Assessment of tissue conditioning materials for

functional impressions
Mahmoud Khamis Abdel Razek, B.Ch.D., M.S. *
Alexandria University, Faculty of Dentistry, Alexandria, Egypt

1 issue conditioning materials were introduced erties of four types of temporary soft materials used
about 18 years ago.’ Wilson and associates’ defined a in prosthetics (Coe-Comfort,* Tempo,? Ivoseal,$
conditioning material as a soft material which is and Ardees). They concluded that none of these
applied temporarily to the fitting (basal) surface of a materials is ideal either for conditioning or for
denture to distribute the load equally, thus permit- functional impressions, since all possess flow and
ting mucosal tissues to return to their normal some recovery; that is, they are viscoelastic. Another
contours. Starcke and associate? defined the materi- disadvantage of these materials is that their softness
al as a soft, resilient, temporary reliner which acts by and recovery change considerably as the specimens
reducing and evenly distributing stress on the muco- age. Wilson and associates considered that the future
sa of the basal seat. It thus has a rehabilitating effect development of these materials should be along two
on unhealthy tissue and allows reversible conditions separate lines, one for conditioners and the other for
to return to their normal states of health. functional impression materials. They believed that
A functional impression material is one which is the two should not be combined as one material.
applied to the basal surface of a denture to make an However, Chase’ and Starcke and associate?
impression under functional stress,’ or it is a material concluded that tissue conditioning materials have
applied to the tissue (basal) surface of a denture or been found useful as functional impression materials.
an impression tray to record the topography and A functional impression technique in which the
position of the basal seat and border tissues as they impression was left in the mouth overnight was
exist in the functional state.” described by Vig.’ The patient was asked not to
The exact composition of these conditioning ma- chew solid or hot food. At the present time there is
terials is not available, but the primary ingredients little agreement about the best method of using
are believed to be similar. Braden” suggested that tissue conditioning materials as functional impres-
Hydrocastf and Coe-CornfortS are composed of a sion materials.7-1o This was the stimulus of the
liquid of carboxylic esters and an acrylic resin present investigation.
powder. Travaglini and associate9 stated that the
Justi treatment reliners has an ethyl alcohol liquid PURPOSE OF THE STUDY
and polyethyl methacrylate powder. Wilson and This study was undertaken to determine:
associates? reported that Coe-Comfort and Tempo1 1 1. The validity of tissue conditioning materials as
have liquids containing ethanol and a plasticizer of compared with two commonly used impression
dibutyl phthalate. The powders are acrylic resin materials.
polymers. 2. The effect of the following factors on the
Controversy exists regarding the use of tissue accuracy of these impressions: (a) the thickness of
conditioning material as a functional impression material, (b) the amount of time necessary to make a
material. Wilson and associates’. ’ studied the prop- good impression, and (c) the best time interval before
pouring the impression.
*Associate Professor, Department of Prosthodontics.
tKay See Dental Mfg. Co., Kansas City, MO. *Coe Laboratories Inc., Chicago, Ill.
$Coe Laboratories Inc., Chicago, Ill. ?Lang Dental Mfg. Co., Chicago, Ill.
IH. D. Justi and Sons, Inc., Chicago, Ill. $Ivoclar AG Schaan, Liechtenstein.
/ILong Dental Mfg. Co., Philadelphia, Pa. $Reliance Dental Mfg. Co., Chicago, Ill.

376 OCTOBER 1979 VOLUME 42 NUMBER 4 0022.3913/79/100376 + 05$00.50/O 8 1979 The C. V. Mosby Co.
TISSUE CONDITIONING MATERIALS FOR IMPRESSIONS

Fig. 1. The two tissue conditioning products used in the study

Fig. 2. The two impression materials used in the study

MATERIALS AND METHODS seat was made with five cone-shaped posts 2 mm
The tissue conditioning materials studied in this high, one at the incisive papilla region (.4 ). two at the
investigation were described by the manufacturer as first premolar regions (B and C). and two at the
being suitable for functional impressions. They were second molar regions (D and E). These posts were
(1) C&-Comfort and (2) Visco-Gel* (Fig. 1). Two used as measuring points in comparing the experi-
commonly used impression materials were also mental data with the original cast.
included. They were (1) a rigid impression material Two acrylic resin trays and occlusion rims with
(zinc oxide-eugenol impression paste)* and (2) an accurate borders were constructed for the master
elastic impression material (Regular Permlastic cast. One tray provided a I.5 mm space for the
rubber base)? (Fig. 2). impression material, and the second provided a 3.0
A master maxillary edentulous cast was con- mm space (Fig. 4).
structed. The anatomic surface consisted of a The master cast was mounted on the upper
chrome-cobalt basal seat to which an acrylic resin member of a hinge articulator. The tray with the 1.5
base was poured (Fig. 3). The chrome-cobalt basal mm wax spacer was placed on the master cast. The
rim and the lower arm of the articulator were
*Amalgamated Dental. London, England. lubricated. Dental stone was poured over the lower
j’Kerr Mfg. Co., Romulus, Mich. arm of the articulator, which was closed until 1 mm

