Dentsply Sirona’s recently introduced Aquasil Ultra+ Smart Wetting Impression Material (Figure 1), an upgrade in the well-established Aquasil line of polyvinyl siloxane impression materials, has been specially designed to help clinicians in 3 key areas.
First, impression materials used intraorally need to work in the presence of moisture (ie, be hydrophilic), not just when cured but more importantly when uncured. To provide hydrophilicity where it’s needed most, in the mouth, Aquasil Ultra+ features a market-leading low contact angle as tested on uncured samples at intraoral relative humidity. This translates to improved accuracy of impressions, potentially leading to better-fitting restorations that require less chairside adjustments.
Second, impression materials must be strong at the time of mouth removal to prevent tearing. Impression material is syringed into a sulcus, creating thin cross sections, and when adequate gingival retraction is not created around equigingival and subgingival preparations, these small extensions of material can be at greater risk for tearing. To prevent tearing thin extensions of material and the loss of precious detail, Aquasil Ultra+ offers market-leading tear strength at both mouth removal and after 24 hours of setting. This bolsters clinician confidence, knowing that the material placed into the mouth will be completely retrieved and allow lab technicians the opportunity to create extremely accurate working models.
Third, no one impression material can satisfy the infinite number of clinical situations. For single-unit cases, a fast-set material may be ideal, but for larger prosthetic cases or removable denture impressions, options for setting times and viscosities may be needed. Aquasil Ultra+ offers 5 viscosities (xtra-light, light, medium, heavy, and rigid), 2 setting times (fast and regular), and several delivery options (the digit Targeted Delivery System, 50-mL cartridges, and DECA cartridges). With all these variations, clinicians can match the most appropriate viscosity, timing, and delivery for each specific clinical situation.
Clinical Case Example
A 32-year-old female patient presented for a full-coverage restoration on tooth No. 3. After local anesthesia was achieved, the tooth was carefully prepared to meet the reduction guidelines for Celtra Duo (ZLS), a zirconia-reinforced lithium-silicate material—in this case, a 1.0-mm circumferential shoulder was created with axial wall and occlusal reductions of 1.0 to 1.5 mm and 1.5 mm, respectively (Figure 2).
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| Figure 1. Aquasil Ultra+ Smart Wetting Impression Material. | Figure 2. Final preparation of tooth No. 3 for Celtra Duo (ZLS) crown. |
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| Figure 3. Syringing Aquasil Ultra+ XLV Fast Set Wash Material around tooth No. 3 using the cartridge delivery system. (Note: syringe the wash material from the margins to occlusal/incisal surface, keeping the syringe tip within impression material during delivery, and push material forward while | Figure 4. Evaluating the Aquasil Ultra+ final impression. |
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| Figure 5. Apply a thin layer of Calibra Universal Self-Adhesive Resin Cement to the inside of the final crown. | Figure 6. After tack-curing for 5 seconds on the buccal and lingual surfaces, the excess cement is easily removed from the marginal and interproximal areas. |
A small amount of Aquasil Ultra+ XLV (xtra-light) Fast Set Wash Material was bled outside the mouth, then immediately syringed around the moist preparation using the digit system (Figure 3). Care was taken to quickly but precisely place the wash material around the preparation and seat the tray containing Aquasil Ultra+ Heavy Tray Material within the 35-second working time. Not exceeding the material’s working time helps to mitigate mixing errors that can result in pulls or drags within the impression, causing poor detail reproduction. After waiting the minimal mouth removal time, in this case 2.5 minutes from the start of mix, the impression was removed from the patient’s mouth and evaluated for errors (Figure 4).
Approximately 2 weeks later, the patient re-turned for delivery of the final Celtra Duo restoration on the tooth. The provisional was removed, and the tooth preparation cleaned of excess cement. After treating the intaglio of the restoration and creating an isolated environment for adhesion, a thin uniform amount of Calibra Universal Self-Adhesive Resin Cement was applied to the inside of the crown, and the restoration was immediately seated onto the tooth (Figure 5). Tack curing and removal of excess cement was accomplished after 5 seconds of light curing on both the buccal and lingual surfaces (Figure 6). Once cleanup and final set of the cement was complete, final occlusion and interproximal contacts were checked, and the patient was released.
Dr. Goodchild is chairman of the department of diagnostic sciences at the Creighton University School of Dentistry, located in Omaha, Neb, and a Dentsply Sirona Restorative clinical education manager.
