RESTORATION OF CARIOUS EXPOSED ABUTMENT TEETH

teeth are also exposed. An impression is made with the fixed partial denture can be salvaged and reused with the
impression material of choice and is poured with die techniques described. This technique will reduce the
stone. The cast, the patient’s fixed partial denture, and time and cost to the patient.
the matrix are sent to the laboratory. The post and core
is made to fit the prepared tooth and the fixed partial REFERENCE
denture. During the period of time for constructing the 1. Taleghani M, Carter G. Rebuilding abutment teeth to permit
cast post and core, the abutment teeth must be protected use of an existing bridge. Gen Dent 1985;33:54-6.
by a temporary restoration.
Reprint requests to:
DR. DOMINIC P. Lu
CONCLUSION
NORTHWESTERN MEDICAL CENTER
An abutment tooth that has sustained extensive root NEW TRIPOLI, PA 18066
caries can be successfully preserved and a preexisting

Considerations for adhesion of impression materials

to impression trays
T. J. Bomberg, D.D.S.,* M. H. Goldfogel, D.D.S.,** W. Hoffman, Jr., D.D.S.,*** and
S. E. Bomberg, D.D.S.****
University of Colorado, School of Dentistry, Denver, Colo.

A n impression made with an elastic impression

material must be securely attached to the tray to assure
resistance when the impression and tray are removed
from the mouth over undercuts. The polysulfide and
an accurate impression. If the material pulls away from polyether adhesives provide the highest bond strengths of
the tray during removal from the mouth, the completed the materials to the impression trays. The silicone base
impression may fail to return to its original shape and impression materials, including the condensation reac-
dimension, resulting in a distorted die, wax pattern, and tion and most of the addition reaction materials, have
casting. lower bonding values to the adhesive materials.le4
Several methods for adhesion that involve liquid The adhesive must be applied thoroughly to assure
paint-on cement and mechanical means may be used. retention of the impression material to the impression
These include (1) bonding with an adhesive material, (2) tray, and a variety of techniques have been described.5-1i
the use of perforations or other devices to retain the All are consistent in emphasizing the completeness of
material, or (3) a combination of these two methods. application of the adhesive and the importance of
The conventional or liquid paint-on adhesive method complete drying of the adhesive before starting an
is the most commonly used. Each class of elastomeric impression. Nevertheless, it is common to observe
impression materials has its own specific adhesive for impression trays that either lack or have only a partial
application on impression trays. Failure to adequately application of adhesive.
apply adhesive material to the tray could compromise The most common mechanical method of providing or
retention of the impression material.’ increasing retention is through the use of perforations in
Some of the newer impression materials (polyethers a variety of forms in the impression tray.
and the addition silicones or polysiloxanes) set up harder This study determined the effect of some of the
than the materials used earlier (polysulfides and conden- adhesion factors of various combinations of trays and
sation silicones). This lower flexibility creates more adhesive usage. These included the use or lack of use of
liquid adhesive cement bonding in perforated and non-
perforated custom acrylic resin and stock impression
This study was supported by BRSG Grant 5SO7 RR05890 and G-C trays.
International Corp., Scottsdale, Ark.
*Professor, Department of Applied Dentistry. METHOD
**Associate Professor and Chair, Division of Fixed Prosthodontics.
***Associate Professor, Division of Removable Prosthodontics. A master posterior quadrant model was made by
****Lieutenant (Dental Corps), U. S. Navy; Dental Department, using extracted teeth mounted in a dental stone base.
U.S.S. Samuel Gompers, FPO San Francisco, Calif. One tooth was prepared for a full veneer cast gold

THE JOURNAL OF PROSTHETIC DENTISTRY 681

 BOMBERG ET AL

Fig. 3. Perforated and nonperforated quadrant stock

Fig. 1. Master model and casting. impression trays.

of baseplate wax was adapted over the teeth for a spacer.

