Implant impression

We will talk about conventional or analogue techniques not

digital one .De nition of impression: physical regestration of the
hard & soft tissues .
‫ سواء‬surrounding tissues ‫ لألسنان بسجل االسنان و كل ال‬impression ‫ملا اخد‬
..soft tissue level ‫ او ال‬root prominence ‫كانت ال‬

Conventional implant impression defined as: Physical registration of the

hard and soft tissues such as teeth, gingival tissues, and alveolar
contours, from which a dental cast can be constructed. Also I will
register :-

*position, alignment, and rotational orientation of implants

*their relationship to the surrounding hard and soft tissues.

‫ وابعتها للمختبر‬impression ‫ رح اخد‬implant impression ‫في اشي اضافي بال‬

-: informations ‫ في عليه عدة‬cast ‫يعملي‬
- Registration of hard & soft tissues
- Implant position
- Inclination of implants (‫ ➡ )ﻣﯿﻼن اﻟﺰرﻋﺔ‬straight, distal , mesial or lingual
- Hex orientation of implant ➡ ‫ الزرعة ما بتكون‬smooth ‫ بكون فيها‬anti rotation

directly ‫ بشتغل‬technician‫ هون ال‬teeth ‫ عن ال‬implant impression ‫هاي ميزة ال‬

abutments ‫ ﺑﺪه ﯾﺤﻂ ال‬bridge or crown ‫ ﻣﺘﻼ ﺑﺪه ﯾﺸﺘﻐﻞ‬ptn’s mouth ‫كأنه عنده ال‬
analog ‫ اوﺣﺘﻰ‬digital technology ‫ او‬wax up ‫ ﺳﻮاء ﺑﺪه ﯾﻌﻤﻞ‬custom made ‫ﺑﻜﻮﻧﻮا‬
‫ ﻟﻠﺴﻦ رح ﯾﺼﯿﺮ ﺗﻐﯿﺮ ﺑﺎل‬preparation ‫ ﺑﻜﻮن اﻧﺎ ﻋﺎﻣﻞ‬teeth impression ‫ﻋﻜﺲ ال‬
‫ ﻟﻞ‬shrinkage ‫ ﻓﻲ ﻋﻨﺪي‬impression ‫ و ﺑﯿﻦ ال‬ptn’s mouth ‫ ﺑﯿﻦ ال‬dimension
.distort expansion ‫ و ﻓﻲ ﻋﻨﺪي‬impression

the implant impression is better than teeth impression & it’s highly
recommended technique, because the technician will work on the abutment
directly so it’s much more accurate.
fi
Conventional implant impression should be accurate as much as
possible, because the
implant is fixated in the
bone very rigidly (there’s
no pdl) misfiring in the
teeth could be
compansated by some
physiological mobility of
the teeth while in the
implant if any misfit in the
implant restoration
couldn’t be absorbed by
any mobility of the implant
(it’s as ankylosed tooth )the sequence of misfitting implant
restoration :-
Mechanical complications:
• porcalin chipping
• Screw loosening
• Screw fracture
And finally Biological complication as bone loss

Implant impression component

2 main components :-

1) Impression copings :
Pick - up direct
Transfer indirect
2) Implant analogues.
Impression coping : that component that will be placed on the
implant to make impression.

‫ ﺣﺴﺐ ﻧﻮع ال‬impression ‫ ﻋﺸﺎن اﺧﺪ ﻓﯿﮭﺎ‬intraorally ‫ﺑﺮﻛﺐ ﻗﻄﻊ ﻣﻌﯿﻨﺔ ﻋﺎﻟﺰرﻋﺎت‬
‫ ﻣﻤﻜﻦ ﺗﻄﻠﻊ ﻣﻊ ال‬coping ‫ ﺑﺴﺘﺨﺪم ال‬impression technique
ptn’s ‫ ﺗﺎﻧﯿﺔ ﺑﺘﻀﻞ ﺑﺎل‬technique ‫( و ب‬Pick up direct technique )impression
(transfer indirect technique) ‫ ﺑﻌﺪﯾﻦ‬impression ‫ واﻧﺎ ﺑﻔﻜﮭﺎ و ﺑﺤﻄﮭﺎ ﺑﺎل‬mouth

• Direct pick-up impression coping

(Open tray technique)

This type of coping will be picked up with

the impression .
There’s a different sizes of coping according
to the implant size

impression‫ ⬅ ﻻﻧﮫ ﺑﻄﻠﻊ ﻣﻊ ال‬pick up

‫ ﻟﻤﺎ ﯾﺼﯿﺮ‬screw ‫ ﺑﺘﻜﻮن ﻣﻔﺘﻮﺣﺔ ﻓﯿﮭﺎ ﻣﻜﺎن ﻋﺸﺎن ﺗﺴﻤﺢ ﻟﻞ‬tray ‫ ⬅ ﻻﻧﮫ ال‬open tray
‫ و ﺑﻄﻠﻌﻮا ﻣﻊ ال‬coping ‫ ﻟﻞ‬unscrewing ‫ ﺑﻌﻤﻞ‬impression ‫ ﻟﻞ‬setting
impression
‫ﺑﺪه ﯾﻄﻠﻊ‬screw ‫ و ھﺎد ال‬open tray ‫ ⬅ﻻﻧﮫ ﻋﻨﺪي‬long screw ‫ ﺑﺴﺘﺨﺪم‬coping ‫ﻋﺎل‬
impression ‫ﻣﻦ ال‬

• transfer indirect (closed tray technique)

