Impression tecnique for implant supported rehabilitation/ dental courses

Impression technique
for implant
supported
rehabilitation
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.comwww.indiandentalacademy.com

CONTENTSCONTENTS
IntroductionIntroduction
Preparation and evaluation of patient forPreparation and evaluation of patient for
prosthetic careprosthetic care
Impression materials and componentsImpression materials and components
Impression procedures for edentulous patientImpression procedures for edentulous patient
Impression procedures for partially edentulousImpression procedures for partially edentulous
Single tooth impressionsSingle tooth impressions
Impressions during maintenance of removableImpressions during maintenance of removable
superstructuresuperstructure
Impressions for soldering the frameworksImpressions for soldering the frameworks
Impressions for maxillofacial implantsImpressions for maxillofacial implants
Summary and ConclusionSummary and Conclusion
ReferencesReferences

Ideal impression must be in the mind of theIdeal impression must be in the mind of the
dentist before it is in his hand .He mustdentist before it is in his hand .He must
literally make the impression rather thanliterally make the impression rather than
take ittake it -- M M DEVANM M DEVAN

Terminologies used in implantTerminologies used in implant
prosthesisprosthesis

 Cover screwCover screw is placed afteris placed after
stage 1 surgery into the top ofstage 1 surgery into the top of
the implant to prevent bone,the implant to prevent bone,
soft tissue, and debris fromsoft tissue, and debris from
invading the abutmentinvading the abutment
connecting area duringconnecting area during
healing.healing.

Healing capHealing cap is placed to facilitateis placed to facilitate
retention of the surgical dressing afterretention of the surgical dressing after
suturingsuturing
Abutment healing cap (2005): any temporary
cover used to provide a seal over the superior
portion of a dental implant; most such covers
are metallic and are intended for interim usage
following exposure of the dental implants
superior surface

 Permucosal extension or healingPermucosal extension or healing
abutmentabutment
Extends the implant above the softExtends the implant above the soft
tissue and results in the developmenttissue and results in the development
of permucosal seal around theof permucosal seal around the
implant, placed after stage 2 surgeryimplant, placed after stage 2 surgery
for soft tissue healing.for soft tissue healing.

 Transfer copingTransfer coping
 It is used to position an analog in anIt is used to position an analog in an
impression and is defined by the portion ofimpression and is defined by the portion of
the implant it transfers to the master cast,the implant it transfers to the master cast,
either the implant body transfer coping oreither the implant body transfer coping or
the abutment transfer coping.the abutment transfer coping.
 Used to position a die in an impressionUsed to position a die in an impression

 AbutmentAbutment is the portion of theis the portion of the
implant that supports or retainsimplant that supports or retains
prosthesis or the superstructureprosthesis or the superstructure
 SuperstructureSuperstructure is defined as a metalis defined as a metal
framework that fits the implantframework that fits the implant
abutment and provides retention for aabutment and provides retention for a
removable prosthesisremovable prosthesis

 An indirect transfer copingAn indirect transfer coping uses anuses an
impression material requiring elasticimpression material requiring elastic
properties.properties.
 It is screwed into the implant or theIt is screwed into the implant or the
abutment body and remains in placeabutment body and remains in place
when the set impression is removedwhen the set impression is removed
from the mouth.from the mouth.
 It is parallel sided or slightly tapered toIt is parallel sided or slightly tapered to
allow ease in removal.allow ease in removal.

 A direct transfer copingA direct transfer coping
 usually consists of a hollow transferusually consists of a hollow transfer
component often square, and a long centralcomponent often square, and a long central
screw to secure it to the abutment orscrew to secure it to the abutment or
implant body and may be used as the pickimplant body and may be used as the pick
up impression coping.up impression coping.
 It takes advantage of impression materialsIt takes advantage of impression materials
having rigid properties and eliminate thehaving rigid properties and eliminate the
error of permanent deformation becauseerror of permanent deformation because
they remain within the impression until thethey remain within the impression until the
master model is poured and separated.master model is poured and separated.