Aluminum foil was used as a separation medium over
the wax spacer.2 Autopolymerizing custom acrylic trays
should not be used for a period of time until they become
dimensionally stable. ‘z-l5 No newly made custom trays
were used within 24 hours for impressions for this study.
The perforations in the custom trays were drilled with a
No. 8 round bur at approximately 1 cm spacing.
Two impression techniques were used. The first was
a single-mix technique. This technique used one mix of
the regular viscosity material, part of which was applied
directly to and around the prepared and adjacent teeth
Fig. 2. Casting seated on master model and stabilized with the large end of a No. 7 wax spatula. A cold-air
for measuring. syringe was used to direct a light stream of air against
the impression material to spread it over the appropriate
teeth. Extra material was added if needed. The remain-
crown. A casting was made on this preparation by using der of the material was placed in the tray to be seated on
a direct waxing technique (Fig. 1). The casting was the master modelI The second technique used a putty/
seated on the master model, stabilized with an elastic wash system. The putty-wash impressions used in this
band, and the marginal opening was measured at two study were made by using the laminated single-mix
points, one at the midpoint on the facial surface and one technique. Regular viscosity material was mixed; some
at the midpoint on the lingual surface, for later reference was applied around the prepared and adjacent teeth and
(Fig. 2). Measurements to 0.001 mm were made on a the remainder was placed over newly mixed unset putty
traveling microscope (Gaertner Scientific Corporation, material in the impression tray and seated on the master
Chicago, Ill.) model.”
A series of 60 impressions of the master model were Single-mix impressions were made by using conven-
made with one brand of impression material (Exaflex, tional adhesive application techniques with either full or
Regular Body, Lot No. 051584, and Putty, Lot No. no application of the impression material adhesive
081886, G-C International, Scottsdale, Ariz.) in 12 test recommended by the manufacturer. The laminated put-
cells of five impressions each. Perforated and nonperfo- ty/wash impressions were made in trays with either full
rated custom acrylic resin trays (COE Tray Plastic, Coe application or no application of the appropriate impres-
Laboratories, Chicago, Ill.), perforated (Disposable sion material adhesive.
Impression Tray [Perforated], D.L. Saslow, Inc., Mount Stone dies (Die-Keen, Columbus Dental, St. Louis,
Prospect, Ill.), and nonperforated (Getz Sanitray, Tele- MO.) were poured in the impressions under standardized
dyne Getz, Elk Grove Village, Ill.) stock trays were used conditions. The casting was seated on each die, the
(Fig. 3). The custom trays of autopolymerizing acrylic stabilizing elastic band placed, and the marginal opening
resin were made on the master model by following the measured at the same two points as the reference
manufacturer’s instructions (Fig. 4). A double thickness measurements (Fig. 5). Data were analyzed by using a

682 DECEMBER 1988 VOLUME 60 NUMBER 6

CONSIDERATIONS FOR ADHESION

Table I. Effect of adhesive application

Marginal opening in microns
Full
application None
Impression tray Mean SD Mean SD

Custom (acrylic resin)

Perforated
Single mix 99.90 27.88 71.00 13.74
Custom (acrylic resin)
Nonperforated
Single mix 70.40 6.54 131.90 63.23
Stock
Perforated
Single mix 75.70 21.80 79.70 34.17
Putty/wash 85.70 14.96 93.30 20.66
Fig. 4. Custom acrylic resin impression tray on master Stock
model. Nonperforated
Single mix 72.40 8.92 181.30 114.99
Putty/wash 88.90 23.65 113.50 45.85

Table II. Regression of marginal opening

distance on adhesive use, tray type, perforations,
impression technique
Variable B SEB B
Tray selection -8.92500 10.92951 -.08134
Tray perforation -25.10000 8.92391 -.24262=
Adhesive -29.20000 8.92391 -.28226*
Impression technique 7.55000 10.92951 -.06881
Constant 121.82500 9.7723
Adjusted R* .I1452
Fig. 5. Casting seated on die and stabilized for measur-
ing. B = Unstandardized regression coefficients; SE,, = standard error of’
regression coefficients; (3 = standardized regression coefficient.
*p < .Ol.
multiple regression approach. The predictive value of
the independent variables was evaluated in terms of the
relative contribution of each variable in explaining the
variation in marginal opening. The casting fit on the dies from single-mix impres-
sions made in custom trays and nonperforated stock
RESULTS impression trays with no adhesive applied were signifi-
The casting fit on the master model was used as a cantly different. The marginal opening was 1.87 to 2.5
reference. The reference measurements were compared times greater and a standard deviation of 10 to 12.9 times
with the measurements of the marginal opening of the greater than the previously described more accurate tray
dies made from the various tray, technique, and adhesive and adhesive combinations used for the replicative
combinations and are summarized in Table I. The most impressions and resultant dies.
replicative impression and resultant die were found in When the four independent variables (application or
the single-mix technique with full adhesive application nonapplication of adhesive, stock or custom tray, single
to the custom acrylic resin, stock nonperforated and mix or putty/wash technique, and perforated or nonper-
perforated impression trays, a.nd with mechanical reten- forated trays) were entered in a regression equation
tion in perforated custom acrylic resin and stock impres- using a stepwise approach, only two of the variables
sion trays. The putty-wash impression technique with showed a significant predictive value. Use of full appli-
full adhesive application yielded poorer but similar cation of adhesive and the use of perforated trays were
results in stock perforated and nonperforated trays, associated with the minimization of marginal opening.
closely followed by the stock perforated tray with no The use of stock or custom trays, and the use of the
adhesive application. putty/wash or single-mix technique had no significant