- After impression taking The coping will

remain in the ptn’s mouth
.impression ‫واﻧﺎ ﺑﻔﻜﮭﻢ و ﺑﺤﻄﮭﻢ ﻋﺎل‬

- Closed tray as teeth impression

screw ‫ ﻋﺎدﯾﺔ ﻣﺴﻜﺮة ﻣﺎ ﻓﻲ ﻓﺘﺤﺎت ﻟﻞ‬tray ‫ﺑﺴﺘﺨﺪم‬
‫ و ﺷﻜﻠﮭﻢ‬long screw ‫ و ﻣﺎ ﻋﻨﺪي‬screw ‫وال‬
.conical shaped ‫ﺑﻜﻮن‬
Implant analogues: Presice replica of the
implant ,placed on the master cast
system ‫ وﻧﻔﺲ ال‬implant ‫ﻧﻔﺲ ﺷﻜﻞ و ﺣﺠﻢ ال‬
‫و‬impression ‫واﻟﺸﺮﻛﺔ ﺑﺲ ﺑﻨﺴﺘﺨﺪﻣﮭﻢ ﻟﻤﺎ ﻧﺎﺧﺪ ال‬
titanium implant ‫ﻧﺒﻌﺘﮭﺎ ﻟﻠﻤﺨﺘﺒﺮ ﺑﺪل ﻣﺎ ﻧﺴﺘﺨﺪم‬
‫ ﻋﺸﺎن اﺑﻌﺘﮭﺎ ﻟﻠﻤﺨﺘﺒﺮ‬cast ‫ اﺣﻄﮭﻢ ﺑﺎل‬costly ‫ﺑﺘﻜﻮن‬
for lab work.

Impression techniques (Direct vs Indirect)

1) Direct pick-up (open tray)

2) Indirect transfer (close tray)
Either implant-level Or abutment level

Open tray technique

‫بعد ما كشفنا عالزرعات و صار في‬-1

soft tissue ‫ لل‬healing
healing abutment ‫بفك ال‬
Then attach open tray coping
‫ زي‬implant ‫ﺟﻮا ال‬screwing ‫بعمللهم‬
‫ من‬perforation ‫ما بالصورة في طالع‬
‫ طالع من‬long screw ‫ بحيث‬tray ‫ال‬
 . tray ‫برا ال‬

should be one ‫ طبعا‬Putty light body ‫ عادي بحط‬impression ‫📌باخذ‬

ptn’s ‫ ﺑﻌﺪ ﻣﺎ طﻠﻌﻨﺎھﺎ ﻣﻦ ال‬.implant ‫ بال‬2stages ‫ اعمل‬option ‫ ﻣﺎ في‬stage
coping ‫ ﻣﻮﺟﻮد ﻋﻠﯿﮭﺎ ال‬mouth

open ‫ بركب ال‬ptn’s mouth ‫هاي الصورة بال‬-2

‫ ﻋﻠﯿﮭﺎ و طﺒﻌﺎ ﻻزم‬long screws ‫ ﺑﻜﻮﻧﻮا‬tray coping
hydrophobic ‫ ﻻﻧﮫ رح اﺳﺘﺨﺪم‬moisture ‫اﺣﺎﻓﻆ ﻋﺎل‬
additional silicone ‫ زي ال‬material

The copings will be‫ ﺑﻌﺪ ﻣﺎ اﺷﯿﻞ ال‬-3

picked up with the impression

After removing the impression

from the ptn’s mouth I will attach
implant analogue to the coping .

‫ ﺟﻮا‬coping ‫ وال‬impression ‫ﻋﻨﺎ ال‬-4

‫ و‬analogue ‫ ﺑﺠﯿﺐ ال‬impression ‫ال‬
‫ ﺑﻮﺻﻞ ﺑﯿﻦ‬،‫ ﺑﻄﺮﯾﻘﺔ ﻣﻌﯿﻨﺔ‬screwing ‫ﺑﻌﻤﻠﮫ‬
‫ وال‬implant analogue ‫ال‬
Cast ‫ ﺑﺎﻻﺧﺮ ﺑﻨﺸﺄ ﻋﻨﺪي ھﺎد ال‬impression coping

‫ ﻓﻲ اﺷﻲ ھﻮن اﺣﻄﮫ ھﻮ ال‬implant restoration ‫ ﻋﺎل‬master cast ‫طﺒﻌﺎ‬

cast ‫ ﺑﻘﺪر اﺷﯿﻠﮫ و ارﺟﻌﮫ ﻋﺎل‬gingival mask ‫ ﺑﺴﻤﯿﮭﺎ‬silicone material
 ‫ ﺑﺪه ﯾﺼﯿﺮ ﯾﺤﻂ و‬technician ‫ وظﯿﻔﺘﮫ اﻧﮫ ال‬stone ‫ﺑﺴﮭﻮﻟﺔ ﺑﺤﻄﮭﺎ ﻗﺒﻞ ﻣﺎ اﺻﺐ ال‬
‫ ﻓﻲ‬straight ‫ ﻓﻲ ﻋﺪة اﻧﻮاع ﻣﻨﮭﻢ‬titanium ‫ ﺑﻜﻮن‬abutments ‫ﯾﺠﺮب ﻋﺪة‬
‫ﺑﺎﻟﻤﻨﻄﻘﺔ ﻣﺶ‬stone ‫ﺗﺎ ﯾﺰﺑﻂ ﻣﻌﮫ واﺣﺪ ازا ﺿﻞ ﯾﻐﯿﺮ و ﯾﺒﺪل و ﻛﺎن‬.. angled
‫ وازا ﺻﺎر‬scratching ‫ ؟ رح ﯾﺼﯿﺮ ﻓﯿﮭﻢ‬abutment ‫ ﺷﻮ ﺑﺪه ﯾﺼﯿﺮ ﺑﺎل‬silicone
‫ و ھﺎي ﻣﺸﻜﻠﺔ ﻛﺘﯿﺮ ﻛﺒﯿﺮة رح ﺗﺼﯿﺮ ﻣﻨﻄﻘﺔ ﻟﻞ‬permanent ‫ رح ﯾﻜﻮن‬scratch ‫ﻓﻲ‬
‫ ﺑﻌﻤﻞ زي‬smooth ‫ ﻓﻌﺸﺎن ﯾﻀﻞ‬abutment ‫ و أﺧﺴﺮ ال‬plaque accumulation
very ‫ ﺑﺘﻜﻮن‬soft tissue replica material ‫ ﻋﻠﯿﮫ‬cast ‫ ﯾﻌﻨﻲ‬soft tissue cast
( mimicking the natural soft tissue ) ‫ ﻛﺘﯿﺮ طﺮﯾﺔ‬flexible