 Analog (1826Analog (1826) something that is analogous in part or whole to) something that is analogous in part or whole to
something else; i.e., a replica of a portion of an implantsomething else; i.e., a replica of a portion of an implant
abutment made of brass, aluminum, steel, or plasticabutment made of brass, aluminum, steel, or plastic
 Abutment Analog (2005Abutment Analog (2005): a replica of the superior portion of a): a replica of the superior portion of a
dental implant. Usually used to provide an exact form of thedental implant. Usually used to provide an exact form of the
dental implant abutment within the dental laboratory duringdental implant abutment within the dental laboratory during
fabrication of a prosthesis supported in part or whole by thefabrication of a prosthesis supported in part or whole by the
dental implantdental implant
 Abutment Post (2005):Abutment Post (2005): that component of a dental implantthat component of a dental implant
abutment which extends into the internal structure of a dentalabutment which extends into the internal structure of a dental
implant and is used to provide retention and/or stability to theimplant and is used to provide retention and/or stability to the
dental implant abutmentdental implant abutment

 Prosthetic copingProsthetic coping is a thin covering usually designed to fit theis a thin covering usually designed to fit the
abutment screw retention and serve as connection between theabutment screw retention and serve as connection between the
abutment and prosthesis or superstructure.abutment and prosthesis or superstructure.

Preparation and evaluationPreparation and evaluation
of patient for prostheticof patient for prosthetic
carecare

1. Remove the surgical pack.1. Remove the surgical pack.
2. Unscrew the healing caps.2. Unscrew the healing caps.
3. Remove any remaining sutures3. Remove any remaining sutures
4. Using radiographs, check if all abutments are correctly4. Using radiographs, check if all abutments are correctly
placed.placed.

5.5. check that the correct abutment length has been usedcheck that the correct abutment length has been used
taking into consideration such factors as oral hygiene,taking into consideration such factors as oral hygiene,
phonetics and cosmetic effects.phonetics and cosmetic effects.
6. Use the hexagonal screw driver to tighten the abutment6. Use the hexagonal screw driver to tighten the abutment
screws so that the abutments are firmly seatedscrews so that the abutments are firmly seated

If the radiographs show a space betweenIf the radiographs show a space between
the fixture and the abutment, it must bethe fixture and the abutment, it must be
corrected before an impression can becorrected before an impression can be
made.made.
1. Loosen the abutment screw using the1. Loosen the abutment screw using the
special screwdriver and remove thespecial screwdriver and remove the
abutment with abutment clamp,abutment with abutment clamp,
2. Inspect the coronal surface of the fixture2. Inspect the coronal surface of the fixture
and remove any soft tissue with a curette.and remove any soft tissue with a curette.

3 Clean the abutment & abutment screw in3 Clean the abutment & abutment screw in
saline solution.saline solution.
Check the silicon ring on the abutmentCheck the silicon ring on the abutment
screw & replace ,if damaged.screw & replace ,if damaged.
4 Tighten the abutment screw a few turns &4 Tighten the abutment screw a few turns &
rotate the abutment until it can be feltrotate the abutment until it can be felt
that it slides into positionthat it slides into position
5 Take new radiograph to verify that the5 Take new radiograph to verify that the
abutment is correctly seatedabutment is correctly seated

Impression materials andImpression materials and
componentscomponents

 Greatest accuracy occurs if impression is poured soon afterGreatest accuracy occurs if impression is poured soon after
they are removed.they are removed.
 Polyether absorbs water so should not be stored in thisPolyether absorbs water so should not be stored in this
medium.medium.
 Addition silicones are very stableAddition silicones are very stable
 Greatest dimensional change is seen with condensationGreatest dimensional change is seen with condensation
siliconessilicones
 Polysulfides shrink drastically after 24 hoursPolysulfides shrink drastically after 24 hours
 Least amount of dimension changes occurs in additionLeast amount of dimension changes occurs in addition
silicones and polyethers, so these should be used for finalsilicones and polyethers, so these should be used for final
impression.impression.
materialsmaterials

