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DIMENSIONAL STABILITY OF VINYLSILOXANETHER IMPRESSION MATERIAL

AFTER AUTOCLAVE STERILIZATION-AN IN VITRO STUDY.

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Dental Materials
Original Article

DIMENSIONAL STABILITY OF VINYLSILOXANETHER IMPRESSION

MATERIAL AFTER AUTOCLAVE STERILIZATION – AN IN VITRO STUDY
1
AIMAN KHAN
2
MUMTAZ-UL-ISLAM
3
TAHIR ALI KHAN
ABSTRACT
Dental impressions are often neglected in clinical practice as a source of spread of infectious
diseases. In Pakistan more than fifty percent of the clinicians do not disinfect impressions. Blood and
saliva contaminated impressions should be either disinfected or sterilized before further handling.
Aim of this study was to determine effect of autoclave sterilization on the time dependent dimension-
al stability of vinylsiloxanether impression material. Impressions of stainless steel die (ADA/ANSI
specification No. 19), were made of Vinylsiloxanether. Out of 40 specimens, half were allotted to group
A and were autoclaved at 134ºC AND 20 psi for 5 minutes. Rest of the specimens (Group B) served
as a control. Dimensional changes were calculated for two time intervals i.e. after one hour and af-
ter twenty-four hours. Samples were scanned and images were analyzed by using Adobe reader XI
(AcroRd 32) software. Paired t-test showed significant difference (p = 0.007) between readings at first
hour (-0.047%) and twenty fourth hour (0.084%) in group A. Whereas independent t-test showed no
significant difference in group A and B for both time intervals i.e. at first hour (p = 0.162) and twenty
fourth hour (p = 0.148). It was concluded that Vinylsiloxanether can be sterilized in an autoclave
without any deleterious change in dimensions.
Key Words: Vinylsiloxanether, Autoclave sterilization, Elastomers, Dimensional stability.

INTRODUCTION Therefore, microorganisms from the oral cavity are

able to survive on the surface of impression material
One of the commonest procedures that can lead to
and are thus can contaminate the cast.5-7
transmission of infection between patients and labo-
ratory technicians is dealing with dental impressions. Rinsing with water, disinfection and sterilization
Apart from general dental practice, prosthodontic are the various methods in use for cross infection control.
procedures are gaining more affirmation regarding Rinsing dental impressions under water is not sufficient
pathogenicity of hepatitis B virus (HBV), herpes, tu- for the removal of pathogens.8 Disinfection of the impres-
berculosis (TB), acquired immunodeficiency syndrome sion materials is strongly advised by American Dental
(AIDS) and pneumonia.1 Human Immunodeficiency Association (ADA) and Centres for Disease Control
Virus (HIV) related oral abnormalities are present in (CDC).9 Disinfection methods effects the dimensional
30-80% of the HIV-infected individuals and few of the stability of the impressions, thus it remained a subject
lesions are said to be contagious.2 HBV and HIV can of interest for many researchers, who used variety of
persist viably on non-living surfaces for more than a approaches.10 Inability of disinfection procedures to
week.3 Seventy two percent of the dental impressions destroy bacterial spores makes autoclaving the more
receiving at laboratories yielded growth of bacteria, with desirable method for sterilization.11
a median number of 130 colony forming units (CFU).4
Amongst the variety of impression materials avail-
1
Aiman Khan, Assistant Professor – Science of Dental Materials, able, Addition silicone (Vinyl polysiloxane) is very well
BDS, MPhil, Sardar Begum Dental College and Hospital, Gand-
hara University, University Town, Peshawar, Pakistan
known for their excellent dimensional stability and
Cell: 0332-9001222 Email: [email protected] precise detail reproduction.12 The storage temperature
2
Mumtaz-ul-Islam, BDS, MHR, Sardar Begum Dental College and recommended by manufacturers, for dental impres-
Hospital, Gandhara University, University Town, Peshawar, Pa-
kistan Email: [email protected]
sions is 15-23°C Where as addition silicones remained
3
Tahir Ali Khan, Professor – Science of Dental Materials, BDS, stable at 134°C without any significant change in its
MDSc, MHR, Sardar Begum Dental College and Hospital, Gand- dimensions.13-17 Where as their inherent hydrophobic
hara University, University Town, Peshawar, Pakistan
Email: [email protected]
nature and low tear strength are the chief drawbacks
Received for Publication: July 31, 2015
associated with addition silicones. On the other hand
Approved: August 25, 2015 Polyether impression materials are hydrophilic and