Indications:
- single & multiple implants
- less likely for the tray to get locked on with divergent implants

Limitations:
- difficult in the posterior
- difficult when insufficient intraoral access

Summary: open tray coping ➡ attached on the implant ➡ stock or

plastic tray (fit ‫ ➡ ) ﺑﺨﺘﺎر وﺣﺪة ﻣﻨﺎﺳﺒﺔ وﺗﻜﻮن‬on the screw positions make
perforations on the tray ➡ check the fitting of the tray
(perforation ‫ ﻛﺎن ال‬Tray ‫ طﺎﻟﻊ ﻣﻦ ﺑﺮا ال‬screw ‫)ال‬
➡ putty light bodymaterial ‫ ﺑﺤﻂ ﻋﻠﯿﮭﺎ‬tray ‫ﺑﺠﯿﺐ ال‬
➡ ‫ ا‬tray ‫ طﺎﻟﻌﯿﻦ ﻣﻦ ال‬screw ‫ وال‬one shot ‫ ب‬impression ‫ﺑﺎﺧﺪ ال‬
➡ ‫ ا‬impression‫ وﺑﺸﯿﻞ ال‬screw‫ ﻟﻞ‬unscrewing ‫ ﺑﻌﻤﻞ‬material‫ ال‬setting ‫ﺻﺎر‬
➡ ‫ا‬impression ‫ و ﺑﺼﺐ ال‬analog ‫ ﺑﻮﺻﻠﮫ ﻣﻊ ال‬impression ‫ﻋﺎل‬coping ‫ﺑﻄﻠﻊ‬
Closed tray technique

1- ‫ ﺑﻔﻚ ال‬healing abutment

2- attach close tray coping
3- short coping
4- impression (‫)ﺑﺎﺧﺬھﺎ ﺑﺎﻟﻄﺮﯾﻘﺔ اﻟﻌﺎدﯾﺔ‬
5- setting of the material ➡ removal of
the tray ➡ pouring ➡ master cast

closed ‫ ﺑﻔﻚ ال‬impression ‫ﺑﻌﺪ ﻣﺎ طﻠﻌﺖ ال‬

‫ و ﺑﻮﺻﻠﮫ‬ptn’s mouth ‫ ﻣﻦ ال‬tray coping
coping ‫ ﯾﻌﻨﻲ ﺑﻌﻤﻞ ﺑﺎﻻﺧﺮ‬analogue ‫ب‬
‫ ﻗﻄﻌﺔ وﺣﺪة ﺑﻌﺪﯾﻦ‬analogue assembly
‫ ﺑﺎل‬reinsertion ‫ ﺑﻌﻤﻞ‬assembly ‫ھﺎد ال‬
‫ ﺑﻜﻮن ﻣﺒﯿﻦ ﻣﻜﺎﻧﮫ ﻋﺎل‬impression
‫ و ﺑﻌﺪھﺎ ﺑﻨﺼﺒﮫ ﺑﺎﻟﻼب ﻧﻔﺲ ال‬impression
‫ ھﻮن ﺑﺼﯿﺮ ﻣﺼﺪر‬open tray technique
inaccuracy‫ال‬
Coping ‫ طﻠﻊ ﻣﺮة وﺣﺪة ﻣﻊ‬open tray ‫ﯾﻌﻨﻲ‬
‫ ﺑﺎل‬not enough secured‫ﻣﻤﻜﻦ ﯾﺮﺟﻊ‬
‫ واﺣﯿﺎﻧﺎ‬Snap inside the impression ‫اﻣﺎ ھﻮن ﻣﻤﻜﻦ ﯾﺮﺟﻊ ﯾﻜﻮن ﺑﺘﺤﺮك ﺑﺮﺟﻌﮫ‬
‫ﻣﺎ ﺑﺘﺮﺟﻊ ﻛﻤﺎ ﯾﺠﺐ‬impression ‫ ﺑﺎل‬voids ‫ ازا ﺑﻜﻮن ﻓﻲ‬snapping ‫ﻟﻤﺎ اﻋﻤﻠﮭﺎ‬
movement inside the impression ‫ ﻓﺄي‬very accurate ‫ﺣﻜﯿﻨﺎ ﻗﺒﻞ ﻻزم ﺗﻜﻮن‬
more ‫ ادق ﻻﻧﮭﺎ‬open tray ‫ ﻋﺸﺎن ھﯿﻚ ﺑﻨﻌﺘﺒﺮ ال‬might lead to inaccuracy
secure

Indications:

- single implants
- short-span bridge impressions
open or ‫ﻟﻮ ﻋﻨﺪي زرﻋﺘﯿﻦ ﺗﻼﺗﺔ ﻟﻮ اﺳﺘﺨﺪﻣﺖ‬
‫ ﺟﯿﺪة ﻟﻜﻦ ﻓﻮق‬result ‫ اﻟﺘﻨﺘﯿﻦ ﺑﻌﻄﻮﻧﻲ‬closed
open ‫اﻟﺘﻼت زرﻋﺎت ﺑﺮوح ﻟﻞ‬
 - posterior implants with insufficient intraoral access
- Pts with exaggerated gag reflex Limitations:
- Not recommended for multiple implants (›3) or divergent
implants

