ORIGINAL ARTICLE
Dimensional s abili y o wo imp ession ma e ials a e a 6-mon h s o age
pe iod
F ancisco Ma ins
a
, Pa
ıcia B anco
a
, Jos
e Reis
a
, Ignacio Ba be o Na a o
b
and Paulo Mau
ıcio
a
a
O al Rehabili a ion Depa men , Ins i u o Supe io de Ci^
encias da Sa
ude Egas Moniz, Almada, Po ugal;
b
O al Medicine Depa men ,
Facul ad de Odon olog
ıa, Uni e sidad de Se illa, Se illa, Spain
ABSTRACT
Objec i e: O al ehabili a ion success is enhanced by an accu a e and ep oducible inal imp es-
sion. The pu pose o his s udy is o e alua e he dimensional changes o a polye he and add-
i ion silicone subjec ed o disin ec ion and/o s e iliza ion a e a long s o age pe iod.
Ma e ial and me hods: Nine y samples we e ob ained om polye he Imp egum
TM
Pen a
TM
(3M ESPE
TM
, See eld, Ge many) and 90 o addi ion silicone Imp in
TM
4 Pen a
TM
Pu y (3M
ESPE
TM
, See eld, Ge many) acco ding o ISO 4823:2000. The samples o each ma e ial we e spli
o o m h ee g oups wi h 30 samples each: a con ol g oup, a hypochlo i e g oup (disin ec ion)
and an au ocla e g oup (s e iliza ion). Samples we e s o ed in he Po uguese Ins i u e o
Quali y o six mon hs a 23 C. Samples we e measu ed by lase in e e ome y, acco ding o
he Michelson echnique be o e calcula ing dimensional s abili y acco ding ISO 4823:2000. A s a -
is ical analysis ia a h ee-way mixed ANOVA was pe o med.
Resul s: Signi ican sh inkage o Imp egum
TM
Pen a
TM
was 0.77 ± 0.17% in he con ol g oup,
0.42 ± 0.19% in he hypochlo i e g oup and 0.52 ± 0.28% in he au ocla e g oup. Fo Imp in
TM
4 Pen a
TM
Pu y, he con ol g oup had a sh inkage o 0.42 ± 0.12%, he hypochlo i e g oup
0.36 ± 0.09% and he au ocla e g oup 0.59 ± 0.13%.
Conclusions: The long- e m s o age o samples subjec ed o disin ec ion wi h 5.25% hypochlo -
i e o au ocla e s e iliza ion can be used in a clinical se ing as he dimensional changes a e
below he maximum pe mi ed by he ISO 4823:2000, since he e a e no clinically signi ican
changes in he dimension o he samples du ing he s o age pe iod.
ARTICLE HISTORY
Recei ed 7 June 2017
Accep ed 3 No embe 2017
KEYWORDS
Elas ome s; s e iliza ion;
lase in e e ome y
In oduc ion
Imp ession ma e ials a e p esen ly s ill a ele an
ma e ial o use in es o a i e den is y [1–3].
Imp essions a e used o ans e he in o ma ion om
he pa ien ’s mou h o a s one analog cas , which can
aid in making a diagnosis and a co ec ea men
plan, c i ical o he success o inal p os he ic es o -
a ion [4].
The imp ession ma e ial selec ed by he den is
mus p o ide good dimensional s abili y and p ecision
in de ail ep oduc ion. The ma e ial should no su e
changes du ing he disin ec ion o s e iliza ion p oc-
esses and should allow adequa e s o age s abili y o e
ime [5,6].
Elas ome s a e he mos commonly used imp es-
sion ma e ial in den is y [1]. Wi hin his g oup, poly-
e he s (PE) and addi ion silicones/ inyl polysiloxanes
(VPS) exhibi excellen dimensional s abili y agains
dis o ion unde a ious s o age condi ions [6].