 Permanent deformation of impression material may bePermanent deformation of impression material may be
concern when the impression distorts from the undercutconcern when the impression distorts from the undercut
region of the indirect impression transfer coping duringregion of the indirect impression transfer coping during
removal.removal.
 60% of the deformation occurs when elastomeric60% of the deformation occurs when elastomeric
impression is removed from 1mm undercut in height andimpression is removed from 1mm undercut in height and
depth.depth.
 Permanent deformation or inaccurate placement of thePermanent deformation or inaccurate placement of the
indirect transfer coping in the impression may beindirect transfer coping in the impression may be
eliminated by using aeliminated by using a direct impression transfer copingdirect impression transfer coping forfor
final impression.final impression.
materialsmaterials

Materials and componentsMaterials and components

The standard abutments are identical inThe standard abutments are identical in
diameter and form and thus interchangeablediameter and form and thus interchangeable
both before and after the impression as long asboth before and after the impression as long as
the same length is used.the same length is used.
 When a squared transfer coping is used, theWhen a squared transfer coping is used, the
impression should be taken in impressionimpression should be taken in impression
plaster or polyether material. The coping areplaster or polyether material. The coping are
mounted on the abutments with screws (guidemounted on the abutments with screws (guide
pins).pins).
 The coping remain in the impression after theThe coping remain in the impression after the
guide pins have been disengaged and theguide pins have been disengaged and the
impression is removed from the mouth after theimpression is removed from the mouth after the
material is set.material is set. www.indiandentalacademy.comwww.indiandentalacademy.com

 Tapered transfer copings act in the same manner as aTapered transfer copings act in the same manner as a
prepared tooth.prepared tooth.
Thus only resilient material can be used like siliconesThus only resilient material can be used like silicones
polyetherpolyether
They are used when available space is lessThey are used when available space is less
 Impression materials must hold its form in a perfectlyImpression materials must hold its form in a perfectly
stable, manner since the tolerances allowed in the finishedstable, manner since the tolerances allowed in the finished
prosthesis is extremely small.prosthesis is extremely small.

 Primary reasons for making an impression is to transferPrimary reasons for making an impression is to transfer
the internal relationship of the abutments to a plasterthe internal relationship of the abutments to a plaster
model, the impression of the alveolar crest and its coveringmodel, the impression of the alveolar crest and its covering
of mucosa is of lesser importance.of mucosa is of lesser importance.
An exception is made in the case of moderate loss of hardAn exception is made in the case of moderate loss of hard
tissue in both the mandible and the maxilla where fortissue in both the mandible and the maxilla where for
cosmetic or phonetic reason; the prosthesis must becosmetic or phonetic reason; the prosthesis must be
formed so as to be in direct contact with the underlyingformed so as to be in direct contact with the underlying
mucosa.mucosa.

Impression proceduresImpression procedures
for edentulous patientfor edentulous patient

 Remove the healing caps with theRemove the healing caps with the
internal hexagon screw driver.internal hexagon screw driver.
 Rinse off debris and clean the areaRinse off debris and clean the area
around abutment.around abutment.
 Place the tapered impression copingsPlace the tapered impression copings
using the frictional fit screw driver.using the frictional fit screw driver.

