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IMPRESSION TECHNIQUES AND MATERIALS USED FOR FIXED PARTIAL DENTURE FABRICATION: A SURVEY AMONG GENERAL DENTAL PRACTIONER AND SPECIALISTS IN SINDH.

Byline: IMRAN SAMEJO, IRFAN AHMED SHAIKH and ERUM BEHROZ

ABSTRACT

The purpose of this study was to evaluate which impression materials and techniques are used for fixed partial denture fabrication among general dental practitioners and specialists in Sindh. In this cross sectional study, 06 structured questionnaires regarding fixed partial denture impression materials and techniques were prepared. Questionnaires were distributed randomly among 150 specialists and general dental practitioners in Sindh.

In this study the response rate was 84%. The material of choice for diagnostic impression was irreversible hydrocollide among specialists 91% and general dental practitioners 25%. Complete arch tray was most commonly used by specialists (78%) and general dental practitioners (88%). To expose the finish line, 91% of the specialists used gingival retraction cord with chemical and most of the general dental practitioners were not using gingival cord 84%. The most common material of the choice for impression after tooth preparation was additional silicon and alginate used by specialists (52%) and general dental practitioner 76% respectively. Type III dental stone was used by specialists (83%) and type II by general dental practitioners (88%). Articulation of cast prior to sending laboratory by specialists and general dental practitioners was 74% and 18% respectively.

Long term success of fixed partial denture is based on materials and techniques. Most of the prosthodontist used recommended impression materials and techniques. Ideal materials and techniques were not followed by general dental practitioners which may lead to compromised and failure of final prosthesis.

Key Words: Survey, fixed partial denture, impression materials, impression technique, specialists, general dental practitioners.

INTRODUCTION

The missing teeth can be replaced by removable partial denture, dental implant, ceramic or metal-ceramic or ceramic fixed partial dentures and resin-bonded fixed partial dentures.1 Dental implants and resin bonded fixed partial denture are the most suggested treatment options, when the nearby teeth are available in ideal position with proper occlusion.2-3 Nevertheless, fixed partial dentures are usually used due to their economical, substantial durability, aesthetics, satisfactory retention and no desire for surgery.4-5

Successful fixed partial dentures in oral rehabilitation depends on impression making and pouring.6

Impression materials should have proficiency to imitate soft and hard tissues around prepared and adjacent teeth in order to gain mechanically, biologically, functionally and aesthetically satisfactory restorations.7 There are few elements such as tooth preparation design, soft tissue management, tray selection, impression material and techniques that influence the final impression quality.8-10 A range of impression trays including prefabricated metal or plastic stock trays are used to record a full or partial arch for fabrication of fixed partial dentures.9

Conventionally, custom trays are encouraged for fixed partial dentures. Accurate casts have been produced by custom trays rather than stock trays as reported by most investigators.11 Prefabricated dual arch tray is most commonly used now a days in order to record the abutments, opposing teeth, adjacent teeth and the maximal intercuspation for fixed partial denture. Other benefits of dual arch impression are accurate record, patients are comfortable, less time and material is required.12 Several elastic impression materials have been used for fixed partial denture such as hydrocolloid, polysuphide, condensation silicone, polyvinylsiloxane and polyether.6,10,13 Alginate hydrocolloid is a popular impression material due to its low cost and easy mixing technique as compared to other elastomers.

Majority of professionals have not been using alginate for fixed partial denture because of its poor dimensional stability and unsatisfactory details.10 During impression making, one of the most challenging feature of fixed partial denture is management of gingival tissues.14-15

Accurate record of finish line can be achieved when gingival sulcus is widened enough in order to provide access for impression material to reach the subgingival margins.16-17 Three principle methods are existing for soft tissue retraction including mechanical, chemo-mechanical and electrosurgical.18-21 The chemo-mechanical technique is doubtless the most extensively used but it is time consuming and can lead to postoperative discomfort, inflammation and marginal recession.20

Different techniques such as single copper band system, monophase, single-step and double-step have been accounted for making of impression for fixed partial denture.22

Every material has its remunerations and drawbacks. Impression material is chosen by particular intraoral conditions. Though, none of these alone will guarantee an accurate impression.23

TABLE 1: PARTICIPANT RESPONSES IN RELATION TO IMPRESSION TECHNIQUES AND MATERIALS USED FOR FIXED PARTIAL DENTURE FABRICATION

Questions###Response options###GDP % (no)###SP % (no)

1-Which material do###Irreversible Hydrocolloid or alginate###25 (26)###91 (21)

you routinely use for Condensation silicone###0.0###4 (1)

diagnostic impres###Addition silicone###0.0###0.0

sions before tooth###Polyether###0.0###0.0

preparation?