Se e al au ho s demons a ed ha he e a e di e en-
ces be ween he wo ma e ials [4,7,8]. Unlike VPS, PE
has an hyd ophilic na u e, which can lead o he
abso p ion o wa e [4,7,8], and he cas ing o his
ma e ial should be conduc ed 1 h a e making he
imp ession [7–9]. The VPS may be cas immedia ely
a e emo al om he o al ca i y o weeks a e com-
ple ing he imp ession, since i is no suscep ible o
mois u e changes, and he e a e no p oduc s de i ed
om he polyme iza ion eac ion [5,9–13]. VPS
ma e ial exhibi s be e ep oduc ion o de ail and
g ea e dimensional long- e m s abili y when com-
pa ed o PE [4,5,9–13].
Imp ession ma e ials come in o con ac wi h po en-
ial sou ces o con amina ion, such as blood and sali a
ha migh con ain pa hogens [14]. Thus, o p e en
ansmission o in ec ious diseases (hepa i is B,
CONTACT F ancisco Ma ins [email p o ec ed] O al Rehabili a ion Depa men , Ins i u o Supe io de Ci^
encias da Sa
ude Egas Moniz,
Campus Uni e si
a io, Quin a da G anja - Mon e de Capa ica, 2829-511 Capa ica, Almada, Po ugal
ß2017 The Au ho (s). Published by In o ma UK Limi ed, ading as Taylo & F ancis G oup.
This is an Open Access a icle dis ibu ed unde he e ms o he C ea i e Commons A ibu ion-NonComme cial License (h p://c ea i ecommons.o g/licenses/by-nc/4.0/), which
pe mi s un es ic ed non-comme cial use, dis ibu ion, and ep oduc ion in any medium, p o ided he o iginal wo k is p ope ly ci ed.
ACTA BIOMATERIALIA ODONTOLOGICA SCANDINAVICA, 2017
VOL. 3, NO. 1, 84–91
h ps://doi.o g/10.1080/23337931.2017.1401933
hepa i is C, human immunode iciency i us, he pes,
ube culosis), i is undamen al o pe o m c oss-in ec-
ion con ol p ocedu es, such as s e iliza ion and dis-
in ec ion, by den al p ac ices and labo a o ies
[3,15,16].
Al hough he e a e se e al disin ec ion me hods
p oposed, chemical disin ec ion o imp essions by
imme sing in a disin ec an solu ion is conside ed he
mos p ac ical and eliable way [6,17]. The ADA ec-
ommends ha he molds mus be disin ec ed by soak-
ing wi h compa ible p oduc s [18]. The selec ed
disin ec an solu ion should demons a e high e ec -
i eness in he educ ion o pa hogenic mic oo gan-
isms wi hou in e e ing wi h he dimensional s abili y
o abili y o ep oduce de ails o he ma e ial [1,16].
Unlike disin ec ion, s e iliza ion is a p ocedu e ha
gua an ees he elimina ion o all mic oo ganisms [19].
The e is no uni e sally accep ed me hod o s e iliza-
ion, bu he li e a u e sugges s ha he au ocla e is
conside ed he mos e ec i e me hod [6,18], al hough
i s e ec s on he dimensional s abili y o he elas o-
me ic imp ession ma e ials a e no su icien ly
desc ibed in he li e a u e [20].
A e disin ec ion o s e iliza ion, he imp essions
a e cas in s one. The dimensional s abili y o he
imp ession ma e ials depends on he ime elapsed
be ween he comple ion o he imp ession and hei
cas ing, hus s o age ime is c i ical o ob ain eliable
cas s [21].
Se e al au ho s ha e s udied imp essions a e dis-
in ec ion o s e iliza ion [22–29] wi hou a clea
ag eemen . Some claim disin ec ion and s e iliza ion
has no ad e se e ec on he dimensional s abili y o
imp essions [15,24,30], while o he s poin o possible
ad e se e ec s [25,31].