 Select the appropriate size stock tray normallySelect the appropriate size stock tray normally
used for natural dentition .used for natural dentition .
 The edentulous stock trays do not provide spaceThe edentulous stock trays do not provide space
for impression copings.for impression copings.
 Make alginate impressionMake alginate impression
 Inspect the impression for accurate reproduction ofInspect the impression for accurate reproduction of
impression copings and rinse saliva from theimpression copings and rinse saliva from the
impressionimpression

 Connect abutment replicas to eachConnect abutment replicas to each
tapered impression copingstapered impression copings
 Slip each replica coping unit into theSlip each replica coping unit into the
impressionimpression
 Use gentle vibration when pouring theUse gentle vibration when pouring the

 Recover the cast and remove theRecover the cast and remove the
impression copingsimpression copings
 Completed diagnostic castCompleted diagnostic cast
 Connect the square impression copingsConnect the square impression copings
with the medium or long length guidewith the medium or long length guide
pinspins

 Block out the impression copings withBlock out the impression copings with
two thickness of base plate wax.two thickness of base plate wax.
 Be certain to leave the heads of theBe certain to leave the heads of the
guide pins exposedguide pins exposed
 Lubricate the cast and adapt tray resinLubricate the cast and adapt tray resin
on the caston the cast

 Make a full arch custom tray andMake a full arch custom tray and
leave the heads of the guide pinsleave the heads of the guide pins
exposedexposed
 Enlarge the guide pin accessEnlarge the guide pin access
holes to approximately 5.0mm inholes to approximately 5.0mm in
diameter.diameter.
 Finish the tray borders.Finish the tray borders.

 Remove the healing caps and connectRemove the healing caps and connect
the square impression coping withthe square impression coping with
medium guide pins.medium guide pins.
 Try in the tray to verify intraorally.Try in the tray to verify intraorally.
 Inject impression material aroundInject impression material around
each impression coping andeach impression coping and
surrounding tissues.surrounding tissues.

 Fill the impression tray with remainingFill the impression tray with remaining
impression material.impression material.
 Seat the tray intraorally and wipeSeat the tray intraorally and wipe
excess impression material to exposeexcess impression material to expose
the guide pins.the guide pins.
 Inspect the impression for accuracyInspect the impression for accuracy
and check for impression materialand check for impression material
between impression copings andbetween impression copings and
abutment cylinders.abutment cylinders.

 Connect abutment replicas toConnect abutment replicas to
each impression copingeach impression coping
 Bead the impression and use aBead the impression and use a
two pour techniquetwo pour technique
 After completing the secondAfter completing the second
pour and the stone has set,pour and the stone has set,
unscrew the guide pins.unscrew the guide pins.

 Separate the cast from the impressionSeparate the cast from the impression
 Trim and complete the master cast.Trim and complete the master cast.

 This provides simultaneous impressions of the implantsThis provides simultaneous impressions of the implants
and the determination of intermaxillary relationships, freeand the determination of intermaxillary relationships, free
of any interfering forces from the position of lips, cheeks,of any interfering forces from the position of lips, cheeks,
or tongue.or tongue.
Impression making with the patient’s mouth
closed

 During the first prosthetic appointment, theDuring the first prosthetic appointment, the
implants are uncovered, and stock traysimplants are uncovered, and stock trays
(ivotray) are used for the initial impressions(ivotray) are used for the initial impressions
of both mandible and maxilla. During thisof both mandible and maxilla. During this
procedure, the intermaxillary relationship isprocedure, the intermaxillary relationship is
estimated preciselyestimated precisely

 During the second appointment, using individualDuring the second appointment, using individual
custom trays with wax rims, the final functionalcustom trays with wax rims, the final functional
impressions of both the jaws can be made usingimpressions of both the jaws can be made using
masticatory pressure, and the definitivemasticatory pressure, and the definitive
intermaxillary relationship determined.intermaxillary relationship determined.

