Evaluating the Effect of Different Impression Techniques and Splinting Methods on the Dimensional Accuracy of Multiple Implant Impressions: An in vitro Study
Rajnish Aggarwal, Shashikala Jain, Sunita Choudhary, Harpreet S Saini, N Kulashekar Reddy
Citation Information :
Aggarwal R, Jain S, Choudhary S, Saini HS, Reddy NK. Evaluating the Effect of Different Impression Techniques and Splinting Methods on the Dimensional Accuracy of Multiple Implant Impressions: An in vitro Study. J Contemp Dent Pract 2018; 19 (8):1005-1012.
Aim: This study was done to determine more accurate impression technique and splinting method for multiple implant impressions in edentulous patients.
Materials and methods: A prefabricated maxillary reference model was taken on which four implants were placed parallel to each other using vertical milling machine. Forty custom trays having different tray designs were fabricated using autopolymerizing acrylic resin on the stone cast obtained from the reference model. A total of 40 samples (n = 40) were divided into five groups, in which group I included casts obtained from impressions made with closed-tray technique, group II: open-tray impression technique, group III: open-tray impressions splinted with acrylic, group IV: open-tray impressions splinted with light cure material, and group V acted as a control group (reference model). Casts obtained were poured with dental stone. The interimplant distances were checked using coordinate measuring machine to evaluate the three-dimensional (3D) positional accuracy in X, Y, and Z axes.
Results: Casts obtained from impressions made with closedtray technique showed highest mean deviation from the reference model while those obtained from open-tray splinted with light cure showed the least deviation. The casts obtained from open-tray nonsplinted and open-tray acrylic splinted showed intermediate mean deviations.
Conclusion: The casts obtained from open-tray impression technique were more accurate as compared with the closedtray technique. Among splinting, the impressions obtained from light cure splinting showed more accuracy than the impressions obtained from acrylic splinting.
Clinical significance: The accuracy of the multiple implant impression is influenced by the type of impression material used which ultimately leads to an accurate cast on which precisely fitting prosthesis is fabricated. Several factors including material accuracy, time span before the impression is poured, and extent of intraoral undercuts are to be kept in mind while choosing an impression material.
Goodacre CJ, Bernal G, Rungcharassaeng K, Kan JY. Clinical complications with implants and implant prostheses. J Prosthet Dent 2003 Aug;90(2):121-132.
Linkevicius T, Svediene O, Vindasiute E, Puisys A, Linkeviciene L. The influence of implant placement depth and impression material on the stability of an open tray impression coping. J Prosthet Dent 2012 Oct;108(4):238-243.
Lahori M, Mahesh L, Nagrath R, Singh S. An evaluation of the accuracy of multiple implant impression techniques: an in vitro study. J Implants Adv Clin Dent 2012 May-Jun;4(3):57-69.
Gallucci GO, Papaspyridakos P, Ashy LM, Kim GE, Brady NJ, Weber H. Clinical accuracy outcome of closed tray and open tray implant impression technique for partially edentulous patients. Int J Prosthodont 2011 Sep-Oct;24(5):469-472.
Rutkunas V, Sveigata K, Savickas R. Effects of implant angulation, material selection, and impression technique on impression accuracy: a preliminary laboratory study. Int J Prosthodont 2012 Sep-Oct;25(5):512-515.
Filho HG, Mazaro JV, Vedovatto E, Assuncao WG, Santos PH. Accuracy of impression techniques for implants. Part 2— comparison of splinting techniques. J Prosthodont 2008 Feb;18(2):172-176.
Choi JH, Lim YJ, Yim SH, Kim CW. Evaluation of the accuracy of implant-level impression techniques for internal-connection implant prostheses in parallel and divergent models. Int J Oral Maxillofac Implants 2007 Sep-Oct;22(5):761-768.
Assuncao WG, Tabata LF, Cardoso A, Rocha EP, Gomes EA. Prosthetic transfer impression accuracy evaluation for osseointegrated implants. Implant Dent 2008 Sep;17(3):248-256.
Jang HS, Kim S, Shim JS, Lee KW, Moon HS. Accuracy of impressions for internal-connection implant prostheses with various divergent angles. Int J Oral Maxillofac Implants 2011 Sep-Oct;26(5):1011-1015.
Sorrentino R, Gherlone EF, Calesini G, Zarone F. Effect of implant angulation, connection length, and impression material on the dimensional accuracy of implant impressions: an in-vitro comparative study. Clin Implant Dent Relat Res 2010 May;12(Suppl 1):e63-e76.
Jo SH, Kim KI, Seo JM, Song KY, Park JM, Ahn SG. Effect of impression coping and implant angulation on the accuracy of implant impressions: an in-vitro study. J Adv Prosthodont 2010 Dec;2(4):128-133.
Conrad HJ, Pesun IJ, DeLong R, Hodges JS. Accuracy of two impression techniques with angulated implants. J Prosthet Dent 2007 Jun;97(6):349-356.
Chai J, Takahashi Y, Lautenschlager EP. Clinically relevant mechanical properties of elastomeric impression materials. Int J Prosthodont 1998 May-Jun;11(3):219-223.
Liou AD, Nicholls JI, Yuodelis RA, Brudvik JS. Accuracy of replacing three tapered transfer impression copings in two elastomeric impression materials. Int J Prosthodont 1993 Jul-Aug;6(4):377-383.
Carr AB. Comparison of impression techniques for a twoimplant 15-degree divergent model. Int J Oral Maxillofac Implants 1992 Winter;7(4):468-475.
Daoudi MF, Setchell DJ, Searson LJ. An evaluation of three implant level impression techniques for single tooth implant. Eur J Prosthodont Restor Dent 2004 Mar;12(1):9-14.
Shankar YR, Sahoo S, Krishna MH, Kumar PS, Kumar TS, Narula S. Accuracy of implant impressions using various impression techniques and impression materials. J Dent Implants 2016 Sep;6(1):29-36.
Del'Acqua MA, Arioli-Filho JN, Compagnoni MA, Mollo Fde A Jr. Accuracy of impression and pouring techniques for an implant-supported prosthesis. Int J Oral Maxillofac Implants 2008 Mar-Apr;23(2):226-236.
Vigolo P, Majzoub Z, Cordioli G. Evaluation of the accuracy of three techniques used for multiple implant abutment impressions. J Prosthet Dent 2003 Feb;89(2):186-192.
Del Acqua MA, Chavez AM, Castanharo SM, Compagnoni MA, Mollo Fde A Jr. The effect of splint material rigidity in implant impression techniques. Int J Oral Maxillofac Implants 2010 Nov-Dec;25(6):1153-1158.
Burawi G, Houston F, Byrne D, Claffey N. A comparison of the dimensional accuracy of the splinted and unsplinted impression techniques for the Bone-Lock implants system. J Prosthet Dent 1997 Jan;77(1):68-75.
Inturregui JA, Aquilino SA, Ryther JS, Lund PS. Evaluation of three impression techniques for osseointegrated oral implants. J Prosthet Dent 1993 May;69(5):503-509.