Walke e al. [32] pionee ed he de elopmen o
s udies on he dimensional s abili y o long- e m
imp ession ma e ials, in oducing he a iable disin-
ec ion and s e iliza ion o ma e ials. He esea ch
p oposed a maximum s o age ime o silicones o
2 weeks; howe e , he li e a u e sugges s ha imp es-
sions can be eused weeks o mon hs a e he se ing
o he ma e ial [2,32,33]. Thus, he p esen s udy
seems o be inno a i e and app op ia e, since he e
a e no s udies co ela ing a 6-mon h s o age ime
along wi h he a iables o disin ec ion and
s e iliza ion.
The objec i e o his s udy is o e alua e he
dimensional changes o a VPS and a PE a e disin ec-
ion and s e iliza ion a e a 6-mon h s o age pe iod.
The null hypo hesis is ha he e is no dimensional
change o he ma e ials s udied, while he al e na i e
sugges s he e is dimensional change in he ma e ials
s udied a e disin ec ion and a e s e iliza ion a e a
6-mon h s o age pe iod.
Ma e ials and me hods
Fo his s udy, Imp in
TM
4 Pen a
TM
Pu y Imp ession
Ma e ial (3M ESPE
TM
, See eld, Ge many, Lo 549538)
as a VPS and as a PE, Imp egum
TM
Pen a
TM
(3M
ESPE
TM
, See eld, Ge many, Lo 559739).
The samples we e ob ained ollowing ADA speci i-
ca ion No 19 and ISO 4823:2000 p o ocol [34]. This
ISO speci ies he use o a block es , a speci ic me allic
cylind ical ma ix/block es and a me al ing/ ing
mold (Figu es 1 and 2). Bo h me al pieces we e
washed wi h deionized wa e in ul asound o wo
cycles and hen placed in an o en a 37 C o 15 min
p io o sample p oducing.
Figu e 1. Block es and ing mold made acco ding o ISO
4823:2000.
Figu e 2. Supe io iew o he block es . Lines 1 and 2 ha e
a wid h o 50 and 20 mic ons, espec i ely. Lines 3, 4 and 5
ha e a wid h o 75.
ACTA BIOMATERIALIA ODONTOLOGICA SCANDINAVICA 85
The VPS and PE we e manipula ed using he
au oma ic mixe Pen amix 2 (3M ESPE
TM
, See eld,
Ge many) in acco dance wi h he manu ac u e ’s
ins uc ions. The ob ained mix u e was dispensed in o
he ing-ma ix assembly. A igid me al pla e co e ed
wi h a shee o e hylene, was subsequen ly placed o e
he assembly, o ensu e i m sealing o he ma e ial in
he me al ma ix. A wo kilog am weigh was placed on
he shee co e ing he me al pla e so ha he ma e ial
was subjec ed o a cons an o ce du ing he se ing and
in o de o mimic he s eng h o he ope a o while
making an imp ession. The en i e assembly was
imme sed in a wa e ba h a 35 C o mimic he em-
pe a u e o he o al ca i y. To he se ing ime indica ed
by he manu ac u e o bo h he PE (3:15 min) VPS
(2:30 min), 3 min we e added o ensu e comple e poly-
me iza ion o bo h ma e ials.
A e he se ing o he ma e ials, hey we e
emo ed om he ba h. The samples we e sepa a ed
om he ma ix, labeled, washed and d ied wi h
blown ai . In o de o app o e a sample o es ing,
all samples we e obse ed unde a 4magni ying
glass Leica S e eo Zoom (Leica Mic osys ems,
We zla , Ge many) by a single calib a ed ope a o , in
o de o e i y he con inui y o he 75 mic on line. I
he e was a con inui y o he line, he sample was
accep ed.
Nine y (90) samples o each ma e ial we e ob ained
and andomly dis ibu ed in h ee g oups:
Sodium hypochlo i e a 5.25%g oup: he samples
we e subjec ed o chemical disin ec ion by imme -
sion in a sodium hypochlo i e solu ion a 5.25%
o 10 minu es.