Review of literatureReview of literature

Paolo vigolo et al in 2003Paolo vigolo et al in 2003 studied and evaluated the accuracy ofstudied and evaluated the accuracy of
3 different impression techniques using polyether impression3 different impression techniques using polyether impression
material to obtain a master cast for the fabrication of a prosthesismaterial to obtain a master cast for the fabrication of a prosthesis
that would fit passively on multiple implants.that would fit passively on multiple implants.
 Group 1, non modified square impression copings ,Group 1, non modified square impression copings ,
 Group 2 square impression copings were used and joinedGroup 2 square impression copings were used and joined
together with autopolymerizing acrylic resin impressiontogether with autopolymerizing acrylic resin impression
procedureprocedure
 Group 3, square impression coping previously airborne particleGroup 3, square impression coping previously airborne particle
abraded and coated with the manufacturer recommendedabraded and coated with the manufacturer recommended
impression were used.impression were used.
 Positional accuracy of the abutments was numerically assessedPositional accuracy of the abutments was numerically assessed
with an optical scanner.with an optical scanner.

 It was concluded that improved accuracy of theIt was concluded that improved accuracy of the
master cast was achieved when the impressionmaster cast was achieved when the impression
technique involved square impression coping joinedtechnique involved square impression coping joined
together with autopolymerizing acrylic resin ortogether with autopolymerizing acrylic resin or
square impression coping that had been airbornesquare impression coping that had been airborne
particle abraded and adhesive coated.particle abraded and adhesive coated.

FULLY BONE ANCHOREDFULLY BONE ANCHORED
PROSTHESISPROSTHESIS

Impression technique forImpression technique for
implant supported overimplant supported over
denturedenture

 The material must be accurate to reproduce the exactThe material must be accurate to reproduce the exact
location of the implants or abutments and be of a viscositylocation of the implants or abutments and be of a viscosity
that does not distort the soft tissue one that is stiff enoughthat does not distort the soft tissue one that is stiff enough
to retain the implant or abutment analog during the pouringto retain the implant or abutment analog during the pouring
procedures.procedures.
 The heavy putty like materials provide the necessaryThe heavy putty like materials provide the necessary
stiffness and the light body material accurately reproducesstiffness and the light body material accurately reproduces
the area around the transfer components and the softthe area around the transfer components and the soft
tissues. The addition type polysiloxane material has thetissues. The addition type polysiloxane material has the
quality required.quality required. www.indiandentalacademy.comwww.indiandentalacademy.com

 The base of the tissue borne over denture should be asThe base of the tissue borne over denture should be as
large as possible within the functional and anatomicallarge as possible within the functional and anatomical
limitations to optimize the distribution of the occlusallimitations to optimize the distribution of the occlusal
forces.forces.
 There are several methods for making impression to obtainThere are several methods for making impression to obtain
a master cast for fabrication of the overdentures.a master cast for fabrication of the overdentures.

Single impression techniqueSingle impression technique

 kk

 AdvantagesAdvantages
 A single impression for the fabrication of the frameworkA single impression for the fabrication of the framework
and the processing of the prosthesisand the processing of the prosthesis
 Decreased patient visits.Decreased patient visits.
 Use of wax up and index to enhance the estheticsUse of wax up and index to enhance the esthetics
 Index to ensure proper fit of framework within theIndex to ensure proper fit of framework within the
prosthesisprosthesis
 Placements of attachments in laboratory instead of usingPlacements of attachments in laboratory instead of using
valuable chair timevaluable chair time
 DisadvantagesDisadvantages
 Possible damage to attachment & framework duringPossible damage to attachment & framework during
processing phase.processing phase.
 More complex laboratory procedures during packing.More complex laboratory procedures during packing.
 Possible movements of attachment during packingPossible movements of attachment during packing
procedures.procedures.

