Journal of Advanced Clinical and Research Insights

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Interocclusal recording materials: A review
  JCRI
REVIEW ARTICLE
Interocclusal recording materials: A review
Sushant A Pai, Krishna Gopan, Keerthi Ramachandra, Smitha B. Gujjar, K. Karthik
Department of Prosthodontics including Crown and Bridge, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Cholanagar, Hebbal, Bengaluru, Karnataka, India
Correspondence: Dr. Krishna Gopan, Department of Prosthodontics including Crown and Bridge, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Cholanagar, Hebbal,Bengaluru, Karnataka, India.
E-mail: krishnagopan17@gmail.com
Received: 10 January 2019 ;
Accepted: 14 February 2019
doi: 10.15713/ins.jcri.251
 
ABSTRACT
To achieve a successful prosthesis, it is important to achieve harmony between the maxillomandibular relationships. This does not pertain only to the opening or closing but is a complex relationship which exists in three dimensions. Hence, it is very important to record this relationship with the least possible error to obtain a successful prosthesis. To record this maxillomandibular relationship, numerous materials are in use and what matters are the precision of the recording materials and their stability. This article seeks to present a review of major bite registration materials and their modification as well as their advantages and disadvantages.
Keywords: Accuracy, bite registration materials, dimensional stability, interocclusalrecording materials
How to cite this article: Pai SA, Gopan K, Ramachandra K,Gujjar SB, Karthik K. Interocclusal recording materials:A review. J Adv Clin Res Insights 2019;6:20-23.
 
 

Introduction

Precise articulation of casts is essential for proper diagnosis, treatment planning, and successive prosthetic rehabilitation of the patient. In few cases, the casts can be easily mounted in maximal intercuspation by upholding them with hand articulation, while in others, it is necessary to record maxillomandibular relationship using relevant interocclusal recording medium and meticulously transfer it to the articulator.[1]

Any imprecision in maxillomandibular records leads to unwanted errors in the final prosthesis.[1] Numerous materials and methods are being used for interocclusal registration procedures since the first maxillomandibular registration material was introduced by Philip Pfaff, in 1956. Materials that have been intended for intermaxillary recording procedures include plaster, modeling compound, waxes, acrylic resin, zinc oxide-eugenol pastes,[2] rubber base, and silicone materials.[3] Newer ones include polyether and polyvinyl siloxane for ideal maxillomandibular registration.

Requirements for ideal interocclusal recording materials
  1. Requirements for ideal interocclusal recording materials include: Initial resistance to closure should be finite.
  2. Dimensional stability after the final set of the recording material should be proper.

 
  1. Post-polymerization, there must be resistance to compression.
  2. Easiness of manipulation.
  3. It should be biocompatible with the tissues involved in the recording procedures.
  4. The inciso-occlusal surface of the teeth should be recorded precisely.
  5. Ease of verification.

There is no material, however, that has all the properties as a "classical" intermaxillary registration medium. The inaccuracies attributed to the maxillomandibular records can be categorized into three as follows:

The biologic characteristics of stomatognathic system, material manipulation, and the properties of the intermaxillary recording media.[4]

At present, the most commonly used materials for bite registration are polyether and polyvinyl siloxane followed by zinc oxide eugenol.

Other bite registration materials are as follows:
Plaster, modeling compound, waxes, and acrylic resin.

Plaster

Anciently, impression plaster has been used as a maxilla-mandibular recording material. Calcinated calcium sulfatehemihydrate was one of the main constituents and this reactedto form a rigid mass of calcium sulfate dihydrate on mixing withwater (Combe, 1975). Berman (1960) found plaster (1) freeflowing, (2) it broke easily as the mix required for the registrationwas thin, and (3) lack of attachment.

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Interocclusal recording materials: A review Pai, et al.

