IMPRESSION TECHNIQUES

FOR IMPLANT PROSTHESES

AAMIR GODIL
FIRST YEAR P.G.
DEPARTMENT OF PROSTHODONTICS
M.A.R.D.C.
 OUTLINE
• INTRODUCTION
• MATERIALS REQUIRED
• IMPRESSION TECHNIQUES
• GINGIVAL MASKING
• ERRORS
• LITERATURE REVIEW
• CONCLUSION
 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)
WHY SHOULD YOU MAKE
IMPLANT IMPRESSIONS?

Position Depth

Axis Soft Tissue Contour

(Angulation) (Emergence Profile)
 WHAT ALL DO YOU NEED TO
MAKE IMPLANT IMPRESSIONS?
WHICH IMPRESSION MATERIAL
TO CHOOSE?
• Minor bone toxicity • Toxic to bone
• Very stable • Relatively Stable
• Multiple viscosities • Slow set
available POLY
POLY- • Unpleasant taste to
VINYL patient
SULFIDE
SILOXANE

• Toxic to bone • Least stable

• Very rigid
POLY- OTHERS • Low tear strength
• Very Stable ETHER (HYDRO- • Least desirable to use
• Most hydrophilic due to limitations of
COLLOIDS) material
HOW TO MAKE AN IMPRESSION
FOR IMPLANT PROSTHESES?

Implant Level Impressions Abutment Level Impressions

1. Pick Up (Open Tray) 1. Direct Technique
2. Transfer Type (Close Tray ) 2. Indirect Technique
IMPLANT LEVEL IMPRESSIONS
 Open Tray Closed Tray
More accurate for multi unit impressions Less accurate for multi unit impressions
In cases with implant/abutment
angulations and path of insertion
withdrawal Less accurate for multi unit
cases

IMPLANT LEVEL IMPRESSION TECHNIQUES

 CLOSED TRAY
IMPRESSION TECHNIQUE
 Indications Advantages Disadvantages
Liou Ad (1993) Conrad H. (2007) Conrad H. (2007)
• Limited inter arch space • Easier • Inaccuracies with
• Tendency to gag • Suitable for short inter recovery and subsequent
• Difficult access in the arch distance deformation of
posterior region of the • Visual fastening of the impression material may
mouth analog to the coping is be encountered with
more accurate nonparallel implants
• Not suitable for deeply
placed implants
 OPEN TRAY
IMPRESSION TECHNIQUE
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)
STEPS IN SPLINTING MULTIPLE IMPLANTS FOR IMPRESSION
 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

ALL ON SIX
 Indications Advantages
Heather J.
• Multiple implants • Reduces the effect of the
• Very closely located implant angulation
implants • Reduces the deformation
of the impression material
• Removes the concern for
replacing the coping back
into its respective space in
the impression.
Disadvantages
Heather 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
ABUTMENT LEVEL IMPRESSIONS

Simple provisional Selecting

For custom-made
restoration abutments in the
abutments
fabrication laboratory
DIRECT- ABUTMENT LEVEL
IMPRESSION TECHNIQUE
INDIRECT- ABUTMENT LEVEL
IMPRESSION TECHNIQUE
GINGIVAL MASKING
 WHAT SHOULD YOU SEND
TO THE LAB?
Necessary restorative
Appropriate and
Lab prescription Mounted models components for
accurate impressions
implant

Temporary abutments
Implant level Preoperative
Detailed with all Impression analog
required prosthetic
design and case
details. Implant analog
Abutment level Diagnostic wax up
Necessary abutment
screws
 WHAT ARE THE PROBABLE ERRORS?
HOW DO YOU MINIMIZE THEM?
VERIFY THE SEATING OF IMPROPER INTERFACE
COMPONENTS BETWEEN IMPRESSION
POST AND IMPLANT
ANALOGUE
ERRORS IN
IMPRESSION MAKING
• Latex gloves with PVS
impression material
• Non-uniform thickness of
material
LITERATURE REVIEW
 Three-Dimensional Accuracy of Implant
and 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

CONCLUSION
• 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
Thank You