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 Table of Contents  
ORIGINAL RESEARCH
Year : 2021  |  Volume : 13  |  Issue : 1  |  Page : 65-70

Variability of dimensional stability of different interocclusal recording materials according to time: A comparative in vitro study


1 Department of Stomatology Rehabilitation, Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru; Posgraduate Unit, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
2 Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru
3 Posgraduate Unit, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
4 Department of Stomatology Rehabilitation, Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru
5 Department of Stomatology Rehabilitation, Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru; Postgraduate Department, Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru

Date of Submission10-Aug-2020
Date of Decision31-Aug-2020
Date of Acceptance21-Sep-2020
Date of Web Publication28-Jan-2021

Correspondence Address:
Dr. Frank Mayta-Tovalino
Postgraduate Department, Faculty Health of Sciences, Universidad Cientifica del Sur, Av. Paseo de la República 5544, Miraflores 15074, Lima.
Peru
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jioh.jioh_277_20

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  Abstract 

Aim: The aim of this study was to assess variability of dimensional stability of different interocclusal recording materials according to time in a comparative in vitro study. Materials and Methods: This was an experimental in vitro study. The sample was made up of n = 80 intermaxillary records. To record dimensional stability, it used a high-precision device manufactured according to specification No.19 of the American Dental Association. Measurement of discrepancies was recorded with a precision digital caliper (0.01 mm). The intermaxillary recording materials were placed inside the metal device as follows: The silicone by addition was injected using a system of cartridges and special mixing tips and Godiva was immersed in hot water (40–45°C) for 5 min to soften them. Inferential statistical analysis was performed with ANOVA and Bonferroni test, with a level of statistical significance of P < 0.05. Results: Aluwax and Godiva wax presented linear dimensional changes from the time the intermaxillary record was taken and increased with storage time. Occlufast silicone remained stable for up to 7 days (0.120 ± 0.015) mm, while Futar D silicone was stable for up to 22 days (–0.028 ± 0.009) mm. Conclusion: Silicones and polyvinyl siloxanes presented greater dimensional stability than the godiva and Aluwax (Futar D silicone being more stable than the Occlufast silicone). Finally, Godiva presented greater dimensional stability than the Aluwax because it presented the greatest dimensional variation over time with respect to the other materials.

Keywords: Dental Occlusion, Dimensional Stability, Intermaxillary Record, Polyvinylsiloxane


How to cite this article:
Lozano F, Sanchez F, Agüero P, Munive-Degregori A, Ambrocio E, Mayta-Tovalino F. Variability of dimensional stability of different interocclusal recording materials according to time: A comparative in vitro study. J Int Oral Health 2021;13:65-70

How to cite this URL:
Lozano F, Sanchez F, Agüero P, Munive-Degregori A, Ambrocio E, Mayta-Tovalino F. Variability of dimensional stability of different interocclusal recording materials according to time: A comparative in vitro study. J Int Oral Health [serial online] 2021 [cited 2021 Feb 27];13:65-70. Available from: https://www.jioh.org/text.asp?2021/13/1/65/308363


  Introduction Top


Direct interocclusal records with or without dental contact are the most commonly used to record the intermaxillary relationship. These records must accurately reproduce the details of the occlusal surfaces in a way that allows their repositioning in the articulator, and therefore, they should not present discrepancies.[1] Lack of precision and variation in dimensional stability results in errors in the diagnosis and treatment of patients.[2],[3],[4]

The American Dental Association considers some waxes, eugenol zinc oxide paste, self-curing acrylic resin, addition silicones, polyethers, and polyvinyl siloxanes as clinical materials for intermaxillary recording.[3],[4],[5],[6],[7] Many studies have evaluated the physical properties of these materials and have concluded that the precision and dimensional stability depend not only on their composition (material properties), but also on the techniques used to record. An ideal intermaxillary recording material is easy to handle, has minimal dimensional changes, does not produce any tooth movement or tissue displacement, does not generate adverse effects on oral tissues, is easy to verify and offers adequate resistance to dental closure during record taking.[7],[8],[9],[10],[11],[12]

