Classification and impression techniques of implants/ dentistry dental implants

Classification and Classification and impression techniques impression techniques

of implantsof implantsINDIAN DENTAL ACADEMY

Leader in continuing dental education www.indiandentalacademy.com

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ClassificationClassification► Based uponBased upon

1.1. Placement within the tissuesPlacement within the tissues2.2. Materials usedMaterials used3.3. Attachment mechanismAttachment mechanism4.4. Surface coatingSurface coating5.5. ShapeShape6.6. Surgical stageSurgical stage7.7. Mode of insertion Mode of insertion 8.8. Tissue response & systemic toxicity effects of Tissue response & systemic toxicity effects of

implantsimplants www.indiandentalacademy.com

►Subperiosteal implantsSubperiosteal implants

Based upon the placement Based upon the placement within the tissuewithin the tissue

Subdivision of subperiosteal Subdivision of subperiosteal implantimplant

o UnilateralUnilateralo InterdentalInterdentalo TotalTotalo circumferentialcircumferential

Unilateral subperiosteal implant

Interdental subperiosteal implant

Total subperiosteal implant

Circumferential subperiosteal implant

Transosteal implantTransosteal implant

Also known asAlso known as o Staple boneStaple boneo Mandibular stapleMandibular stapleo TransmandibularTransmandibular

Transosteal implantTransosteal implant

Endosteal implantEndosteal implant

Root formBlade/plate form

Ramus frame www.indiandentalacademy.com

Intramucosal insertsIntramucosal inserts

Endodontic stabilizer implant

Based upon materials usedBased upon materials used1.Metallic implants-commercially pure titanium1.Metallic implants-commercially pure titanium Titanium alloyTitanium alloy Cobalt chromium molybdenum Cobalt chromium molybdenum alloy alloy

2.Nonmetallic implants-Ceramics2.Nonmetallic implants-Ceramics CarbonCarbon

Ceramic and titanium alloy implants

Based upon the attachment Based upon the attachment mechanismmechanism

1.Osseointegration2.Fibro osseous integration

Based upon their surface Based upon their surface coatingcoating

o Titanium plasma sprayedTitanium plasma sprayedo Hydroxyapatite coatingHydroxyapatite coatingo Grid blasting with TiOGrid blasting with TiOo SLA(sandblasted-largegrid-acidetched)SLA(sandblasted-largegrid-acidetched)o Acid etchedAcid etchedo Machined surfaceMachined surface

Based upon the shapeBased upon the shape

Contd….Contd….o Threaded,nonthreadedThreaded,nonthreadedo Tapered,parallelTapered,parallelo With vent holes,without vent holesWith vent holes,without vent holeso Hollow cylinder,solid screwsHollow cylinder,solid screwso Root form,blade formRoot form,blade form

Based upon the surgical Based upon the surgical stagestage

Two stage implantsTwo stage implants One stage implant

Based upon mode of Based upon mode of insertioninsertion

1.Axially inserted 1.Axially inserted (crestal approach)(crestal approach)

2.Laterally inserted(basal approach)

Based upon tissue response Based upon tissue response &systemic toxicity effects of &systemic toxicity effects of

implantsimplantso Biotolerant materials-Biotolerant materials-

polmethylmethacrylatepolmethylmethacrylate

o Bioinert materials-titanium and Bioinert materials-titanium and aluminium aluminium oxide oxide

o Bioactive materials-glass and calcium Bioactive materials-glass and calcium phosphate ceramic phosphate ceramic

Components of implantComponents of implant

Implant body Implant body

Cover screw Healing abutment

Healing cap Implant abutment

Impression posts

Laboratory analogs

IMPRESSION MATERIALS

Ideal Requirements

•Complete plasticity before cure

•Fluidity to record fine detail

•Ability to wet oral tissues

•Dimensional accuracy

•Dimensional stability

•Complete elasticity after cure

•Optimal stiffnesswww.indiandentalacademy.com

Materials Used

o Alginateo Agaro Polysulphideo Polyethero Condensation Siliconeo Addition Silicone

ALGINATE

o Poor dimensional stabilityo Poor dimensional accuracyo Poor tear strength o Poor stiffnesso Interferes with setting of gypsum

o Interferes with setting of gypsumo Dimensional instabilityo Elaborate equipment neededo Low tear resistance

