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mpression material selection depends on the procedure at hand and the clinicians preference. Alginate, an aqueous hydrocolloid, was developed during the 1940s. Recently, alginate substitutes have been introduced as an alternative to alginate materials.
comfortable removal of the set impression, giving it a softer feel during removal similar to that of an alginate impression. The elasticity of alginate substitutes is also such that the set material recovers its shape following any distortion of the set impression during its removal. Dimensional Stability Alginate substitutes, together with other VPS materials, are the most dimensionally stable impression materials. Alginates shrink as they dry out, and absorb/imbibe water and other liquids when exposed to these, while alginate substitutes do not and are less sensitive to temperature and humidity. Alginates also dry out from within even if they are kept moist to prevent surface drying water exudes from the internal areas of the impression to the surface, again resulting in shrinkage. The dimensional stability of alginate substitutes allows for impressions to be stored for extended periods of time and poured later. Alginate substitutes can be poured up to 14 days after an impression is taken, allowing transport to the laboratory and pouring of the model at leisure. It has been recommended that alginate substitutes be poured at least 60 minutes after taking the impression, to allow for outgassing of the material rst that might otherwise result in small surface porosities and imperfections. In contrast, with regular alginates, model pouring should occur within 30 minutes of the impression being taken
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(note however that extended-storage alginates that allow pouring 48 hours after impression-taking and storage for 100 hours). Multiple Pours Alginate substitutes allow for multiple pours, while the majority of alginate impression materials are suitable for only one pour or at most two pours. The ability to perform multiple pours is desirable for record models in addition to the models being used as well as in situations where the rst pour resulted in errors. A further aspect with model pouring is that, in contrast to alginate substitutes, if alginates are left attached to the set model for extended periods of time (instead of being removed shortly after the model has set), this can result in fracture of the model when the alginate is removed as it would have continued to shrink while attached to the model. Accuracy and Detail Reproduction Alginate substitutes are more accurate than alginates (although the level of accuracy demanded of an impression for indirect restorations is not required for the clinical indications for which alginates are used). They are also more suitable for impressions for removable prosthetics due to their level of accuracy. Detail reproduction and smoother model surfaces are achieved using alginate substitutes. Their use has been shown to increase the accuracy of models of opposing dentitions used during the traditional laboratory fabrication of indirect restorations, resulting in superior results and potentially less chairside time for adjustments at the seating appointment. A smoother surface can also be expected to result in a smoother provisional restoration fabricated using an alginate substitute matrix, and the extended shelf life of the set impression means that the same impression can be used to fabricate a second provisional restoration should this become necessary. Ease of Use Substitute alginates are available with singleuse mixing tips that mix the impression material in the required ratio as the two pastes are extruded from the double-barrel tube of impres-
Summary
Alginate substitutes offer several advantages compared to alginates, and have been described as superior replacements for these. They are dimensionally stable, offer the ability to perform multiple pours, are more accurate and result in improved detail reproduction. Although more expensive than alginate materials they are still relatively low cost and cost-effective, easy to use and reliable.
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sion material into the tip. This auto-mixing during extrusion increases accuracy by avoiding incorrect ratios of materials (paste/paste or, in the case of alginates, powder/water), avoids mess and clean-up, and makes substitute alginates easy to use. Some alginate substitutes are also available in packages designed for use with an automated mixing machine.
References
1. Baxter RT, Lawson NC, Cakir D, Beck P, Ramp LC, Burgess JO. (2012) Evaluation of Outgassing, Tear Strength, and Detail Reproduction in Alginate Substitute Materials. Operative Dentistry. 2012;37(5):540-7. 2. Boksman L. Point of care: how do I minimize the amount of occlusal adjustment necessary for a crown? J Can Dent Assoc. 2005;71:494-495 3. Centers for Disease Control and Prevention. Guidelines for Infection Control in the Dental Healthcare Setting, 2003. 4. Carvalhal CI, Mello JA, Sobrinho LC, Correr AB, Sinhoreti MA. Dimensional change of elastomeric materials after immersion in disinfectant solutions for different times. J Contemp Dent Pract. 2011 Jul 1;12(4):252-8. 5. Estafanous EW, Palenik CJ, Platt JA. Disinfection of bacterially contaminated hydrophilic PVS impression materials. J Prosthodont. 2012 Jan;21(1):16-21. 6. Walker MP, Burckhard J, Mitts DA, Williams KB. Dimensional change over time of extended-storage alginate impression materials. The Angle Orthodontist. 2010;80(6):1110-5.
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