Au ocla e g oup: he samples we e subjec ed o an
au ocla e s e iliza ion p o ocol in a 40-minu e
cycle a 134 C.
Con ol g oup: he samples we e no subjec o
any ype o s e iliza ion o disin ec ion p o ocol.
All samples we e measu ed wice, a e s e iliza ion
o disin ec ion (T0) and a e a 6-mon h s o age (T1).
Con ol g oup samples we e measu ed a e being
ob ained and a T1. The measu emen p o ocol
ollowed he guidelines o ISO 4823:2000. A S emi
2000-C s e eomic oscope (Ca l Zeiss, Obe kochen,
Ge many) wi h a 12magni ica ion c oss hai e icle,
equipped wi h a XY able (only used o s abilizing he
sample).
These ins umen s we e moun ed on ca ha uns
on a SIP3002M (Soci
e
e Gene oise DIns umen s de
Physiques, Gene a, Swi ze land) ail. The ca also has
a mi o o e lec he lase beam.
As he ca mo es ho izon ally on he ail, i allows
o all measu emen s o be made on he same axis
wi h a HP
V
R
5508 A (Hewle Packa d, San a Cla a, CA)
Michelson in e e ome e wi h an accu acy o 10 nm.
Fo each sample, he dis ance om he e ical
lines 4 and 5 was measu ed h ee imes o each ho i-
zon al line (1, 2, and 3), o ensu e ep oducibili y o
he me hod (Figu e 2), making a o al o nine meas-
u emen s in each sample. The same measu emen
me hod was applied o he mold be o e he imp es-
sions we e made in o de o calcula e he dimensional
change. The pe cen age o dimensional change o
each specimen was calcula ed acco ding o he o -
mula p esen ed by ISO 4823:2000:
DL¼L1 L2
L1
100
whe e L1 ep esen s he dis ance measu ed be ween
he wo e ical lines (4 and 5) on he mold and L2
ep esen s he dis ance measu ed be ween he e ical
lines (4 and 5) on he samples.
The samples we e s o ed in he me ology depa -
men o he Po uguese Ins i u e o Quali y a
20 ± 2 Ca 70%humidi y.
The da a we e in oduced o IBM SPSS S a is ics
so wa e – e sion 20.0. (IBM SPSS S a is ics,
A monk, NY) A s a is ical analysis ia h ee-way
mixed ANOVA was pe o med. The p esence o s a -
is ically signi ican di e ences o s a is ically signi i-
can in e ac ion be ween g oups is accep ed in
acco dance wi h he le el o signi icance p<.05.
Resul s
F om he 180 samples, a o al o 3240 measu emen s
we e eco ded, 1080 o each g oup. A e age dimen-
sional change o PE and VPS samples in all g oups a
he wo measu emen imes can be ound in Figu e 3.
A T0, he au ocla e g oup has he highes a e age
dimensional change (0.30 ± 0.30% o PE and
0.30 ± 0.12% o VPS) and he con ol g oup has he
lowes a e age dimensional change (0.13 ± 0.19% o
PE and 0.12 ± 0.18% o VPS). In T1, he hypochlo i e
g oup has he lowes a e age dimensional change o
bo h ma e ials (0.64 ± 0.23% o PE and 0.52 ± 0.24%
o VPS). In T1 o he PE, he con ol g oup has he
highes a e age dimensional change (0.90 ± 0.26%),
and o he VPS, he au ocla e g oup is he g oup
ha has he highes dimensional change
(0.87 ± 0.13%).
A h ee-way mixed ANOVA was un o unde s and
he e ec s o ma e ial, s udied g oups and ime on
dimensional s abili y. The e was a s a is ically
86 F. MARTINS ET AL.
signi ican h ee-way in e ac ion be ween ime, ma e -
ial, and s udied g oups (p<.001).