###Polysulfide###0.0###4 (1)

###Not make diagnostic impression###75 (79)###0.0

2-Which tray do you###Dual arch tray###0.0###17 (4)

use for impression###Complete arch###88 (92)###78 (18)

making after tooth###Sectional tray###12 (13)###4 (1)

preparation?###Custom made acrylic tray###0.0###0.0

3-What do you prac-###Plain gingival retraction cord###0.0###0.0

tice routinely for gin Gingival retraction cord with chemical###16 (17)###91 (21)

gival retraction?###Electro surgery###0.0###0.0

###Laser###0.0###0.0

###Rotary curettage###0.0###0.0

###Not retract gingiva###84 (88)###9 (2)

4-Which material do###Condensation silicone###19 (20)###4 (1)

you routinely use for Addition silicone###5 (5)###52 (12)

impression after tooth Polyether###0.0###30 (7)

preparation?###Polysulfide###0.0###4 (1)

###Alginate Hydrocolloid###76 (80)###9 (2)

###Agar-Alginate Combination###0.0###0.0

###Agar Hydrocolloid###0.0###0.0

5-Which material do###Dental plaster (Type II)###88 (92)###17 (4)

you use for pouring###Dental stone (TYPE III)###12 (13)###83 (19)

impression?###Dental stone High strength (TYPE IV)###0.0###0.0

###Dental stone high strength, High expansion (TYPE V)###0.0###0.0

6-Do you articulate###Yes###18 (19)###74 (17)

the casts prior to###No###82 (86)###26 (6)

sending laboratory?

METHODOLOGY

A cross sectional study conducted among general dental practitioners (GDP) and specialists (SP) in Sindh, Pakistan. GDP included in the study were those who graduated as dentist and had completed minimum one-year house job. SP were those who had completed a postgraduate specialist program in prosthodontics and/or headmaster's degree. Participants also had to be currently engaged in private dental practice. The contact details of the clinicians were obtained from the office of Pakistan Dental Association. A questionnaire was prepared and randomly distributed among 150 General dental practitioners and specialists by hand, email and through post practicing in main cities of Sindh, Pakistan. The questionnaire was comprised of six multiple choice questions pertaining to techniques and materials used in the fabrication of fixed partial denture.

RESULTS

In this study the response rate was 84%. The material of choice for diagnostic impression was irreversible hydrocollide among specialists (91%) and general dental practitioners (25%). Complete arch tray was most commonly used by specialists 78% and by general dental practitioners 88%. To expose the finish line 91% of the specialists used gingival retraction cord with chemical and 84% of the general dental practitioners were not using gingival cord. The most common material of choice for impression after tooth preparation was additional silicon and alginate used by specialists (52%) and general dental practitioners 76% respectively. Type III dental stone was used by specialist (83%) and type II by 88% general dental practitioners. Articulation of cast prior to sending laboratory by specialists and general dental practitioners was 74% and 18% respectively.

DISCUSSION

Many surveys regarding complete denture and removable partial denture have been conducted in Pakistan. Regarding fixed partial denture no one survey has been conducted in Pakistan. Therefore this survey was conducted to know which materials and techniques are used by general dental practioner and specialist regarding fixed partial denture fabrication.

In present study 91% (21) specialists and 25% (26) general dental practitioners were using irreversible hydrocolloide impression material for making diagnostic impression. Most of the general dental practitioners (75%) were not making diagnostic impression. The most commonly used impression trays were complete arch tray which are used by specialists (78%) and general dental practitioners (88%).

Gingival retraction cord with chemical was the choice for 91% specialists and by 16% general dental practitioners. This is in agreement with previous surveys conducted in india.3 It was found in current survey that 52% of specialists and 76% of general dental practitioners used addition silicon and alginate for impression after tooth preparation respectively. These findings are in agreement with other surveys.3,8

Amongst the specialists and general dental practitioners 83% used type III dental stone and 88% used type II stone for pouring impression respectively. This is in contrast with previous surveys where 60% prosthodontists and 53% other practitioners used type IV and type III dental stone respectively. This might be due to cost effectiveness or the deficiency in the knowledge of the practitioners.3,8 Articulation of cast is not common in general dental practitioners, but most of the specialists articulated the cast prior to sending to laboratory.

CONCLUSION

Long term success of fixed partial denture is based on materials and techniques. Most of the prosthodontists used recommended impression materials and techniques. Ideal materials and techniques are not followed by general dental practitioners which lead to compromised and failure of final prosthesis.

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Title Annotation:Sindh, Pakistan
Author:Samejo, Imran; Shaikh, Irfan Ahmed; Behroz, Erum
Publication:Pakistan Oral and Dental Journal
Article Type:Report
Geographic Code:9PAKI
Date:Dec 31, 2016
Words:2317
Previous Article:LABORATORY TECHNIQUE OF "BOXING, BEADING AND POURING FINAL EDENTULOUS IMPRESSION" AN UNDERGRADUATE CURRICULUM BASED SURVEY.
Next Article:KENNEDY'S CLASSIFICATION - A STUDY DONE AT DOW INTERNATIONAL DENTAL HOSPITAL.
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