The most widely used interocclusal registration materials are made from wax, zinc, and eugenol oxide, although the introduction of new elastomeric materials on the market has currently generated new alternatives for selection and use in the intermaxillary registry. Elastomeric materials are chemically similar to impression materials that have been used for many years, thus achieving good precision results.[6],[7],[8],[9] For example, Godiva is a dental material made up of a mixture of wax, thermoplastic resin, and a coloring agent. It has a melting temperature above which the material softens to form a smooth mass and below which it reaches its rigid phase. Also, it can be softened by immersion in a hot water bath to make a good dental impression. However, the ideal material for interocclusal registration must allow intraoral placement to achieve correct occlusal registration, and these registration materials have to be dimensionally stable.[2],[3],[4],[5],[6]

Since there is little literature evaluating dimensional stability over time, the objective of this study was to assess variability of dimensional stability of different interocclusal recording materials according to time in a comparative in vitro study.


  Materials and Methods Top


Study design

This was an experimental in vitro, longitudinal study. The sample was calculated using the Stata 15.0 software Texas, USA (mean comparison formula) with an alpha of 0.05 and a beta of 0.8. An (n = 80) intermaxillary recording material was determined following the American Dental Association specifications. The CRIS Guidelines (Checklist for Reporting In-vitro Studies) in Dental research (Dental Materials) were used to write this manuscript.

Group allocation

The following materials were used:

Aluwax ™ Bite and Impression Waxes––Aluwax Dental Products Co, USA.

Godiva from Kerr Hawe ™ (KE60064), Thermoplastic Bar Impression, USA.

Occlufast Rock (C200726), Zhermack, Italy.

Futar D (11961), Kettenbach, Spain.

The following groups were formed:

Group 1: 20 records of Aluwax wax.

Group 2: 20 records of Godiva (Rigid impression material).

Group 3: 20 records of Occlufast silicone.

Group 4: 20 records of Futar D silicone.

Dimensional stability

To record the dimensional stability of intermaxillary recording materials: Aluwax, Godiva, Occlufast and Futar D silicones [Figure 1]. A high precision stainless steel cylindrical device was used which was manufactured following ADA specification No. 19[9],[10],[11],[12] [Figure 2]. The intermaxillary recording materials were placed inside the metal device as follows: The silicone by addition was injected using a system of cartridges and special mixing tips (provided by the manufacturers of the silicone by addition) and an automatic applicator gun kit (DMA50 1: 1 and 2: 1 Plunger) for silicone.[11]Godiva and Aluwax were placed manually directly into the metal device. The investigator’s hands and a glass plate of dimensions 10cm x 10cm were covered with disposable polyethylene (R&G) gloves that avoided any type of contamination that prevented the correct polymerization of the intermaxillary recording materials.[12],[13]
Figure 1: Intermaxillary recording materials (Aluwax, Godiva, Occlufast, Futar D.)

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Figure 2: Three high-precision parts of the metal device: device body or work area, drive disc, and ring or cylinder

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Interoccusal registration with silicones

After the silicones were injected into the metal device through the mixing tips, the glass plate covered with the polyethylene glove was placed on the surface of the recording silicone (Occlufast and Futar D). An external weight of 500 g plus the weight of the glass plate simulated the moderate mandibular closing force of 1kg.[12],[13],[14],[15] The metal device with the intermaxillary recording material (silicone), the glass plate covered in polyethylene and the external weight were dipped in a water bath at a temperature of 36 ±1°C (which simulated the temperature of the open mouth) for a period of 3 min. After 3 min, it was removed from the water and the record taken was dragged [Figure 3].
Figure 3: Registration procedure

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Interocclusal registration with Godiva

Godiva was immersed in hot water (40–45°C) for 5 min to soften them.[14],[15] Once softened, a ball was made with the material and they were placed in the metal device and due to the weight that simulates the moderate mandibular closing force at the time of recording (1kg), the impression of the metal device surface. The temperature at which the Godiva was softened was recorded using a digital thermometer (measuring range –50°C to + 300°C). The metal device with the intermaxillary recording material, the polyethylene covered glass plate and the external weight were immersed in a water bath at a temperature of 36 ± 1°C (which simulated the temperature of the open mouth) for a time 3 min. After 3 min, it was removed from the water and the record taken was dragged.[4],[5],[6]