The e was a s a is ically signi ican simple wo-way
in e ac ion o ma e ial and g oups a he T1 le el
(p<.025), bu no a he T0 le el (p¼.794). Tha
in e ac ion a ises om he s a is ically signi ican di -
e ences be ween he con ol g oups o he wo ma e-
ials (p<.05). S a is ical signi icance o a sample main
e ec was accep ed a a Bon e oni-adjus ed alpha
le el o 0.025.
Acco ding o sample main e ec s in he au ocla e
and hypochlo i e g oups, a e he 6 mon hs o s o -
age, he e we e no signi ican di e ences in he
dimensional beha io be ween wo ma e ials
(p>.025). So, he PE and VPS when subjec ed o s e -
iliza ion o disin ec ion do no di e in hei dimen-
sional beha io a e a 6 mon hs s o age o he
samples, bu when no c oss-in ec ion con ol p oced-
u e is applied PE (0.90 ± 0.26%) p esen s highe
sh inkage when compa ed o VPS (0.53 ± 0.19%)
(Table 1).
Acco ding o he sample compa isons, VPS con ol
and VPS hypochlo i e a e di e en om VPS au o-
cla e (p<.05) a T1 ime le el. A s a is ically signi i-
can di e ence (p<.05) o PE con ol and PE
au ocla e wi h PE hypochlo i e was also ound a T1
(Table 1).
The e a e s a is ically signi ican di e ences
be ween he wo measu emen imes in all g oups o
bo h ma e ials, p<.05 (Table 1). Thus, all he PE and
VPS g oups had signi ican dimensional changes o
he samples du ing hei s o age pe iod. In he PE,
he g oup ha expe ienced smalle dimensional
changes was he hypochlo i e, wi h a s a is ically sig-
ni ican sh inkage o 0.42 ± 0.19%, he au ocla e g oup
and con ol g oups whe e he e we e g ea e dimen-
sional changes o he samples, wi h a s a is ically sig-
ni ican sh inkage o 0.53 ± 0.28%and 0.77 ± 0.17%,
espec i ely (Table 1). Fo he VPS, he g oup ha
expe ienced he leas changes o he dimensions o he
samples was he hypochlo i e, wi h a s a is ically sig-
ni ican sh inkage o 0.36 ± 0.09%. The au ocla e
g oup and he con ol g oup we e he g oups whe e
he e was g ea e dimensional change o he samples,
Figu e 3. Desc ip i e s a is ics o PE and VPS g oups wi h mean alues and s anda d de ia ion a T0 and T1 ime le el.
Table 1. Desc ip i e and h ee-way ANOVA analysis be ween
he h ee a iables.
T0
(Mean % ± SD)
T1
(Mean % ± SD)
Sh inkage
(Mean % ± SD) p
PE
Con ol 0.13 ± 0.19 0.90 ± 0.26
d,e
0.77 ± 0.17 p<.05
b()
Hypochlo i e 0.22 ± 0.19 0.64 ± 023
c
0.42 ± 0.19
Au ocla e 0.30 ± 0.30 0.83 ± 0.32 0.52 ± 0.28
VPS
Con ol 0.12 ± 0.18 0.53 ± 0.19
c
0.42 ± 0.12 p<.05
b()
Hypochlo i e 0.16 ± 0.22 0.52 ± 0.24
c
0.36 ± 0.09
Au ocla e 0.30 ± 0.12 0.87 ± 0.13 0.58 ± 0.13
p¼.794
a
p<.025
a,#
Iden i ies a s a is ically signi ican di e ences, o a 95% con idence
le el.
#Iden i ies a s a is ically signi ican in e ac ion, o a 95% con idence le el.
a
Th ee-way mixed ANOVA –be ween-subjec s e ec s.
b
Th ee-way mixed ANOVA –wi hin-subjec s e ec s.
c
S a is ically signi ican di e ences wi h au ocla e g oup –pai wise
compa isons.
d
S a is ically signi ican di e ences wi h hypochlo i e g oup –pai wise
compa isons.
e
S a is ically signi ican di e ences wi h VPS ma e ial –pai wise
compa isons.