Pakistan Oral & Dental Journal Vol 35, No. 3 (September 2015) 535
 Dimensional stability of vinylsiloxanether

stable materials but they are quite expensive, bitter in pouches (A.R. Medicom Inc. Hong Kong) and were steam
taste and have high elastic modulus.18 A new elastomeric sterilized in an autoclave (Glow Pak International,
impression material, Vinylsiloxanether was introduced S. No. 487, Italy) at 134ºC and 20psi for 5 minutes.23
in early 2009 which combines the countenance of ad- Specimen of Group B (control group) were only washed
dition silicone and polyether impression material.19, 20 under tap water for 10 seconds and dried. All specimens
were stored for twenty-four hours in moisture free,
Autoclaving of elastomeric impression materials
transparent polyethylene bags at room temperature
is a new idea which will help in attaining complete
of 28 ± 2ºC.
sterility, thus will lend a hand in eliminating one of the
causes of cross contamination among laboratory per- Digital pictures of all the specimens were obtained
sonnel and a standard protocol will be advised to break by using scanner (HP DeskJet 2050 J510),10 at three
the cycle of indirect transmission of infection through time intervals i.e. soon after their making, after one
dental impressions. This study will focus on the time hour of intervention and after twenty-four hour storage
dependent changes in dimensions of Vinylsiloxanether period. The resolution of 600dpi (dots per inch) was used.
after being autoclaved. As there is lack of published Images were analyzed by Adobe reader XI (AcroRd 32)
work on this material, it provides an extensive range software.24 Distance between the crosslines (cd and c'd')
for further inquiry. was measured with accuracy of 0.01mm. Data obtained
were analyzed by SPSS version 16 software. A statisti-
METHODOLOGY cal tool was applied to evaluate data at 95% confidence
A metallic test block was fabricated according to interval (P value ≤ 0.05). Paired student’s t-test was
ADA specification number19 and International Stan- applied to determine difference between mean initial
dards Organization (ISO) Standard 4823 designed for and final values of each group separately. Intergroup
the evaluation of Non-Aqueous, Elastomeric Dental comparison was done by using independent t-test.
Impression materials.21 It consisted of three parts:
RESULTS
Ruled block, impression material mold and riser
(Fig 1). Specimens of Group A showed mean dimensional
change of -0.04710% after one hour of autoclaving
Vinylsiloxanether (Identium® - Kettenbach, Ger-
and 0.08495% after twenty four hours. Group B mean
many) elastomeric impression material having type 2
dimensional change of 0.04235% and -0.00320% was
medium-bodied consistency and fast setting type was
observed for same time intervals respectively (Fig
used. Pre-packed Cartridge (1:1, 50ml, Identium® - Ket-
2). Paired T test was applied to group A and B to
tenbach, Germany) along with the static mixing tip was
determine changes in linear dimensions before and
loaded into the auto mix cartridge dispenser (1:1 - 3M
after autoclaving at one hour and twenty four hours
ESPE). Mold was filled with mixed material extruding
interval (Table 1). Percentage dimensional changes at
from the mixing tip in a zigzag pattern, Where as the
two different time intervals i.e. at first hour (-0.047%)
tip remained buried in the material to avoid air entrap-
after autoclaving and at twenty fourth hour (0.084%)
ment. It achieved in ≤ 45 seconds, i.e. the working time
showed a statistically significant difference (p =
recommended by manufacturer. After that mold was
covered immediately with polyethylene sheet followed
by a glass slab (weighing 75 ± 5 grams), plus a 500g Ruled block Impression Material Mold Riser

weight, was placed over it to standardize the pressure X Y Z

on the impression material during setting. Assembly 12.5

c d

was then transferred into a water bath (Zhengji HH-S4 A A B B C C

Jiangsu, China) maintained at 32 ± 2°C (open mouth 12.5

c' d' 38.0

temperature) and allowed to set. Riser was used to

remove the recorded impression from the mold. Total 2.5
5.0
30.00D
30.00D 29.97D

40 impression specimens were prepared and divided 29.97D

into two groups each containing twenty specimens 3.0

(n=20). Where α = 0.05 and power = 80. 22 Specimens 0.5 CLA

having all three lines recorded continuously for the full

length of 25 mm between cross lines were included in 31.0
3.0
the study. Where as those having air bubbles / voids 6.0

incorporated in 20µm wide line, were excluded.

Section A-A Section B-B Section C-C

Specimens of group A were washed under tap wa-

Fig 1: Section A-A: Ruled block, section B-B: impres-
ter for 10 seconds and allowed to dry. They were then
sion material mold, section C-C: Riser (*All measure-
packed in 57mm x 130mm self sealing sterilization
ments are in milimeters)21
Pakistan Oral & Dental Journal Vol 35, No. 3 (September 2015) 536
 Dimensional stability of vinylsiloxanether

0.10% between percentage dimensional changes at twenty-four

hours (p = 0.148).
0.08%

DISCUSSION
Percentage dimensional change

0.06%

0.04% Among presently available dental impression

one hour materials, the dimensional stability and accuracy of
addition silicone and polyether is widely accepted.25,26
0.02%
twenty-four hours
0.00% Vinylsiloxanether is the hybrid of addition silicone and
-0.02%
Group A Group B
polyether elastomeric impression materials; therefore
we discuss the parent components.27
-0.04%
Present study evaluated Vinylsiloxanether material
-0.06%
for time dependent linear dimensional change after
Fig 2: Percentage dimensional change in Group A & B autoclave sterilization. Dimensional change is discussed