Interocclusal registration with Aluwax

Circles of the same diameter and thickness of the metal device were made [Figure 4]. Once softened, it was placed inside the metallic device and for the correct impression of the measuring surface, the glass plate and the external weight were placed, simulating the moderate mandibular closing force at the time of recording (1kg). The metal device with the intermaxillary recording material, the polyethylene covered glass plate and the external weight were immersed in a water bath at a temperature of 36 ± 1 ° C (which simulated the temperature of the open mouth) for a time 3 min. After 3 min, it was removed from the water and the record taken was dragged.[16],[17]
Figure 4: Metal device, digital thermometer, polyethylene gloves, and high precision digital caliper

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For each group, 20 records were taken that were kept at room temperature (28 ± 2°C) isolated from humidity using hermetic bags 15cm long x 10cm wide[16],[17] [Figure 5]. Five measurements were made in each registry: at different times after the registry was taken. To facilitate measurements, each of the records was labeled with the sample number and the time they were made. The discrepancies were measured with a high precision Mitutoyo (Igashi, Japan) brand digital caliper with a graduation of 0.01 mm. This caliper allowed the scales to be rotated by means of an external ring.
Figure 5: Storage of the recording obtained

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Statistical analysis

The results were analyzed using descriptive and inferential statistics. The descriptive analysis consisted of obtaining central tendency measures (arithmetic mean) and dispersion measures (standard deviation), while inferential analysis was performed using the ANOVA test and the post hoc analysis with Bonferroni test because the data they had normal distribution (Shapiro Wilk test). The level of statistical significance was established with a P < 0.05. All analyzes were performed with Stata 15.0 software (Texas, USA)


  Results Top


[Table 1] shows that in relation to Aluwax, Godiva, the greatest variability was presented on day 22 with (0.256 ± 0.010; 0.213 ± 0.009) mm. However, Occlufast and Futar D silicone had the lowest variability of dimensional stability on day 22 with 0.072 ± 0.010 and –0.028 ± 0.009 mm respectively. This indicates the great precision and dimensional stability that these silicones maintain over time.
Table 1: Variability of the dimensional stability of the different materials for intermaxillary recording over time

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On the other hand, all groups were normal because the P value was > 0.05. Therefore, when the inferential statistical analysis was performed with the ANOVA test, it was evidenced that there were statistically significant differences between the variability of dimensional stability as the evaluation time increased [Graph 1].
Graph 1: Linear dimensional stability of materials for intermaxillary recording over time

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A post hoc analysis was performed to determine if the linear dimensional variation over time was the same or different among the different materials for intermaxillary recording. The Bonferroni test found statistically significant differences among the dimensional variations of the Aluwax, Godiva, Occlufast and Futar D materials according to time (P < 0.001) [Table 1].


  Discussion Top


Interocclusal registration materials are used to determine the intermaxillary relationship of the mouth[4] During the restorative phase of any dental treatment, optimal inter-occlusal registration and precise recording of the diagnosis are essential for good prosthetic rehabilitation.[18],[20] Currently, the creation of new biomaterials for interocclusal registration means that knowledge must be renewed regarding which material has the best routine clinical performance for the precise registration and transfer of existing occlusal records. In the world of dentistry, different materials are introduced for interocclusal registration with different marks because of this; the usefulness of the material is unclear due to the lack of in vitro or in vivo studies that predict the property of the material with useful recommendations.[12]

Proper use of materials and techniques can minimize mismatches in future dental prostheses and clinical errors, making strict selection of the most adequate recording material for each case essential.[9] The materials most commonly used to record occlusal records are as follows: wax, plaster, zinc-eugenol oxide paste, among others,[4],[5],[6] although elastomeric materials based on polyether and polyvinylsiloxane have recently been introduced.[7]

In the study by Anup et al.[1] polyvinyl siloxanes were found to be dimensionally more stable than Aluwax wax. These results are similar to those obtained in the present study with measurements at different times. In addition, Ashistaru et al.[2] found that the polyvinyl siloxanes are more precise and therefore presented less dimensional change over time, which agrees with the results obtained in this study. Likewise, the results obtained in the study carried out by Walker et al.[10] showed that silicones are dimensionally more stable than other intermaxillary recording materials. In addition, it was determined that Aluwax wax shows great dimensional changes over time. However, the results obtained by Tejo et al.[12] showed that silicones undergo greater dimensional stability variation over time compared to other materials. The present study showed that the polyvinyl siloxanes presented better dimensional stability compared to the other intermaxillary recording materials.