ACTA BIOMATERIALIA ODONTOLOGICA SCANDINAVICA 87
wi h a sh inkage o 0.57 ± 0.11%and 0.41 ± 0.12%
(Table 1).
Discussion
Dimensional s abili y o imp ession ma e ials has been
a cons an subjec o s udy and esea che s ha e a
hei disposal a ious me hods o e alua ing he
dimensional s abili y [16,35]. This s udy eso ed o
ADA speci ica ion no. 19 and ISO 4823:2000, since i
is an easily ep oducible me hod among in es iga o s,
allowing di ec compa ison be ween s udies wi h a i-
ous ma e ials [20]. Howe e , as wi h any in i o
in es iga ion he e a e limi a ions. The accu acy o
his me hod depends upon he ope a o who is in
cha ge o he measu emen s and he mic oscopic
eadabili y [6]. Ano he disad an age is he ac ha
he ma e ials es ed did no p esen a clinically ele-
an shape and he imp ession is pe o med wi hou
he p esence o mois u e o sali a. This means ha
he execu ion and emo al o he imp essions, as well
as he de o ma ion su e ed does no mimic he clin-
ical condi ion [2,5–7,32]. Howe e , as he objec i e o
he s udy is o e alua e dimensional changes in oduc-
ing he a iable ime, s e iliza ion, and disin ec ion, i
becomes impo an o educe he numbe o associ-
a ed a iables. A hi d limi a ion is based on he ac
ha he measu emen s a e ca ied ou on a la su -
ace elimina ing he possibili y o de ec dimensional
changes in h ee dimensions [6]. The ac ha he wo
ma e ials ha e compa able iscosi ies did no a ec
he ou come as he esul s a e e y simila .
The Michelson me hod allows a di ec measu e-
men o he sample and has a high accu acy and p e-
cision o esul s [36,37]. ISO 4823:2000 eques s an
accu acy o 0.01 mm o he measu ing echnique.
Howe e , in he p esen s udy, he use o a Michelson
in e e ome e allowed an accu acy o 0.00001 mm.
The samples we e subjec ed o wo di e en p oce-
du es, all common in den al p ac ice. In he con ol
g oup, no s e iliza ion o disin ec ion p ocedu e was
pe o med, and his g oup was used o compa a i e
pu poses and con ol o he beha io o bo h
ma e ials.
A disin ec ion p o ocol by imme sion o he sam-
ples in a sodium hypochlo i e solu ion a 5.25% o
10 min was employed in he hypochlo i e g oup. This
concen a ion is known o ha e i ucidal, ungicide
and bac e icide p ope ies and is adequa e o allow
disin ec ion [6,31]. We chose an imme sion ime o
10 min since he e a e se e al au ho s ad oca ing i
[6,15,22,23,30,31]. This ime is below he maximum
imme sion pe iod allowed by ADA, which is 30 min
[6]. One can ques ion why he ADA does no es ab-
lish a minimum ime pe iod. Adabo e al. [15] s a e
ha he disin ec ion o PE and VPS wi h a 5.25%
hypochlo i e solu ion o 10 min is no only e ec i e
in educing he numbe o mic oo ganisms p esen on
he ma e ial su ace, i causes no signi ican dimen-
sional changes in he imp essions. Langenwal e and
Tullne , who s udied he same ma e ials wi h simila
disin ec ion p o ocols, also ob ained he same conclu-
sions [23,30]. Ke n e al. [22] made use o an imme -
sion o he imp essions in a solu ion o
glu a aldehyde and sodium hypochlo i e o 10 min
and obse ed ha hese wo disin ec ion p o ocols do
no cause clinically signi ican ad e se e ec on he
dimensional s abili y o he imp essions.
In he au ocla e g oup, he samples we e subjec ed
o a 40-min s e iliza ion cycle a 134 C in a s eam
au ocla e as his is conside ed he mos e ec i e
me hod o s e iliza ion. None heless, he e a e insu i-
cien s udies on he e ec s o his p ocedu e on he
s abili y and ep oducibili y o he imp essions [20].