Skurnik (1969) said working with plaster was complicatedand not conducive to a neat and clean field of operation. Inaddition, on removal from the mouth plaster may fracture, ifundercuts were present. Craig (1975) noted the launch of theelastic materials, the popularity of dental impression plaster haddiminished.[5]

Dental Waxes

Dental wax may be hard or soft, thick or thin, or heated orchilled throughout its bulk without uniformity. Once the recordis made, it is subject to being blunted, distorted, scraped, andcompressed. At best, the basic variable nature of wax hinders itsusefulness as a recording and transferring material for SO criticala relationship. The material used to achieve this important centricrelation record has much to do with its resultant accuracy. Thechoice of recording medias cut down to plaster, wax, modelingcompound, and zinc oxide and eugenol impression paste. Plasterflows readily but breaks easily, lacks adherence, and vital parts ofit may be lost since it has to be mixed thin. Modeling compoundand wax hold many comparable characteristics. Nonetheless,wax has achieved the extensive recognition for gaining themaxillomandibular record.[5]

Zinc Oxide Eugenol

Zinc oxide eugenol was discovered by Bonastre, in 1837;Chisholm has used it later on in the field of dentistry in 1876.ZoE paste is an effective intermaxillary recording material. Theprimary components of many zinc oxide-eugenol pastes werestuck to zinc oxide, eugenol, and rosin. Many additives such asplasticizers, fillers, accelerators, and other substitutes were addedto bring in the properties required for different products.[5]

Advantages

Fluidity before setting - fluidity is a critical quality of a biterecording material because it provides nominal interference withmandibular closure during record making procedures.
  • Adherence to its carrier.
  • After final set, there is rigidity and inelasticity.
  • Accuracy in recording occlusal and incisal surfaces of theteeth.
  • High intensity of repeatability.

Disadvantages
  • Long setting time.
  • Highly brittle.

Accuracy of the registration material may exceed the accuracyof the casts resulting in proper fit.[6]

 
Zinc oxide and eugenol type of bite registration paste isone material of choice for the maxillomandibular record. Thismaterial can be mixed to a proper fluid consistency, offeringno resistance to closure, and adheres to its carrier. It sets toa hard, non-compressible consistency and is sharp and easilyread. Articulation of the casts may be accomplished accuratelywithout fear of distortion or compressing the record unevenly inthe vertical dimension.[7]

Gurav et al. in a study stated that the comparison ofdimensional stability showed that zinc oxide eugenol andpolyether were more dimensionally stable followed by silicone.[4]

Polyether

Polyether impression material is an elastic type material, as isthe polysulfide and silicone materials. These materials havedemonstrated good accuracy in clinical evaluations and arethixotropic, which provide good surface detail. The polyethershave low-to-moderate tear strength and much shorter workingtime and setting times, which can limit the usefulness of thematerial.

The flow characteristics and flexibility of the polyethermaterials are the lowest of any of the elastic materials. Thesecharacteristics can limit the use of polyethers in removable partialdenture impression procedures. The stiffness of the materialcan result in cast breakage when removal of cast from customtray is attempted. These materials have a higher permanentdeformation than addition reaction silicones. Some have anunpleasant taste, and the material will absorb moisture, it cannotbe immersed in disinfecting solutions or stored in high humidityfor any extended period of time.[8]

There were many studies conducted on evaluating theprecision of polyether occlusal bite registration materialcompared to other commercially available bite registrationmaterials.

In a study conducted by Joshi et al. concluded that Ramitecpolyether bite registration material is the most handy materialwhen compared with commonly used modeling wax during thetooth preparation.[9]

Owen and Goolam recommend that polyethers should not beimmersed for duration surpass 5 h because they may expand.[10]

Silicones

Silicones are synthetic compounds. The chain is composedof silicon and oxygen linked to form a 16 siloxane chain. Themolecular weight was determined by the length of the siloxanechain, and thus, silicone character was affected. Viscosity of thematerial increased with increase in the length of siloxane chains.Furthermore, polymer properties were affected by cross-linking,as observed in silicone resins and rubbers. When the materialwas stressed, sliding of polymer chains over one another wasprevented by a small degree of cross-linking. Thus, there was anincrease in the elasticity of the material.