THE JOURNAL OF PROSTHETIC DENTISTRY 377

 RAZEK

Fig. 3. The master maxillary cast. A, B, C, D, and E are

measuring points used to compare the experimental data Fig. 5. The tissue conditioning material is in the tray
with the original cast. with the articulator closed to pin contact.

ture. After mixing, the material was distributed

evenly over the tissue surface and borders of the tray
with a cement spatula. It was then seated on the
lower core of stone, and the articulator was closed
until the pin returned to its contacting position (Fig.
5). When testing Visco-Gel, a very thin coat of the
lubricant furnished with the material was applied
over the master cast. For zinc oxide-eugenol impres-
sions, the master cast was oiled. Coe-Comfort or
rubber base impressions did not need a separating
medium.
The following characteristics of the materials were
considered :
The relation between the time of compression, the thickness
of the impression, the time of pouring, and the accuracy of the
impression. After the material set, following the manu-
Fig. 4. The acrylic resin trays with occlusion rims
provide a 1.5 mm space and a 3.0 mm space for the test facturers’ directions, the impression was removed
materials. and poured immediately in dental stone. The setting
times recommended by the manufacturer for the
of the rim was immersed in the stone. The pin of the four materials were followed. For each impression
articulator was adjusted to hold the vertical opening. material, this technique was repeated five times
After the stone set, the articulator was opened and using trays with spaces of 1.5 mm and 3.0 mm.
the lower core of stone removed from the lower The same technique was repeated again as before,
member of the articulator. The same technique was but the five impressions of each material were
repeated in the tray with 3 mm space, using the same poured after waiting 2, 5, 24, or 48 hours at room
vertical opening. The wax spacer was then temperature. There were 50 impressions for each
discarded. The impression surface was cleaned and impression material, resulting in 200 impressions for
dried carefully. all (Table I).
The two tissue conditioning materials and the two The same procedure was repeated but the Visco-
impression materials were mixed and used according Gel and Coe-Comfort impressions were left on the
to the manufacturers’ recommendations. All impres- articulator for 2 hours and then removed and poured
sions were made at 37°C controlled room tempera- immediately. This procedure was repeated five times

378 OCTOBER 1979 VOLUME 42 NUMBER 4

TISSUE CONDITIONING MATERIALS FOR IMPRESSIONS

for each impression material in trays with 1.5 mm Table I. No. of impressions made by the four
space and 3.0 mm space. types of impression materials
All the impression techniques were again
repeated, but casts were poured after standing for 2, Using a tray Using a tray Total
Time of with a space with a space No. of
5, 24, or 48 hours on the bench. There were 50 pouring of 1.5 mm of 3.0 mm impressions
Visco-Gel impressions and 50 Coe-Comfort impres-
sions (Table II). Immediate 5 5 40
2 hours 5 5 40
The same technique was repeated, but the impres-
5 hours 5 5 40
sions were left compressed on the articulator for 24
24 hours 5 5 4c
hours, then poured immediately, after 2, 5, 24, or 48 48 hours 5 .5 40
hours. There were 50 Visco-Gel impressions and 50 Total 200
Coe-Comfort impressions (Table II).
The same technique was repeated again, but the Table II. No. of impressions made by L’isco-Gel
impressions were left compressed on the articulator and Coe-Comfort
for 48 hours and then poured immediately, after 2,5,
24, or 48 hours. There were 50 Visco-Gel impressions Compression time (hours)
and 50 Coe-Comfort impressions (Talbe II).
2 24 48
Testing the validity of V&o-Gel and Coe-Comfort impres-
1.5 3.0 1.5 3.0 1.5 3.0
sions as duplicating materials. The Visco-Gel and Coe-
Timeof mm mm mm mm mm mm
Comfort impressions which were compressed until pouring space space space space space space Total
the material had set and those compressed for 2
hours were poured 10 times. There were 400 casts in Immediate 5 5 5 .5 5 5 60
2 hours 5 5 5 5 5 5 60
all (Table III).
5 hours 5 5 5 5 5 5 60
24 hours 5 5 5 5 5 5 60
Measurements
48 hours 5 5 5 I 5 5 60
Measurements of the master cast and the 900 Total 300
stone casts were made between the centers of the
posts and designated as AB, AC, AD, AE, BC, and Table III. No. of casts made in test B
DE. All measurements were subjected to statistical
analysis. 1.5 mm 3.0 mm
space tray space tray
RESULTS
No. of Poured No. of Poured Total
The results of this investigation agree with Peyton impres- 10 imps- 10 No. of
sions times SiOOS times casts
and associates’” in that zinc oxide-eugenol paste and
rubber base impressions can be considered to be Setting time
reasonably stable in dimension. It was found that compression 5 50 5 50 200
when casts obtained from zinc oxide-eugenol paste 2 hours
and rubber base impressions were compared with the compression 5 50 5 50 200
Total 400
master cast, there was no significant difference
between the dimensions of the two groups. In spite of
that, casts obtained from zinc oxide-eugenol paste eugenol paste or rubber base impressions and those
impressions using a tray with a space of 3.0 mm and obtained from Visco-Gel and &e-Comfort impres-
poured immediately, or within 5 hours, have dimen- sions. This applied whether trays with 1.5 mm or 3.0
sions closer to that of the master cast than those with mm space were used or whether setting time or a
1.5 mm space. compression of ‘2 hours was applied. The difference
The reverse of this result was obtained with rubber was significant when 24 hours or 48 hours of
base impressions. Casts obtained from an impression compression was employed. This confirms that
in a tray with a space of 1.5 mm and poured at any Visco-Gel and Coe-Comfort materials are valid as
time have dimensions closer to that of the master cast impression materials.
than those with a tray of 3.0 mm space. The results of this investigation also emphasized
There was no significant difference between the that there was no significant difference between
dimension of casts obtained from either zinc oxide- dimensions of the casts obtained from second, fifth,