Open tray technique Closed tray technique

No. Of steps 1 step 2 steps

Accuracy Much more accurate Less accurate, Any movement in

the impression might lead to
inaccuracy

No. Of implant 1 or multiple implant (4 or more Not recommended for multiple

implants) implants ( 3 or fewer )

Presence of divergent implant ✅ ❌

Time Long time (Unscrewing inside the Short time (when the setting of
ptn’s mouth) the material is achieved the
impression will be picked up from
the ptn’s mouth )

Gag re ex Di cult to achieve in gag re ex Can ba achived in gag re ex ptn

ptn

Mouth opening Di cult in limited mouth opening Can achieved In limited mouth
pth opening ptn

Source of accuracy I need Very Secured connection btw the coping & the impression
(zero movement btw them )
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ffi
fl
fl
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• Other implant impression techniques

Traditional crown & bridge impression

‫ ع طﻮل ﺑﺎل‬abutment ‫دارﺟﺔ ﺑﺎﻟﺴﻮق اﻧﮫ اﻟﺪﻛﺘﻮر ﯾﺤﻂ‬technique ‫ﻟﻼﺳﻒ ھﺎي ال‬
‫ اﺣﯿﺎﻧﺎ ﻟﻤﺎ ﯾﺤﻂ ال‬technician ‫ )ال‬technician ‫ وﻛﺎﻧﮫ اﺷﺘﻐﻞ ﺷﻐﻞ ال‬ptn’s mouth
( ‫ ﺑﺤﻀﺮ‬cast ‫ ﻋﺎل‬abutment
‫ و ﺑﻨﺤﻀﺮ اﻻﺳﻨﺎن ھﻮن ﻧﻔﺲ‬retraction cord ‫ ﻛﯿﻒ ﺑﻨﺤﻂ‬preparation ‫ﺑﻌﺪھﺎ ﺑﻌﻤﻞ‬
retraction cord ‫ ﯾﺤﻂ‬finish line ‫ ﻣﻤﻜﻦ ﯾﻘﺼﺮه او ﯾﻌﻤﻞ‬abutment‫اﻻﺷﻲ ﺑﺤﻀﺮ ال‬
impression ‫و ﯾﺎﺧﺪ‬

- The main advantage is simplicity ( doesn’t need experience from

the operator or the technician )

- Disadvantages :
1) can’t be achieved in screw retained only in cemented restoration
( the best retention for the implant restoration is screw retained)
2) Not accurate (‫)ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻲ ﺣﻜﯿﻨﺎ ﻋﻨﮭﻢ‬

not the first choice ‫ ًوﻻ ﺑﻨﺤﻜﻲ ﻋﻨﮭﺎ ﻏﻠﻂ ﻟﻜﻨﮭﺎ‬not contraindicated ‫ھﻲ‬

Impression material

- Dimensionally accurate.
- Rigid
- Good tear resistance
- Good elastic recovery
- Dimensionally stable over time.
- Reasonable cost

how could I achieve secure connection btw the implant & ‫داﺋﻤﺎ ﺑﺪي اطﻠﻊ‬
coping
!yess ‫ ﺑﺄﺛﺮ ؟ اﻟﺠﻮاب‬impression material ‫ھﻞ اﺧﺘﯿﺎر ال‬

The least elastic property the more secure connection(1

‫ او‬ZOE ‫ اﻛﯿﺪ ﻣﺎ رح اﺳﺘﺨﺪم‬elastomers ‫ ﻣﻦ ﻋﯿﻠﺔ ال‬material ‫اﻛﯿﺪ رح ﺗﻜﻮن ال‬
.‫ ﺑﻜﻮن اﻓﻀﻞ‬less elastomer ‫ ﻟﻜﻦ ﻛﻞ ﻣﺎ ﻛﺎﻧﺖ‬compound rigid material
Examples of elastomers: A-silicone, C-silicone & polyether

‫ ﻓﻲ ﺳﺒﻊ زرﻋﺎت‬Arch ‫ ﻋﻨﺪي ﻣﺘﻼ‬multiple coping ‫ ﻋﻨﺪي‬2

‫ ﻣﻤﻨﻮع ﯾﻜﻮن ﻓﻲ‬accurate ‫ ﻻزم ﯾﻜﻮن ﻛﺘﯿﺮ‬screw retained ‫ﺑﺪي اﻋﻤﻞ ﺟﺴﺮ ﻛﺎﻣﻞ‬
‫ ؟‬security of connection ‫ ﺷﻮ ﻣﻤﻜﻦ اﻋﻤﻞ ﻋﺸﺎن ازﯾﺪ ال‬7 copings ‫ﺣﺮﻛﺔ ﺑﺎل‬
‫ ﺑﻮﺻﻠﮭﻢ ﻣﻊ ﺑﻌﺾ ﺑﺤﻂ‬copings ‫ ﻟﻞ‬splinting ‫ ﺑﻌﻤﻞ‬impression ‫ﻗﺒﻞ ﻣﺎ ﻧﺎﺧﺪ ال‬
‫ ھﯿﻚ ﺑﻀﻤﻦ اﻧﻲ اﺧﺪت‬impression ‫ﺑﻌﺪھﺎ ﺑﺎﺧﺬ ال‬.. acryl ‫ ﻣﻊ‬composites ‫ ﻣﻊ‬floss
🥲 redo ‫ ﻻﻧﮫ ﻟﻮ واﺣﺪ ﻣﻨﮭﻢ ﺗﺤﺮك‬secured ‫ ﻛﺘﯿﺮ‬copings ‫ وال‬impression ‫ال‬
prosthesis . ‫ ﻟﻞ‬misfitting ‫اي ﺣﺮﻛﺔ ﻣﻌﻨﺎھﺎ ﺑﺰﯾﺪ ﻧﺴﺒﺔ ال‬