Polysulphide

o Base-polusulfide polymer, Catalyst- lead dioxideo High tear strengtho Messy,unpleasant odouro Long setting timeo Poor dimensional stabilityo Hydrophobic

Condensation silicone

o Cheapero Good tear strength, accuracy & elastic propertieso Dimensional instability,due to loss of ethyl alcoholo Poured quickly

Addition silicone

o Shorter setting timeo Easy to mix- automatic mixing deviceso Adequate tear strengtho Extremely high accuracyo Dimensional stability even after 1 weeko Least distortion on removalo Hydrophilico Good compatibility with gypsum

Polyether

o Good dimensional stability & accuracyo Short setting timeo Material very rigido Not available in all consistencieso Most expensive

Dispensed as :

Manual mixing

Automixing system

Manual mixing

o Puttyo Heavy bodyo Monophaseo Light body

Automixing equipment & materials

Two basic impression techniques for implants are

1. indirect technique or closed tray technique

2.direct or pick-up or open tray technique.

Indirect impression technique

Contd…

Direct impression technique

Contd…

Indirect method

Direct method

Related articles

Tautin(1985)presented a technique to accurately, transfer and reproduce the relationship between implant dentures , in which no preliminary impression or acrylic resin custom tray were needed. He used modeling compound to form a custom tray by adapting it over transfer copings,pressing the compound over the superior aspect of the coping so that its circular outline is seen through the compound.After trimming the outline of the coping showing through the top of the tray an impression plaster is used to record and transfer the coping to the impressions www.indiandentalacademy.com

Loos(1986)presented a detail technique for the fabrication of a fixed prosthesis supported by implants.His technique incorporated plugging the incisal end of the transfer coping with beading wax(to prevent impression material from flowing into it)splinting the transfer copings with orthodontic ligature wire and Duralay acrylic resin,use of a plastic perforated impression tray with incisal window to access the transfer coping and making the final impression with putty light body addition silicone.

Rasmussen(1987)presented a technique in which the existing denture is modified using tissue conditioning material is used instead of healing caps after second stage surgery ,eliminating the use of impression copings at the final impression.

Humphries et al (1990) evaluated the accuracy of implant master casts constructed from transfer impressions using three techniques.The techniques used were splinted square polymer copings,unsplinted square polymer copings and unsplinted hydrocolloid copings.Tapered hydrocolloid copings were more accurate than the other two methods.

Carr (1991) compared impression techniques for five implant mandibular model by both indirect and direct transfer coping techniques and found that for the models used ,the direct method produced more accurate working casts.

Vigolo et al(2000)evaluated the accuracy in transferring the position of the hexagonal head of a single implant to the working cast, and concluded that the sandblasting and coating the roughened surface of the impression coping with an impression adhesive will result in more accurate orientation of the implant replicas in the laboratory master casts in single tooth implant restorations.

Conclusion

Success with implant prosthodontics requires a careful attention to each and every step from diagnosis and treatment planning. Several implant systems are available , selection of appropriate one is mandatory. The prosthesis fit can be accurate only if a proper impression is made. Thus usage of correct impression technique and material are important.

References

1. contemporary implant dentistry , Carl E. Misch

2. Implants in dentistry , Michael,John and Luis.

3. Implant prosthodontics Stevens & freidrickson

4. Dental implants- Fundamental & advanced laboratory

technology , Robert Winkleman &Kenneth orth.

References contd…5. Philip’s science of dental materials

6. Contemporary fixed prosthodontics, Rosentiel

7. Principles & practice of implant dentistry, Weiss

8. Theory & practice of ossteointegration, Hobo

9. Carr AB. Int J Oral Maxillofac Implants. 1991;6(4):448-55

10. Assif etal. Int J Oral Maxillofac Implants. 1999;14(6):885-88

11. Loos Larry G. J Prosthet Dent 1986;55:232-42

12. Rasmussen Eric J. J Prosthet Dent. 1987;57:198-203

13. Tautin Francis S. J Prosthet Dent. 1985;54:250-51

14. Vigolo etal. J Proshtet Dent. 2000;83:562-66

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