The comparison of the dimensional stability of intermaxillary recording materials showed that these materials undergo linear dimensional changes over time, which is consistent with previous studies comparing the dimensional stability of various materials for intermaxillary recording. Futar D and Occlufast intermaxillary registration addition silicones showed the least variation in linear dimensional stability. The study by Freilich et al.[21] outlined the general principles for selecting interocclusal records. In addition, other studies evaluated the effects of storage and concluded that materials may be affected by shrinkage of silicone-based impression materials due to evaporation.[11] Tejo et al.[12] evaluated the time-dependent linear dimensional stability of 3 inter-occlusal recording materials and concluded that polyether bite registration materials showed less distortion with good dimensional stability compared to polyvinyl siloxane and eugenol zinc oxide at 1, 24, 48, and 72 h.[19]

On the contrary, the study by Patel et al.[20] reported that Ramitec (polyether) showed minimal dimensional stability after immersion in 2% glutaraldehyde solution for 60 min, and zinc oxide with eugenol showed the maximum dimensional stability when immersed in 2% glutaraldehyde and 5% sodium hypochlorite for 60 min. Furthermore, Aluwax showed maximum dimensional stability when immersed in 5% sodium hypochlorite for 60 min. O-Bite (polyvinyl siloxane) showed maximum dimensional stability when immersed in 2% glutaraldehyde and 5% sodium hypochlorite for 10 min. An increase in the dive immersion time increases dimensional inaccuracy. However, our results are different from that described by Tejo et al.[12] whom mentioned a significant difference between the dimensional stability of the three materials at different intervals with a P < 0.05. The polyether record material showed less distortion with good dimensional stability compared to the polyvinyl siloxane record (Jetbite), zinc oxide eugenol record at 1, 24, 48, and 72 h.

The interocclusal recording materials used in our study were chosen based on the scientific literature[22],[23],[24] and the frequency with which they are used by dentists. However, one of the limitations of this study was that measurements of the variation in dimensional stability of the intermaxillary recording materials were only performed using a digital caliper, although there are other more expensive methods that can provide smaller measurements. however, this did not preclude measurements in units at the micrometer level. Another limitation was that since it was a purely experimental in vitro study, it was not possible to simulate all the variables present in the mouth of the patients at the time of taking intermaxillary records; therefore, studies of another methodological design are needed to observe the behavior of these materials in the stomatognathic system.

Conclusion

According to the results of the study, addition silicones and polyvinyl siloxanes presented greater dimensional stability than Godiva and Aluwax (Futar D silicone being more stable than the Occlufast silicone). Godiva presented greater dimensional stability than the wax of metallic components. Aluwax presented the greatest dimensional variation over time with respect to the other materials. Below, the clinical significance of this study is that dentists will be able to demonstrate the interocclusal registration material with greater precision. This is very important for a correct intermaxillary registration, especially in more complex clinical cases.

Future scope

The importance and scope of this study is that it evidenced that a correct intermaxillary registration is based on its precision. Therefore, it is important to know the characteristics of the intermaxillary registration materials used in our daily clinical practice, and specifically the linear dimensional stability to be able to use the most appropriate registration material.

Acknowledgement

We wish to thank the Universidad Nacional Federico Villarreal, Universidad Nacional Mayor de San Marcos and Universidad Cientifica del Sur (UCSUR) for constantly supporting us in the elaboration of the present manuscript.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Authors contributions

Study conception (FL, FS, and PA), data collection (FL, FS, PA, and EA), data acquisition and analysis (FL, FS, and FMT), data interpretation (FL, FMT, AMD, and FS), and manuscript writing (AMD, FL, PA, EA, FS, and FMT).

Ethical policy and institutional review board statement

This experimental in vitro study has no ethical implications because it only works with dental materials, for which it was exonerated from review.

Declaration of patient consent

Not applicable.

Data availability statement

The data of the study results are available from the author (Dr. Felipe Lozano email: [email protected]) on request.

 
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