What’s the most rigid material in the elastomers ? Polyether

‫ ﻣﺘﻼ ﻋﻨﺪي‬polyether ‫ و ﻓﻲ ﻋﻨﺪي اﺳﻨﺎن ﺷﻮ ﻣﺸﻜﻠﺔ ال‬impression ‫📍ﻟﻮ ﺑﺪي اﺧﺪ‬

‫ ؟‬wide traiangular spaces ‫زرﻋﺎت و ﻋﻨﺪي اﺳﻨﺎن ورا ﻓﯿﮭﻢ‬٣
partially edentulus cases ‫ ﻓﻠﻮ ﺑﺪي اﺳﺘﺨﺪﻣﮭﺎ ب‬، ‫ازا ﻋﻠﻖ ﻓﯿﮭﻢ ﻛﺘﯿﺮ ﺻﻌﺐ اﺷﯿﻠﮫ‬
A- ‫ أو ﺑﺴﺘﺨﺪم ال‬rigid ‫ ﻻﻧﮭﺎ ﻛﺘﯿﺮ‬undercut ‫ ﻟﻞ‬block ‫ ﺑﻌﻤﻞ‬undercuts ‫ﺑﺴﻜﺮ ال‬
silicone
‫ ﻛﺨﯿﺎر أول‬polyether ‫ ﺑﺴﺘﺨﺪم ال‬full edentolus ‫ﻟﻮ ﻋﻨﺪي‬

A-silicone ‫ ﻣﻤﻜﻦ اﻓﻀﻞ اروح ﻟﻞ‬Divergent implants ‫📍ﺑﺎل‬

(‎
✅ A higher accuracy for addition silicone (PVS) in the presence of
nonparallel implants,
✅ PE achieved the best results with parallel implants and standard
impression copings
✅ Condensation silicone had been described as the worst material for
implant transfer impressions and may be considered contraindicated

Splinted versus Non-Splinted

Connection of all copings with

an acrylic resin to prevent
individual coping movement
and achieve rotation
stabilization during the
impression procedure.

If I have 2 or more implants to achieve the secure connection btw

coping & implant it’s recommended prior to impression making
‫ ﺑﻮﺻﻠﮭﻢ ﺑﺒﻌﺾ‬splinting ‫ وﺑﻌﻤﻞ‬floss ‫ ﺑﺠﯿﺐ‬ptn’s mouth ‫ ﺑﺎل‬coping ‫ﺣﻄﯿﺖ ال‬
‫ ﻛﺘﯿﺮ ﯾﻜﻮﻧﻮا‬copings ‫ اﻧﮫ ﻛﻞ ال‬impression‫ ﻓﺒﻀﻤﻦ ﻟﻤﺎ اﺧﺪ ال‬rigid material ‫ﺑﺄي‬
‫ ﻣﺴﺘﺤﯿﻞ ﯾﺘﺤﺮﻛﻮا ﺣﺘﻰ ﻟﻮ ﺿﻐﻄﺖ ﺑﺎﺻﺒﻌﻲ ﻣﺎ ﺑﺘﺤﺮﻛﻮا ﻻﻧﮭﻢ ﻣﻮﺻﻮﻟﯿﻦ ﻣﻊ‬secured
‫ﺑﻌﺾ‬

acrylic or composite ‫ ﻣﻮﺻﻮﻟﯿﻦ ب‬copings ‫ ﻋﻨﺪي‬full arch ‫📍ﺑﺎﻟﺼﻮرة‬

material

📍 if you want to make splinted technique you should select material

with minimal shrinkage, for example: light cured composite filling
material
Light cured ➡ has lower shrinkage compared with self cured
Composite filling ➡ the higher filler material makes good result
 ‫ ﺑﻮﺻﻞ‬floss ‫ زرﻋﺎت ﺑﺠﯿﺐ‬4-5 ‫ ل‬one shot ‫ ب‬impression ‫📍ازا ﺑﺪي اﻋﻤﻞ ال‬
‫ ﻣﻤﻜﻦ‬composite ‫ ﻋﺸﺎن اﺣﻂ ﻋﻠﯿﮫ ال‬scaffold ‫ وظﯿﻔﺘﮫ ﯾﻌﻤﻠﻲ‬copings ‫ﺑﯿﻦ ال‬
‫ ﺑﺘﻜﻮن‬impression ‫ وﺑﺎﺧﺪ ال‬light cure ‫ ﺑﻌﻤﻞ‬composite ‫اﺳﺘﻐﻨﻲ ﻋﻨﮫ ﺑﻌﺪھﺎ ﺑﺤﻂ ال‬
‫ و ھﺎد ﺑﺄﺛﺮ‬composite ‫ ﻛﺎﻣﻞ ﻣﻦ ال‬tube ‫ ﻟﻜﻦ ﻣﺸﻜﻠﺘﻲ ﻣﻤﻜﻦ اﺧﻠﺺ‬very accurate
‫ ﻓﺎل‬chaiside time ‫ ﺑﺰﯾﺪ ال‬ptn’s mouth ‫ ﺑﺎل‬time ‫ و اﺿﺎﻓﺔ ﻟﻞ‬cost ‫ﻋﺎل‬
⬇ ‫ھﻸ رح ﻧﺤﻜﻲ ﻋﻨﮭﺎ‬2 stages ‫ اﻋﻤﻞ‬more common ‫ ال‬technique