Nassa e al. s udied he dimensional s abili y o
a VPS du ing 2 weeks o s o age and ound
small dimensional changes ha we e s a is ically
signi ican [5].
The esul s ob ained in ou s udy demons a e a
s a is ically signi ican dis o ion o he samples du ing
he 6 mon hs o s o age. The ISO 4823:2000 se s a
maximum dimensional change o 1,5% o ype 0
ma e ials, such as PE and VPS [34]. Howe e , he
maximum dimensional changes ob ained in his s udy
we e 0.90 ± 0.26%, which shows ha he dimensional
changes o e he s o age o he ma e ials a e no clin-
ically signi ican .
Some au ho s claim ha disin ec ion and s e iliza-
ion ha e no ad e se e ec on he dimensional s abil-
i y o imp essions [15,24,30], while o he s poin o
possible ad e se e ec s [25,31]. Tullne e al. [30]
ound ha he disin ec ion o s e iliza ion o imp es-
sions did no p oduce clinically signi ican changes in
hei dimensions. O he au ho s no ed, as showed in
his s udy o bo h ma e ials, ha he disin ec ion
o he imp essions b ings in he long e m bene i s
o e he imp essions which ha e no unde gone his
p ocess [25,31]. In ac , samples subjec ed o disin ec-
ion by imme sion in 5.25%sodium hypochlo i e
solu ion a e 6-mon h s o age showed less dimen-
sional change when compa ed wi h he con ol g oup
and au ocla e g oup.
Thoua i e al. [31] obse ed, a e disin ec ion o
he elas ome s by imme sion in a 5.25%hypochlo i e
solu ion o 30 min, a signi ican dimensional change
88 F. MARTINS ET AL.
o he imp essions (be ween 0.008%and 0.29%),
and ha his dimensional change is smalle when
compa ed o he imp essions ha did no unde go
disin ec ion by imme sion. Al hough he disin ec ion
in ou s udy was ca ied ou o only 10 min, ou
esul s a e co obo a ed by he p e ious wo k o
Thoua i e al. [31]. Fo he PE hypochlo i e g oup,
a e 6 mon hs, shows a sh inkage o 0.64%and he
con ol g oup0.90%; VPS hypochlo i e g oup has a
sh inkage o 0.52%and 0.53%in he con ol g oup.
In ac , he e ec o he disin ec an solu ion was no
signi ican on he dimensional a ia ions o hese
ma e ials, showing ha applying c oss-con ol in ec-
ion p ocedu es, such as disin ec ion, is a o able
om a clinical iewpoin . Ma in and Jedynakiewicz
in 2007 s a ed ha Aquasil
V
R
Monophase (Den sply,
Caulk) had a e y low sh inkage o jus 0.05%and
Imp egum
TM
F (3 M ESPE, S Paul, MN) p esen ed a
g ea e dimensional change a e imme sion in
sodium hypochlo i e 5.25%[36]. The ac ha he PE
is a hyd ophilic ma e ial jus i ies he u he dimen-
sional change ha his ma e ial unde goes when com-
pa ed wi h VPS [36]. This idea is suppo ed by ou
esul s, since he PE hypochlo i e g oup su e ed a
sh inkage o 0.64%and he VPS hypochlo i e g oup a
sh inkage o 0.52%. Nassa and Chow [26] sugges
ha because o he hyd ophilic s uc u e o PE his
ma e ial imbibes a g ea e amoun o disin ec an
solu ion du ing he disin ec ing p ocedu e esul ing in
a highe dimensional change and a g ea e sh inkage
due o he loss o ola ile componen s o e ime.
