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IMPRESSION TECHNIQUES FOR IMPLANT PROSTHESES AAMIR GODIL FIRST YEAR P.G. DEPARTMENT OF PROSTHODONTICS M.A.R.D.C.

Impression techniques

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Page 1: Impression techniques

IMPRESSION TECHNIQUESFOR IMPLANT PROSTHESES

AAMIR GODIL FIRST YEAR P.G.

DEPARTMENT OF PROSTHODONTICSM.A.R.D.C.

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OUTLINE

• INTRODUCTION• MATERIALS REQUIRED• IMPRESSION TECHNIQUES• GINGIVAL MASKING• ERRORS• LITERATURE REVIEW• CONCLUSION

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INTRODUCTION• Accurate recording of spatial implant position is required to obtain a proper

support to definitive restoration with passive fitting. Conrad et al (2007)

Implants V/S Crowns and Bridges

• It is more critical to record 3- dimensional position of the implants as they occur intraorally.

• Natural teeth have a PDL to compensate for minor inaccuracies while implants have not.

Pesun IJ (1997)

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WHY SHOULD YOU MAKE IMPLANT IMPRESSIONS?

Position Depth

Axis(Angulation)

Soft Tissue Contour (Emergence Profile)

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WHAT ALL DO YOU NEED TO MAKE IMPLANT

IMPRESSIONS?

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WHICH IMPRESSION MATERIAL TO CHOOSE?

•Least stable •Low tear strength•Least desirable to use due to limitations of material

•Toxic to bone•Very rigid•Very Stable•Most hydrophilic

•Toxic to bone•Relatively Stable•Slow set•Unpleasant taste to patient

•Minor bone toxicity•Very stable•Multiple viscosities available POLY

VINYL SILOXAN

EPOLY-

SULFIDE

OTHERS (HYDRO-COLLOID

S)

POLY-ETHER

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HOW TO MAKE AN IMPRESSION FOR IMPLANT

PROSTHESES?

Implant Level Impressions1. Pick Up (Open Tray) 2. Transfer Type (Close Tray )

Abutment Level Impressions 1. Direct Technique 2. Indirect Technique

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IMPLANT LEVEL IMPRESSIONS

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Open TrayMore accurate for multi unit

impressionsIn cases with implant/abutment

angulations and path of insertion withdrawal Less accurate for

multi unit cases

Closed TrayLess accurate for multi unit

impressions

IMPLANT LEVEL IMPRESSION TECHNIQUES

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CLOSED TRAY IMPRESSION TECHNIQUE

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IndicationsLiou Ad (1993)

•Limited inter arch space•Tendency to gag •Difficult access in the posterior region of the mouth

AdvantagesConrad H. (2007)

•Easier •Suitable for short inter arch distance•Visual fastening of the analog to the coping is more accurate

DisadvantagesConrad H. (2007)

•Inaccuracies with recovery and subsequent deformation of impression material may be encountered with nonparallel implants•Not suitable for deeply placed implants

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SPLINTING FOR MULTIPLE IMPLANT IMPRESSION• The common practice of joining the direct transfer copings with acrylic resin

is an attempt to – stabilize the copings against rotation during fixture or abutment analog fastening – control the relationship between implants in a rigid fashion

(Spector MR, Donovan TE, Nicholls JI. An evaluation of impression techniques for osseointegrated implants.J Prosthet Dent 1990;63:444–447)

• Assif et al. and Naconecy et al. showed that splinting technique was significantly more accurate than unsplinted techniques

(Assif D, Marshak B, Schmidt A. Accuracy of implant impression techniques. Int J Oral Maxillofac Implants 1996;11:216–222)(Naconecy MM, Teixeira ER, Shinkai RS, Frasca LC, Cervieri A. Evaluation of the accuracy of 3 transfer techniques for

implant-supported prostheses with multiple abutments. Int J Oral Maxillofac Implants 2004;19:192–198)

OPEN TRAY IMPRESSION TECHNIQUE

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STEPS IN SPLINTING MULTIPLE IMPLANTS FOR IMPRESSION

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1. Autopolymerising resin (sectioned and reconnected)

2. Impression Plaster (PI) and Polyether (FI)

2. Impression Plaster

3. Autopolymersing resin at the time of impression

3. VPS bite registration material

J Adv Prosthodont. 2011 Dec;3(4):177-85

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ALL ON SIX

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Indications

•Multiple implants•Very closely located implants

AdvantagesHeather J.

•Reduces the effect of the implant angulation•Reduces the deformation of the impression material•Removes the concern for replacing the coping back into its respective space in the impression.

DisadvantagesHeather J.

•Some rotational movement of the impression coping when securing the implant analog may occur•Blind attachment of the implant analog to the impression coping may result in a misfit of components

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ABUTMENT LEVEL IMPRESSIONSSimple

provisional restoration fabrication

For custom-made

abutments

Selecting abutments in the laboratory

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DIRECT- ABUTMENT LEVELIMPRESSION TECHNIQUE

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INDIRECT- ABUTMENT LEVEL IMPRESSION TECHNIQUE

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GINGIVAL MASKING

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WHAT SHOULD YOU SEND TO THE LAB?

Lab prescription

Detailed with all required

prosthetic design and

case details.

Appropriate and accurate impressions

Implant level

Abutment level

Mounted models

Preoperative

Diagnostic wax up

Necessary restorative components for

implant

Temporary abutments

Impression analog

Implant analog

Necessary abutment screws

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WHAT ARE THE PROBABLE ERRORS?HOW DO YOU MINIMIZE THEM?

VERIFY THE SEATING OF COMPONENTS

IMPROPER INTERFACE BETWEEN

IMPRESSION POST AND IMPLANT

ANALOGUE

ERRORS IN IMPRESSION

MAKING• Latex gloves with PVS impression material• Non-uniform thickness of material

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LITERATURE REVIEW

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Three-Dimensional Accuracy of Implantand Abutment Level Impression Techniques:

Effect on Marginal Discrepancy

With comparison of different impression methods, including abutment level and implant level (closed tray and open tray), no

significant difference was noted

Journal of Oral Implantology

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CONCLUSION

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• Precise impression methodology would decrease the failures related to the supra structure fabrication

Ozkane, 2006

• Imprecise superstructure fit results in mechanical and biologic consequences that disrupt the function of dental implants

Heather J. et al, 2007

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Thank You