THE JOURNAL OF PROSTHETIC DENTISTRY 683

 BOMBERG ET AL

effects on the observed marginal opening. These findings 7. Khera SC. Impression materials and techniques. In: Thayer KE,
are presented in Table II. ed. Fixed prosthodontics. Chicago: Year Book Medical Publish-
ers, Inc, 1984;102-3.
PRACTICAL SIGNIFICANCE 8. McCoy RB. Impression techniques utilizing elastomeric
materials. In: Baum L, McCoy RB, eds. Advanced restorative
Adequate retention of impression material in the tray dentistry. Philadelphia: WB Saunders Co, 1984;204-5.
is necessary for consistent results. Complete application 9. Dykema RW, Goodacre CJ, Phillips RW. Johnston’s modern
of impression material adhesive is a critical step in the practice in fixed prosthodontics. Philadelphia: WB Saunders Co,
1986:115.
impression process to assure accurate and consistent
10. Gilmore HW, Lund MR, Bales DJ, Vernetti JP. Operative
results. The results are enhanced, both in accuracy and Dentistry. 4th ed. St Louis: CV Mosby Co, 1982;277-8.
consistency, when the adhesive is used in a perforated 11. Sturdevant JR, Sturdevant CM. Gold inlay and gold onlay
tray. The perforated stock trays used in this study may preparations for class II cavity preparations. In: Sturdevant CM,
have had a higher retentive value than other stock Barton RE, Sockwell CE, Strickland WD, eds. The art and
science of operative dentistry. 2nd ed. St Louis: CV Mosby Co,
perforated trays available on the market because of the
1985;458.
size and location of the perforations. Furthermore, the 12. Eames WB, Sieweke JC. Seven acrylic resins for custom trays
position (parallel or perpendicular to the tensile axis) of and five putty-wash systems compared. J Oper Dent 1980;5:
retentive perforations affects mechanical retention values 162-7.
13. Craig RG, ed. Restorative dental materials. 7th ed. St Louis: CV
and should be a design consideration in stock trays or
Mosby Co, 1985;508-9.
perforation placement in custom acrylic resin trays.‘* 14. Goldfogel MH, Harvey WL, Winter D. Dimensional change of
Further examination of current and improved mechani- acrylic resin materials. J PR~STHET DENT 1985;54:284-6.
cal retention factors should be made. 15. Fehling AW, Hesby RA, Pelleu GB Jr. Dimensional stability of
autopolymerizing acrylic resin impression trays. J PR~~THET
DENT 1986;55:592-7.
REFERENCES
16. Brokaw WC. A modified technique for rubber-base impressions.
1. Davis GB, Moser JB, Brinsden GI. The bonding properties of Gen Dent 1985;33:230-1.
elastomer tray adhesives. J PROSTHET DENT 1976;36:278-85. 17. Fusayama T. Laminated single impression technique with
2. Farah JW, Powers JM. On making good impressions. The silicone. Quintessence Int 1977;8: 15-25.
Dental Advisor 1984;1:1-8. 18. Pines M, Penugonda B, Vaidyanathan TK, Schulman A. Tray
3. Nicholson J, Porter I, Dolan T. Comparing addition silicone perforation effects on the retention of PVS impression material
adhesive bond strengths to other elastomeric adhesives [Abstract]. [Abstract]. J Dent Res 1987;66:133.
J Dent Res 1983;62:299.
4. Pines M, Penugonda B, Vaidyanathan TK, Schulman A. Adhe- Reprint requests to:
sive bond strength of PVS impression material adhesives [Ab- DR. THOMAS J. BOMBERG

stract]. J Dent Res 1986;65:259. UNIVERSITY OF COLORADO HEALTH SCIENCES CENTER

Shillingburg HT Jr, Hobo S, Whitsett LD. Fundamentals of SCHOLL OF DENTISTRY
5.
DENVER, CO 80262
fixed prosthodontics. 2nd ed. Chicago: Quintessence Publishing
Co, 1981;230.
6. Baum L, Phillips RW, Lund MR. Textbook of operative Contributing author
dentistry. Philadelphia: WB Saunders Co, 1981;430. B. Flower, D.D.S., Denver, Colo.

Temperature gradients at two locations within the .

tooth during cavity preparation in vitro
Harold E. Goodis, D.D.S.,” Benjamin Schein, D.D.S., M.Sc.D.,* and
Paul Stauffer, M.Sc., E.E.**
University of California at San Francisco, Schools of Dentistry and Medicine, San Francisco, Calif.

T his study sought to establish a methodology for

measuring temperatures at the dentinoenamel and pul-
reduction procedure. Although temperature itself may
not be harmful to the pulp, it is a good guide to other
podentin junctions (DEJ and PD J) during a tooth modalities of harm to the pulp, such as intrapulpal
pressure.‘,’ Most studies of this kind have been carried
*Assistant Professor, Department of Restorative Dentistry. out by placing a temperature probe through the lingual
**Assistant Adjunct Professor, Department of Radiation Oncology. surface of the test tooth until it is in contact with the

684 DECEMBER 1988 VOLUME 60 NUMBER 6