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Pai, et al. Interocclusal recording materials: A review

Extreme cross-linking affected hardness and chemicalreactivity and during setting, dimensional changes occurred.Polymerization affected shrinkage, also the loss of alcohol as thesetting reaction proceeded (Philips, 1973).[5]

Merchant et al.[11] found that polysulfide and vinyl polysiloxanedid not show any dimensional change after immersion for halfan hour in different disinfectant solutions. Measurements werecarried out with a Boley gauge and a micrometer and the resultswere duplicated in a following study using a digital electroniccaliper.[12]

Vinyl polysiloxane impression material was tested by Tohet al. after immersing in 16 disinfectant solutions for 30 min andfound that there were changes in dimension post-immersion inthe iodophors and the glutaraldehyde except one.[13]

Soganci et al. in a study stated that dimensional accuracy andstability of two elastomeric impression materials, polyether andvinyl polysiloxane, are alike when immersed in two differentdisinfecting medias. Dimensional changes in impressionmaterials may not occur with small time period (maximum 24 h).It can be concluded that both elastomers are superior and alike.Further clinical studies need to be carried out to stimulate oralenvironment.[14]

According to a study conducted by Godbole, the effect ofultraviolet (UV) radiation on dimensional stability of vinylpolysiloxane materials was not significant. Before and afterdisinfection with UV light, there was no difference in dimensionalstability of impression.[15]

Anup et al. in a study stated that, among all materialstested, polyvinyl siloxane showed more accuracy, at differenttime intervals followed by zinc oxide eugenol and Aluwax,respectively.[16]

Conclusion

During restorative phase of any dental treatment, the properarticulation of patient's diagnostic or working casts is essentialfor fabrication of clinically acceptable prosthesis. Apart from theoperator's clinical capability and the procedure followed, thematerial chosen can affect the accuracy of the bite registrationand thereby ultimate outcome of the restoration.

Bite registration materials such as wax and zinc oxideeugenol are used for registering intermaxillary relationship. Theintroduction of polyether and polyvinyl siloxane bite registrationmaterials has made clinicians unclear of which material to beused. These elastomeric materials are chemically identical tothe impression materials that have been used for many years.To increase the chance of success of the recording properties,alterations have been made by adding plasticizers and catalystto bring in different handling characteristics; however, itremains anonymous whether these modifications in the parentimpression materials have modified their properties such asaccuracy and dimensional stability.

Polyether bite registration paste is gaining acceptance dueto its ease of manipulation and accuracy. Polyether exhibitedoutstanding flow characteristics than addition silicone andwaxes.

 
Numerous techniques and bite registration materials forrecording the maxilla-mandibular relations are described inthe dental literature, but there is little agreement between thematerials and their correlation with dimensional stability andaccuracy post-impression techniques.

To summarize, in the past 2-3 decades, many new materialshave been introduced along with new techniques. Many ofthese materials have shown promising results, but clearly, thereis a need for long-term studies to identify the best material forobtaining the better or best maxilla-mandibular relations or theinterocclusal records.

References
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  2. Michalakis KX, Pissiotis A, Anastasiadou V, Kapari D. Anexperimental study on particular physical properties of severalinterocclusal recording media. Part 1: Consistency prior tosetting. J Prosthodont 2004;13:42-6.
  3. Dua PM, Gupta SH. Evaluation of four elastomericinterocclusal recording materials. Med J Armed Forces India2007;63:237-40.
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  10. Owen CP, Goolam R. Disinfection of impression materials toprevent viral cross contamination: A review and protocol. Int JProsthodont 1993;6:480-94.
  11. Merchant VA, McNeight MK, Ciborowski CJ, Molinari JA.Preliminary investigation of a method for disinfection of dentalimpressions. J Prosthet Dent 1984;52:877-9.
  12. Herrera SP, Merchant VA. Dimensional stability of dentalimpressions after immersion disinfection. J Am Dent Assoc1986;113:419-22.
  13. Langenwalter EM, Aquilino SA, Turner KA. The dimensionalstability of elastomeric impression materials followingdisinfection. J Prosthet Dent 1990;63:270-76.
  14. Soganci G, Cinar D, Caglar A Yagiz A. 3D evaluation of the effectof disinfectants on dimensional accuracy and stability of twoelastomeric impression materials. Dent Mater J 2018;37:1-10.

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  1. Godbole SR. Evaluation of the effect of ultraviolet disinfectionon dimensional stability of the polyvinyl silioxane impressionsan in vitro study. J Clin Diagn Res 2014;8:ZC73-6.

 
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