Accuracy of The Implant Impression Obtained From Different Impression Materials and Techniques: Review
Accuracy of The Implant Impression Obtained From Different Impression Materials and Techniques: Review
Accuracy of The Implant Impression Obtained From Different Impression Materials and Techniques: Review
doi:10.4317/jced.3.e106
Correspondence:
Dept. of Prosthodontics.
Govt. Dental College and Research Institute, Bangalore.
Victoria Hospital Campus, fort, Bangalore.
560002
[email protected]
Received: 30/04/2010
Accepted: 06/12/2010
Abstract
With the predictable integration of implants, the emphasis is shifted towards precise prosthesis. Reproducing the
intraoral relationship of implants through impression procedures is the first step in achieving an accurate, passively
fitting prosthesis. The critical aspect is to record the three dimensional orientation of the implant as it is present
intraorally, other than reproducing fine surface detail for successful implant prosthodontic treatment. The development of impression techniques to accurately record implant position has become more complicated and challenging. During the prosthetic phase of implant therapy there are numerous options available to the implantologist in
relation to different impression techniques and materials available for impression making. It is critical to ensure that
implant prosthesis interface have passive fit and original position of the implant maintained in the master cast.
There is no evidence supporting that one impression technique or material is better than the other. In the present
article the various parameters affecting the accuracy of implant impression along with impression material and
technique pertaining to different clinical situations is reviewed.
Key words: dental implants, impression techniques, snap fit technique, open tray technique, closed tray technique.
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Introduction
Osseointegrated dental implants have been proven successful in the treatment of edentulism (1). Mainly, osseointegrated implants were used for rehabilitation of
edentulous patients with the principle objective of replacing conventional complete dentures with an implantsupported prosthesis. Other applications of implants in
dentistry include partially edentulous, single-tooth, and
implant overdenture treatments (2). In implant prosthodontics, a successful result can be achieved only
when passively fitting prostheses are fabricated (3). Reproducing the intraoral relationship of implants through
impression procedures is the first step in achieving an
accurate, passively fitting prosthesis. The critical aspect
is to record the 3-dimensional orientation of the implant
as it is present intraorally, other than reproducing fine
surface detail for successful implant prosthodontics
treatment (4-6).
Although there is some evidence that prosthesis misfit
may not affect osseointegration, there is evidence that
prosthesis misfit is likely to increase the incidence of
mechanical component loosening or fracture. The causes of component failure and loosening are multifactorial, but it must be assumed that prosthesis misfit plays
an important role in complications such as occlusal and
abutment screw loosening and fracture in implant restorations (7-10). Because of these, prosthesis misfit is to
be minimized.
An electronic search was performed from MEDLINE
databases with the key words accuracy of implant impression techniques. To be included, the study had to
investigate the accuracy of implant impressions techniques and materials and be published in an English peerreviewed journal. In addition, hand search of related articles were performed to enrich the results for the time
period from January 1983 to June 2009.
At present, various implant impression techniques, such
as splint, pickup, and transfer techniques and different
impression materials, like polyether, vinyl polysiloxane
(VPS), and polysulfide have been introduced and investigated for accuracy. Other factor related to the accuracy
of the implant impression, including the angulation or
depth of implants has also been studied. However, the
results are not always consistent, and various studies reported greater accuracy with different impression techniques as well as impression materials. The purposes of
the present review are to investigate the:
1) Accuracy of reported implant impression techniques.
2) Accuracy of various implant impression materials.
3) Factors affecting the implant impression accuracy.
One of the most important factors for the success of
implant prosthesis is the accuracy of the impression
procedure, in order to obtain the original position of
the implants during the processing of the master cast
and to allow the passivity of the framework casting to
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Impression Techniques
Author
( Year)
Barrett
et al. (4)
(1993)
Assif et al.
(12)
(1992)
Implant Splint
number material
6
DF+AAR
Splint method
Impression
accuracy
No difference
PE
Splint
PE
Splint
PE
Non splint
PE
No difference
PE
Splint
PE
No difference
PE, VPS,
plysulfide,
condensation
silicone
VPS
Splint
No difference
VPS
Splint
AAR
Assif et
al. (13)
(1996)
AAR
Polymerize on
individual copings,
then join 15 min
before impression
Splint
Inturregui
et al. (17)
(1993)
Impression
plaster
Splint copings to
custom tray
Splint and wait for
10 minutes
Hsu et al.
(18)
(1993)
DF+AAR
Stainless steel
wire+AAR
AAR
Polymerize on
individual copings,
then join 20 min
before impression
Splint 30 min before
impression
Naconecy 5
et al. (19)
(2004)
Del Acqua 4
et al. (20)
(2008)
Steel
pin+AAR
Assuncao
et al. (29)
(2004)
AAR
Splint
Herbst et
al. (35)
(2000)
Cabral et
al. (38)
2007)
DF+AAR
DF+AAR
AAR
Impression
material
VPS
AAR
Splint 17 min,
section, then rejoin
before impression
Daoudi et al. (26) investigated repositioning of the copings after making the transfer impression by 3 different
groups of people: senior dentists, postgraduate dental
students, and dental technicians. The copings never returned to the original position and this was believed to
be the primary source of error in the transfer impression
technique. This error could be multiplied when the impression is made in situations of multiple implant placements. It was found that for situations in which there
were 4 or more implants, more studies showed more accurate impressions with the pick-up technique than the
transfer technique.
Some implant manufacturers have developed a snap-fit
(press fit) plastic impression coping. This technique is
not a pick-up impression because it does not require an
open tray, but instead uses a closed tray. It is not a transfer impression, either, because the plastic impression
copings are picked up in the impression. The press-fit
impression coping is easier to manipulate, time saving,
and more comfortable for both the clinician and patient
because the coping is connected to the implant by pressing instead of screwing. The press-fit coping design
allows removal of the coping with the impression and
has the advantage of both the open- and closed-tray implant impression techniques. Thus, the press-fit impression coping helps to overcome movement of impression
copings inside the impression material. The snap-fit technique may be a reliable impression making technique
(28) but regarding accuracy of this technique none of
the study is available for investigation.
Impression Materials
Coping Modification
Liou et al. (22) found that the impression copings with
different designs showed a different level of impression
accuracy. To increase accuracy, the coping was extended or treated with airborne-particle abrasion and impression adhesive (33-35). However, the same surface
treatment did not increase the accuracy in another study
(32). Acrylic resin transfer caps and Gold machined castable abutments have been introduced to achieve better
accuracy (36,37). Lee et al. (30) found that adding a
4-mm piece of the impression coping as an extension on
the original impression coping compensated for the inaccuracy of subgingival placement of the implant. These
modifications may lead manufacturers to develop new
impression coping designs to enhance the accuracy of
the impression.
Vigolo et al. (37) evaluated in vitro the accuracy of definitive casts obtained from transfer impressions using
square copings for the replacement of one tooth. In the
first group, nonmodified square impression copings
were used; in the second group square impression copings previously airborne-particle abraded and coated
with manufacturer-recommended impression adhesive
were used. It was observed that displacement abutment
positions in the specimens were significantly smaller in
casts obtained from modified transfers than nonmodified
transfers.
Angulation
Conclusions
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