Impression with linked “pick-up” impression coping using custom

tray

1) Very fast primary impression

closed ‫ ﺑﺴﺘﺨﺪم ال‬primary impression ‫ﺑﺪي اﻋﻤﻞ‬
‫ اﻧﺎ ﻣﺶ ﻣﮭﺘﻤﺔ ﺗﻜﻮن ال‬alginate ‫ وﻣﻤﻜﻦ اﺳﺘﺨﺪم‬tray
‫ ﺣﺘﻰ ﺑﻨﺼﺒﮭﺎ ﺑﺪون ﻣﺎ ﻧﺤﻂ ال‬، ‫ دﻗﯿﻘﺔ‬impression
‫ ﺑﺸﻜﻞ‬rough estimation ‫ ﻓﺒﺘﻌﻄﺒﻨﻲ‬gingival mask
‫ ﻣﺶ ﻣﮭﻢ ﯾﺠﻲ اﻟﻤﺮﯾﺾ ﺟﻠﺴﺔ‬, ‫ﻋﺎم ﻋﻦ ﻣﻜﺎن اﻟﺰرﻋﺎت‬
cast ‫ﺧﺎﺻﺔ ﻋﺸﺎﻧﮭﺎ ﻣﻤﻜﻦ اﻋﻤﻠﮭﺎ ﺑﺎي ﺟﻠﺴﺔ ﺑﻌﻤﻠﮫ ھﺎد ال‬

* splinted technique is used only in open tray not closed one

open tray ‫ ﺑﻮﺻﻞ ال‬cast ‫(ﻋﺎل‬2

duraly ‫ و ﺑﻀﯿﻒ‬analogue ‫ ﻋﺎل‬copings
floss ‫ ﻋﺎل‬acryl

accurate ‫ ﻣﺶ ﻛﺘﯿﺮ‬cast ‫(اﺗﻔﻘﻨﺎ اﻧﮫ ھﺎد ال‬3

‫ ﻛﺘﯿﺮ‬disk ‫ واﻟﺘﺎﻧﻲ ب‬coping ‫ﺑﻔﻀﻞ ﺑﯿﻦ ﻛﻞ‬
very minimal amount ‫ﺻﻐﯿﺮ ﺑﺸﯿﻞ‬
‫ ﻋﺸﺎن ﻣﺎ ﻧﺨﺮﺑﻂ‬coping ‫و ﺑﺮﻗﻢ ال‬
ptn’s mouth ‫ﺑﺎل‬
‫‪4) custom tray‬‬
‫ﻣﻤﻜﻦ اﻋﻤﻞ ب ‪ stock tray‬ﺑﺲ ال‬
‫‪ custom‬ﺑﺘﺴﺮع ﻋﻤﻠﯿﺔ ال ‪impression‬‬

‫‪(5‬بفك من ال ‪ cast‬ال ‪ copings‬احتمال‬

‫كبير ملا احط ال ‪ material‬الحظوا انه في‬
‫‪ thin slice‬بني كل وحدة في احتمال انه‬
‫كل وحدة تضرب بالتانية النه ال‬
‫‪ accuracy‬مش ‪%100‬‬
‫ملا يكون وحدة ضاربة بالتانية بجيب‬
‫‪ needle bur‬عشان افصل بينهم الزم كل‬
‫وحدة تقعد باملكان الصح‬

‫‪advantages :‬‬

‫‪ -‬هيك ال‪ chair side time‬صار اقل ضفت كمية قليلة من ال ‪acryl‬او ‪composite‬‬
‫ولو ضفته ما رح اضيف كبيرة فال ‪ cost‬مش عالية‬
‫‪The most accurate technique if I don’t want to use one shot ( if I‬‬
‫‪don’t have time ) i go for 2 steps primary secondary technique‬‬

‫‪ -‬كل ما زادت كمية ال ‪ acryl‬بزيد ال ‪ shrinkage‬لكن انا هون ضفت كمية قليلة من‬
‫ال ‪ acryl‬فما بخاف من ال ‪ shrinkage‬حتى لو استمر ‪ ٢٤‬ساعة 👍‬
‫بس يصيرله ‪ setting‬باخد ال ‪impression‬‬

‫&‪This technique is more common‬‬

‫‪more used‬‬
‫ازا بدي استخدم ال ‪ acrylic resin‬ﻻزم‬
‫ و ﺑﻀﯿﻒ ﻛﻤﯿﺔ ﺻﻐﯿﺮة ﻣﻦ ال‬thin slices ‫ ﻻزم ﯾﻜﻮن ﻋﻨﺪي‬technique ‫اﺳﺘﻌﻤﻞ ھﺎي ال‬
‫ ﻣﺎ رح ﺗﻜﻮن‬acrylic ‫ اﻋﻤﻠﮫ ﻛﻠﮫ ب‬one shot ‫ أﻣﺎ ال‬ptn’s mouth ‫ ﺑﺎل‬resin
🫡 ‫ ﻣﺴﺘﻤﺮ‬shrinkage ‫ ﺑﻜﻮن اﺣﺴﻦ ﻻﻧﮫ ال‬splinting ‫ اﺑﺪا ﯾﻌﻨﻲ ﻟﻮ ﻣﺎ اﻋﻤﻞ‬accurate

to achieve ACCURACY ‫ ھﻮ‬technique ‫ ﻣﻦ ھﺎي ال‬AIM ‫✅ﻛﻞ ال‬

impression materials ‫ﻛﺘﺒﺘﮭﺎ ﺑﺎﻟﻨﻘﻄﺔ اﻟﺘﺎﻧﯿﺔ ﻋﻨﺪ ال‬

‫ ﺗﺎﻧﯿﺔ ازا ﻣﻌﯿﺶ وﻗﺖ‬technique ‫ھﺎي‬

light cured ‫ﺑﻮﺻﻠﮭﻢ ب‬
highly filled ‫ و ﺗﻜﻮن‬composite
secondary ‫ و‬primary ‫ﻣﺎ ﻋﻤﻠﺖ‬
moisture control ‫ﻻزم ﻧﻌﻤﻞ‬
‫ ﻋﺸﺎن ال‬saliva ‫ﺿﺮوري ﻣﺎ ﯾﺠﻲ‬
composite .
‫ ﻻﻧﻲ‬good quality material ‫ﻻزم‬
‫ ﻣﺶ ﻣﻌﻨﯿﺔ ﯾﺼﯿﺮ‬one shot ‫ﺑﺪي اﻋﻤﻞ‬
tube ‫ ﺻﺢ رح ﯾﻜﻠﻔﻨﻲ‬shrinkage
chair side ‫ﻛﺎﻣﻞ ﻟﻜﻦ اﺧﺘﺼﺮت ال‬
time

Implant Angulation

•Regardless of the splinted technique

used, the angulated implant always
presents the worst accuracy in
comparison with the straight implant in
all splinted techniques.