This s udy did no u he elucida e he eason why
he dimensional changes in bo h ma e ials we e in e -
io in he hypochlo i e g oup. Acco ding o Sinobad
e al chlo ine a 5.25%is a highly eac i e elemen and
could eac wi h imp ession ma e ials and adhe e on
he ma e ial [6]. Howe e , Oda specula ed ha he
samples disin ec ed wi h hypochlo i e a 5.25%may
ha e some disin ec an up ake du ing he disin ec ion
p ocedu e [27]. This in e ac ion be ween he hypo-
chlo i e and he cons i uen s o he imp ession ma e -
ial migh esul in a ‘sealing’, p e en ing o educing
he dimensional change o e ime. I seems he e a e
indeed possible bene icial e ec s o disin ec ion by
imme sion in 5.25%NaOCl o 10 min [27]. A e
his pe iod, he e is a chemical s abiliza ion whe e
mino changes in he dimension o he ma e ial can
occu [6,27].
Acco ding o Tho a e al. [20] au ocla ing is he
mos e ec i e s e iliza ion p ocedu e o VPS, bu o
PE his p ocedu e is no ecommended. Fo PE, he
disin ec ion p ocedu e should be he one speci ied by
he manu ac u e . Howe e , he p esen s udy ound
ha he au ocla e g oup o VPS has a sh inkage o e
he 6 mon hs o 0.87%, highe han he hypochlo i e
g oup, in o he wo ds, he la ges dimensional change
esided in he au ocla e g oup.
This s udy e ealed no s a is ically signi ican di -
e ences be ween VPS and PE when compa ed a T0.
In T1 he e we e only s a is ically signi ican changes
be ween he wo ma e ials in he con ol g oup, while
he PE has a highe sh inkage han VPS. These esul s
can be explained by he hyd ophilic na u e o PE
[23,28,29]. Chen e al. [38] concluded ha p olonged
s o age causes dimensional changes in VPS; howe e ,
hese changes a e lowe when compa ed wi h hose
which occu in o he ma e ials. Nassa s udied he
dimensional change in wo VPS ma e ials EXA’lence
370 Monophase (GC Ame ica Inc Alsip, III and
Imp in
TM
3 Monophase (3 M ESPE
TM
, S Paul, MN)
and one PE Imp egum
TM
Pen a
TM
(3 M ESPE
TM
AG,
See eld, Ge many) a e wo weeks o s o age and con-
cluded ha changes in PE a e highe han in VPS;
howe e , in bo h ypes, hese changes a e no clinic-
ally signi ican [5]. Walke e al. [39] e alua ed he
dimensional s abili y o a PE and a VPS a e disin ec-
ion a e a wo-week s o age pe iod and concluded
ha he PE showed signi ican dimensional changes
a e s o age, while he VPS did no show signi ican
changes in i s dimension.
Bo h ma e ials exhibi dimensional changes when
subjec ed o disin ec ion and s e iliza ion. Hence, he
null hypo hesis a he 5%le el is ejec ed. The long-
e m s o age o samples subjec ed o disin ec ion wi h
5.25%hypochlo i e o au ocla e s e iliza ion can be
used in a clinical se ing as he dimensional changes
a e below he maximum pe mi ed by he ISO
4823:2000, since he e a e no clinically signi ican
changes in he dimension o he samples du ing he
s o age pe iod.
Mo e s udies on disin ec ion, s e iliza ion, and s o -
age condi ions o imp ession ma e ials a e necessa y
o ensu e g ea e success o clinical p ocedu es and
c oss-con amina ion p e en ion.
Acknowledgemen s
The au ho s would like o hank 3M ESPE Po ugal o he
ma e ials and he Po uguese Ins i u e o Quali y o he use
o he acili ies.
Disclosu e s a emen
No po en ial con lic o in e es was epo ed by he
au ho s.
ACTA BIOMATERIALIA ODONTOLOGICA SCANDINAVICA 89
ORCID
F ancisco Ma ins h p://o cid.o g/0000-0001-9141-0723
Jos
e Reis h p://o cid.o g/0000-0002-7685-8762
Ignacio Ba be o Na a o h p://o cid.o g/0000-0003-
3286-7111
Paulo Mau
ıcio h p://o cid.o g/0000-0002-0269-6983
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