TABLE 1: PAIRED T TEST FOR GROUP A AND B

Paired differences t df Sig. (2-

95% Confidence tailed)
Interval of the
Difference
Mean Std. devi- Std. error Lower Upper
ation mean
Group % dimensional -.132050 .196420 .043921 -.223978 -.040122 -3.007 19 .007
A change at 1hour &
24 hours
Group % dimensional .031250 .164792 .036849 -.045875 .108375 .848 19 .407
B change at 1 hour
& 24 hours
TABLE 2: INDEPENDENT T TEST FOR PERCENT DIMENSIONAL CHANGE BETWEEN GROUP A & B

Levene's Test t-test for Equality of Means

for Equality of
Variances
F Sig. t Df Sig. (2- Mean Std. 95% Confidence
tailed) differ- Error Interval of the
ence Differ- Difference
ence
Lower Upper
After Equal varianc- 1.511 .227 -1.425 38 .162 -.08945 .06278 -.21654 .03764
1 hour es assumed
After Equal varianc- 3.974 .053 1.476 38 .148 .08815 .05972 -.03274 .20904
24 es assumed
hours

0.007). Percentage dimensional changes at two dif- in terms of expansion and shrinkage along with the
ferent time intervals i.e. at first hour (0.042%) and at accuracy of samples. In this study Vinylsiloxanether
twenty fourth hour (-0.003%) for control group showed was found to be dimensionally stable after autoclaving.
no statistically significant difference (p = 0.407).
Group A showed shrinkage of specimens, when
Independent T test was applied for inter group observed after one hour of autoclaving. Results were
comparisons (Table 2). Percentage dimensional changes consistent with the study of Ramakrishnaiah et al
at one hour were compared between group A and group in which the polyvinylsiloxane showed contraction
B, the difference was not statistically significant (p = after autoclave sterilization. According to their study
0.162). Similarly no significant difference was found shrinkage was attributed to the loss of chemical con-
Pakistan Oral & Dental Journal Vol 35, No. 3 (September 2015) 537
 Dimensional stability of vinylsiloxanether

stituents from the elastomers when subjected to high nificant changes in dimensions of addition silicones
temperature of autoclave.11 Generally polymerization were also observed after autoclaving by Xu et al17
shrinkage, loss of volatile components, loss of water, and Surendra et al.34 The only significant difference
and lack of elastic recovery are considered the main was found between one hour and twenty-four hours
reasons for contraction in elastomeric materials.19 dimensions (P=0.007) but this difference was within
the acceptable range of ADA specification as also been
Specimens in Group A showed expansion after
previously concluded by Surendra et al.34
24 hours. Nissan et al explained that this expansion
was due to the environmental factors as the polyether Purk et al found clinically significant change in
material (Impregum) expanded during storage.28 Me- dimensions of addition silicones in comparison to poly-
gremis et al reported alteration in dimensions of an ether when evaluated at different storage temperatures
impression material because of storage temperature e.g. -10, 24 and 66ºC.35 Corso et al studied effect of
and humidity factor.29 During 24 hours storage period temperature changes on the dimensional stability of
average ambient humidity was 63.6%. Variations in polyvinylsiloxane and polyether. Storage of both ma-
environmental humidity lead to loss or gain of water terials at 4ºC for 24 hours and then allowing them to
by the material e.g. in polyethers due to their hydro- attain room temperature showed slight expansion which
philic nature, according to Mandikos et al.30 Endo and was partly compensated by polymerization shrinkage.
Finger studied effect of humidity (0%, 33%, 50%, 75%, Polyether impression material showed slight expansion
and 100%) on the dimensional accuracy and found that from 40ºC to room temperature.36
polyether materials were significantly affected by raise
in humidity level Where as addition silicones had no CONCLUSION
adverse effects on their dimensions.31 Within the limitations of this study it was concluded
Jacob et al noticed expansion of polyether impres- that Vinylsiloxanether remained dimensionally stable
sion material under dry condition.32 Where as Walker after autoclave sterilization. Though a significant
et al found no expansion of polyether impressions under difference was found between dimensions at one
moist condition.33 Therefore Jacob et al concluded that hour and twenty four-hours, but still they meet
expansion of polyether impression material appeared the requirements for dimensional stability by ADA
to be material dependent, i.e. significant differences specification number 19.
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CONTRIBUTION BY AUTHORS
1 Aiman Khan: Main author in writing.
2 Mumtaz-Ul-Islam: Data collection/discussion.
3 Tahir Ali Khan: Supervised the project.

Pakistan Oral & Dental Journal Vol 35, No. 3 (September 2015) 539

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