) parallel‫ﺣﻜﯿﻨﺎ ﻗﺒﻞ ﻟﻮ ﻛﻨﺎ ﻣﺶ ﻣﺘﺎﻛﺪﯾﻦ اﻧﮫ اﻟﺰرﻋﺎت‬

open tray ‫ ﺑﺲ ﺣﺘﻰ ﺑﺎل‬.open tray technique ‫(ﺑﻨﺮوح ﻟﻞ‬divergence ‫ﯾﻌﻨﻲ ﻓﯿﮭﻢ‬
accuracy ‫ ﺑﺘﻘﻞ ال‬divergence ‫ﻛﻞ ﻣﺎ زاد ال‬
• The addition silicon produced more accurate casts for nonparallel
implants, it’s the first option because I need elastic material

Note :if I make splinted technique the impression material versay will
not have significant effect
‫ ما رح يفرق‬impression ‫ بطريقة صح نوع ال‬splinted technique ‫يعني لو عملت‬
. splinting ‫ ﻻﻧﮫ ﻋﺎﻣﻠﺔ‬accuracy ‫ ﻣﺶ رح ﺗﺎﺛﺮ ﻋﺎل‬alginate ‫ﺣﺘﻰ ﻟﻮ اﺳﺘﺨﺪﻣﺖ‬

‫ ﻏﯿﺮ ھﯿﻚ‬good splitting ‫ ازا ﻛﻨﺖ ﻋﺎﻣﻠﺔ‬is an option ‫ ﺑﻜﻮن اﺣﯿﺎﻧﺎ‬C-silicone ‫ال‬
polyether ‫ او‬A-silicone ‫ﺑﺴﺘﺨﺪم‬

• For multi-unit partially edentulous situations with implants having

minimal divergence, the technique employed (direct or indirect) has
no significant statistical influence
If I have divergence ➡ go for direct technique
.
abutment level ‫ اﺳﻤﮭﺎ‬divergence ‫ ﻟﻠﺤﺎﻻت اﻟﻲ ﻓﯿﮭﻢ ﻛﺘﯿﺮ‬technique ‫ ﺷﺮﺣﺖ‬-
😵💫 ‫ ﻣﺎ ﻛﺘﺒﺘﮭﺎ ﻻﻧﻲ ﺗﻌﺒﺖ‬just to know ‫ ﺣﻜﺖ‬technique

Impression tray

a little bit ‫ ؟‬accuracy ‫ ﺑﺘﺄﺛﺮ ﻋﺎل‬tray ‫ھﻞ ال‬

-Rigid ( whether it’s plastic or metal)
- adequate extension
- there must be no contact between impression tray and the structures
or components to be recorded

Custom or stock both can be used &

gain accurate results
Butt Custom tray is much easier (fit in
the ptn’s mouth)
materials‫ﻛﻤﺎن اﻟﻜﻤﯿﺔ اﻟﻲ رح ﻧﺴﺘﺨﺪﻣﮭﺎ ﻣﻦ ال‬
‫رح ﺗﻜﻮن اﻗﻞ‬
Note that If I make splinting the effect
of tray will be insignificant
 ‫كتير منيح استخدم اشي‬
impression ‫اسمه‬
adhesive ‫ في‬adhesive
‫ و في‬A-silicone ‫لل‬
‫بالذات اكتر اشي لل‬
‫ لنفس ال‬polyether
security ‫ هو ال‬concept
of connection
‫ عال‬adhesive ‫لو احط‬
security ‫ اكيد رح تزيد ال‬coping

The accuracy of the final implant cast also depends on

- Impression & pouring techniques➡ open is more accurate than

closed one

Impression material & die stone properties -

directly ‫ ﻣﺨﺘﻠﻒ ﻋﻦ اﻻﺳﻨﺎن ﻻﻧﮫ ھﻮن رح ﯾﺸﺘﻐﻞ‬stone ‫ ﻻزم ﯾﺴﺘﺨﺪم‬technician ‫ال‬
zero expansion ‫ ﻻزم ﯾﻜﻮن‬cast ‫ﻋﺎل‬
‫ ﺑﺘﻠﻌﺐ دور ﻟﻜﻦ ﻣﺶ ﻣﻮﺿﻮﻋﻨﺎ ھﺎي ﺷﻐﻠﺔ اﻟﻤﺨﺘﺒﺮ‬pouring technique ‫ ال‬+

- Machining tolerance of prosthetic components

‫ ﻣﺴﺘﻮاه اﻋﻠﻰ ﻛﻞ ﻣﺎ‬system ‫ ﻛﻞ ﻣﺎ ﻛﺎن ال‬accuracy of the components ‫ﯾﻌﻨﻲ ال‬
inaccuracy ‫ و‬misfiting ‫ ﻛﻞ ﻣﺎ ﻛﺎن ﻣﺴﺘﻮاه اﻗﻞ ﺑﻌﻄﯿﻨﻲ‬more accuracy ‫اﻋﻄﺎﻧﻲ‬
Analogous & copings ‫ ﻗﺼﺪي ﻓﯿﮭﺎ ال‬Components

- Implant angulation and/or depth

accuracy ‫ ﺑﺘﺰﺑﺪ ال‬parallel ‫ﻛﻞ ﻣﺎ ﻛﺎﻧﻮ‬

- Number of implants, ‫ﻛﻞ ﻣﺎ زادت ﻋﺪد اﻟﺰرﻋﺎت زادت ﻧﺴﺒﺔ اﻟﺨﻄﺄ‬

- The selected implant systems
- The proximity of adjacent tooth
‫ وﻛﺎن ﻣﯿﻼن اﻟﺰرﻋﺔ‬coping ‫ازا رﻛﺒﺖ ال‬
coping ‫ ﻟﻞ‬trimming ‫ﻗﺮﯾﺐ ﻋﺎﻟﺴﻦ ﺑﻌﻤﻞ‬
‫ ﯾﻜﻮن‬coping ‫اﻛﯿﺪ ﻣﺶ اﻟﺴﻦ ﻻﻧﻲ ﺑﺪي ال‬
impression material ‫ﻣﺤﺎط ﺑﺎل‬
coping ‫ﻛﻤﺎن ﻧﻘﻄﺔ ﻣﮭﻤﺔ ﻻزم اﺗﺎﻛﺪ اﻧﮫ ال‬
seated well in the implant
‫ ﺑﺮﻛﺐ‬deep implants ‫اﺣﯿﺎﻧﺎ ﺑﻜﻮن ﻋﻨﺪي‬
‫ ﻋﻠﯿﮭﻢ ﺑﺲ ﻣﺎ ﺑﻜﻮن ﺿﺎﻣﻨﮫ اﻧﮫ‬coping ‫ال‬
‫ﻋﺸﺎن اﺧﺪ‬parallel technique ‫ ﻋﺎﻻﺧﺮ ﻓﻌﺸﺎن اﺗﺎﻛﺪ ﺑﺼﻮر اﺷﻌﺔ ب‬seated
.‫ ﺻﺢ‬information
‫ رح‬implant ‫ ﺑﺎل‬seated completely ‫ ﻣﺶ‬coping ‫ ﻣﺎﺳﻚ ﺑﺲ ال‬screw ‫ﻟﻮ ﻛﺎن ال‬
‫ﺗﻄﻠﻊ ﻛﻞ طﺒﻌﺘﻲ ﻏﻠﻂ‬

- Splitting in a proper technique ➡ more accurate than non splinting

Impression of deeply placed implants

‫ ؟‬deep ‫ﺷﻮ ﻣﺸﻜﻠﺘﻲ ﺑﺎﻟﺰرﻋﺔ ال‬

‫ ﻣﺶ رح ﺗﻜﻮن ﻛﺘﯿﺮ‬open tray ‫ﺣﺘﻰ ﻟﻮ‬
‫ و ﯾﻄﻠﻊ ال‬screw ‫ﺛﺎﺑﺘﺔ و ﻟ ًﻤﺎ اﻓﻚ ال‬
retentive ‫ ﺑﻜﻮن ﺑﺘﺤﺮك ﻻﻧﮫ ال‬coping
‫ ﻓﻮق اﻟﻠﺜﺔ ﻛﺘﯿﺮ ﻗﻠﯿﻠﺔ ﻓﻜﯿﻒ رح‬features
! ‫ﺗﻤﺴﻚ‬
square‫ ﺑﻜﻮن‬open tray ‫ﻓﻲ ﻋﺎل‬
‫ ﺑﮭﺎي‬retention ‫ﻋﺸﺎن ﯾﺰﯾﺪوا ال‬areas
hidden beneath the ‫اﻟﺤﺎﻟﺔ رح ﯾﺼﯿﺮﻟﮭﻢ‬
secure ‫ ﻣﺎ رح ﯾﺼﯿﺮ‬gingiva
connection
retentive ‫ ﺑﺤﯿﺚ ﺗﻜﻮن ال‬very long coping ‫ اﻣﺎ اﺳﺘﺨﺪم‬How to manage
😔 ‫ ﻣﺎ ﺑﺘﻮﻓﺮه‬coping systems ‫ طﺎﻟﻌﺔ ﻓﻮق اﻟﻠﺜﺔ ﺑﺲ ﻟﻼﺳﻒ ﻣﻌﻈﻢ ال‬features
 Some modifications to achieve retention‫اﻟﻄﺮﯾﻘﺔ اﻟﺘﺎﻧﯿﺔ اﻋﻤﻞ‬
‫ ﺑﻜﻮن ﻣﻌﻈﻤﮭﺎ ﻓﺎﺗﺖ ﺗﺤﺖ اﻟﻠﺜﺔ ﻻﻧﮭﺎ‬retentive features of the coping ‫اﻧﻲ ازﯾﺪ ال‬
‫ ﺑﺘﻜﻮن‬ring ‫ ھﺎي ال‬retention ‫ ﺑﺘﻌﻤﻠﻲ‬composite ring ‫ ﻣﻤﻜﻦ اﻋﻤﻞ‬deep ‫اﻟﺰرﻋﺔ‬
any ‫ ﯾﻌﻨﻲ ﺑﻤﻌﻨﻰ آﺧﺮ اﻋﻤﻞ‬impression ‫ و ﺑﺘﻤﺴﻚ ﺟﻮا ال‬material ‫ﻣﺤﺎطﺔ ﺑﺎل‬
‫ اﻟﻤﮭﻢ ﻧﻀﻤﻦ ال‬undercuts ‫ ﺣﺘﻰ ﻟﻮ ﻋﻤﻠﺖ‬retentive features you want
retention

Done ✅