THE JOURNAL OF PROSTHETIC DENTISTRY 379

 RAZEK

or tenth pourings of V&o-Gel and Coe-Comfort 6. Both kinds of materials tested can be used as
impressions and the first pouring, whether the duplicating materials under certain conditions.
setting time compression or 2 hours of compression
were made in a tray with 1.5 mm or 3.0 mm space REFERENCES
(the t-test showed no significant differences). This 1. Chase, W. W.: Tissue conditioning utilizing dynamic adop
indicates that the two materials can be used as tive stress. J PROSTHET DENT 11:804, 1961.
duplicating materials. 2. Wilson, H. J., Tomlin, H. R., and Osborne, J.: Tissue
conditioners and functional impression materials. Br Dent J
SUMMARY AND CONCLUSIONS 121:9, 1966.
3. Starcke, E. N., Fischer, T. E., and Sweeney W. T.: Physical
The validity of two types of tissue conditioning properties of tissue-conditioning materials as used in func-
materials was studied and compared with that of two tional impressions. J PROSTHE,T DENT 27:111, 1972.
commonly used impression materials. The effect of 4. Wilson, H. J., Tomlin H. R., and Osborne, J.: The assess-
three important factors on the accuracy of the ment of temporary soft materials used in prosthetics. Br Dent
J 1:303, 1969.
impressions was observed. These factors were thick-
5. Braden, M.: The composition, structure, and flow properties
ness of the impression material, time of compression of functional impression materials (tissue conditioners). Dent
of the impression, and the time interval before Pratt l&301, 1966.
pouring the impression. 6. Travaglini, E. A., Gibbons, P., and Craig, R. G.: Resilient
A chrome-cobalt master cast was specially liners for dentures. J’ PROSTHET DENT 10:664, 1960.
7. Vig, R. G.: A modified chew-in and functional impression
designed and 500 impressions were made and
technique. J PROSTHET DENT 14:214, 1964.
poured, resulting in 900 casts. 8. Pound, E.: Preparatory dentures: A protective philosophy. J
Conclusions reached from this investigation were PROSTHET DENT 15:5, 1965.
that: 9. Walson, R. M.: The use of tissue conditioner for obturator
1. Visco-Gel and Coe-Comfort tissue conditioning impression. Br Dent J 124:226, 1968.
10. Tucker, K. M.: Relining complete dentures with the use of
materials can be used as impression materials.
functional impressions. J PROSTHET DENT 16~1054, 1966.
2. The dimensional accuracy of Visco-Gel is 11. Peyton, F. A., Asgar, K., Charbeneau, G. T., Craig, R. G.,
better than that of the Coe-Comfort impressions. and Myers, G. E.: Restorative Dental Materials, ed 3. St.
3. There is no significant difference between using Louis, 1968, The C. V. Mosby Co., pp 181-188, 200-207.
a tray with a space of 1.5 mm or 3.0 mm for the
Reprint requests to:
impression material.
DR. MAHMOUD KHAMIS ABDEL RAZEK
4. The less bulky the impression, the less time is ALEXANDRIA UNIVERSITY
required for compression with fewer inaccuracies. FACULTY op DENTISTRY
5. It is preferable to pour the cast in the impres- ALEXANDRIA, EGYPT
sion immediately or within 2 hours.

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380 OCTOBER 1979 VOLUME 42 NUMBER 4