although elastomers were dimensionally more
accurate than the improved alginates, but the
discrepancy was less as compared to alginates.

4) Further clinical study is required to compare and

assess the accuracy of improved alginates with that
of the elastomers.
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 Annexure
Formulae used: