impression techniques-.pptx

IMPRESSION TECHNIQUES FOR IMPLANT PROSTHESES  OUTLINE INTRODUCTION MATERIALS REQUIRED IMPRESSION TECHNIQUES GINGIVAL MASKING ERRORS LITERATURE REVIEW CONCLUSION  INTRODUCTION Accurate recording of spatial implant position is r...

IMPRESSION TECHNIQUES FOR IMPLANT PROSTHESES  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 Soft Tissue Axis Contour (Angulation) (Emergence Profile) WHAT ALL DO YOU NEED TO MAKE IMPLANT IMPRESSIONS? WHICH IMPRESSION MATERIAL TO CHOOSE? Minor Minor bone bone toxicity toxicity Toxic Toxic to to bone bone Very stable Relatively Stable Multiple viscosities POLY Slow set available VINYL POLY- Unpleasant Unpleasant taste taste to patient SILOXAN SULFIDE E Toxic Toxic to to bone bone POLY- OTHERS Least Least stable stable Very Very rigid Very rigid ETHER (HYDRO- Low Low tear tear strength strength Very Stable Stable Least Least desirable desirable to to Most hydrophilic COLLOID use use due due to to S) limitations limitations of of material  HOW TO MAKE AN IMPRESSION FOR IMPLANT PROSTHESES? Implant Level Abutment Level Impressions Impressions 1. Pick Up (Open Tray) 1. Direct Technique 2. Transfer Type (Close 2. Indirect Technique Tray ) IMPLANT LEVEL IMPRESSIONS  Open Tray Closed Tray More accurate for multi unit Less accurate for multi unit impressions 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 Easier Inaccuracies with space Suitable for short recovery and Tendency to gag inter arch distance subsequent Difficult access in Visual fastening of deformation of the posterior region the analog to the impression material of the mouth coping is more may be encountered accurate with 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- ALL ON SIX  Indications Advantages Disadvantages Heather J. Heather J. Multiple implants Reduces the effect of Some rotational Very closely located the implant movement of the implants angulation impression coping Reduces the when securing the deformation of the implant analog may impression material occur Removes the concern Blind attachment of for replacing the the implant analog to coping back into its the impression coping respective space in may result in a misfit the impression. of components ABUTMENT LEVEL IMPRESSIONS Simple For custom- Selecting provisional made abutments in restoration abutments the laboratory fabrication DIRECT- ABUTMENT LEVEL IMPRESSION TECHNIQUE INDIRECT- ABUTMENT LEVEL IMPRESSION TECHNIQUE GINGIVAL MASKING  WHAT SHOULD YOU SEND TO THE LAB? Necessary Appropriate and restorative Lab prescription accurate Mounted models components for 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 IMPROPER ERRORS IN OF COMPONENTS INTERFACE IMPRESSION BETWEEN MAKING IMPRESSION POST Latex gloves with AND IMPLANT PVS impression ANALOGUE 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