DoubleDouble impression techniqueimpression technique
 The metal superstructure is firstThe metal superstructure is first
constructed and then secured in positionconstructed and then secured in position
intraorally and a final impression is made.intraorally and a final impression is made.
The superstructure is reproduced in stoneThe superstructure is reproduced in stone
in the master cast.in the master cast.
 This requires two impressions;This requires two impressions;
 One that transfers the position of either theOne that transfers the position of either the
abutments or the implants to a working castabutments or the implants to a working cast
and a final impression for the fabrication ofand a final impression for the fabrication of
the prosthesis itselfthe prosthesis itself

 AdvantagesAdvantages
 Conventional & simplified processing of the final prosthesis.Conventional & simplified processing of the final prosthesis.
 Eliminating the possibilities of damaging the framework duringEliminating the possibilities of damaging the framework during
the processing of denture.the processing of denture.
 DisadvantagesDisadvantages
 1. Necessity for blocking out of framework before making final1. Necessity for blocking out of framework before making final
impression & placing retentive portion of attachments.impression & placing retentive portion of attachments.
 2. Inability to use index for the fabrication of the framework to2. Inability to use index for the fabrication of the framework to
ensure its fit within the confines of dentureensure its fit within the confines of denture
 3. Inability to recognize compromises in aesthetics caused by the3. Inability to recognize compromises in aesthetics caused by the
position of implants in the wax up stage before the fabrication ofposition of implants in the wax up stage before the fabrication of
the framework.the framework.
 4. Extended chair side time at delivery to accomplish placement of4. Extended chair side time at delivery to accomplish placement of
the attachment.the attachment.

Impression procedures forImpression procedures for
partially edentulouspartially edentulous

Review of literatureReview of literature
 Nicolas in 2004Nicolas in 2004 described a technique for making implantdescribed a technique for making implant
impression designed to reduce framework misfitimpression designed to reduce framework misfit
The two stage impression technique combines the use ofThe two stage impression technique combines the use of
plaster and a silicone impression material. The method canplaster and a silicone impression material. The method can
be used for either completely or partially edentulousbe used for either completely or partially edentulous
patientspatients
 He concluded that the technique combines- the flexibility ofHe concluded that the technique combines- the flexibility of
an elastomeric impression material for capturing the underan elastomeric impression material for capturing the under
cut intraoral topography with the splinting effect ofcut intraoral topography with the splinting effect of
impression plaster to improve the accuracy of the fit of theimpression plaster to improve the accuracy of the fit of the
prosthetic component.prosthetic component.

Primary impressions

Impression recorded at the level ofImpression recorded at the level of
top of implanttop of implant
 1. To delay the decision on the type and size of1. To delay the decision on the type and size of
the abutment after the construction of the masterthe abutment after the construction of the master
model.model.
 2. To provide a master impression for construing2. To provide a master impression for construing
a one piece prosthesis designed to fit directly ona one piece prosthesis designed to fit directly on
the Implantsthe Implants
 3. To construct a master cast for the use of3. To construct a master cast for the use of
prepable abutments or custom made abutmentsprepable abutments or custom made abutments

Abutment level impression
Following confirmation from the radiograph of complete
seating they are then definitively secured by tightening the
retaining screws with a torque device.
Incorrect seating may be due to
Failure to ensure that the abutment correctly engages an
anti rotation features.
The presence of soft tissue or bone encroaching on the
head of the implant.

 There are two different method to available toThere are two different method to available to
record abutment impressionrecord abutment impression
 Pick up impression coping technique atPick up impression coping technique at
abutment levelabutment level
 Reseating technique.Reseating technique.

Pick up impression coping technique at abutment
level

Reseating technique.Reseating technique.
 Where lack of space makes access to the screw retained copingsWhere lack of space makes access to the screw retained copings
impossible, a non retentive, usually aimpossible, a non retentive, usually a tapered copingstapered copings may bemay be
employed.employed.
 This utilizes a one piece machined impression coping, whichThis utilizes a one piece machined impression coping, which
screws directly on the abutment and remains in the mouth whenscrews directly on the abutment and remains in the mouth when
the impression is removed it is then unscrewed from thethe impression is removed it is then unscrewed from the
abutment and reseated in the impression.abutment and reseated in the impression.
 This must be done carefully, as it is a common source ofThis must be done carefully, as it is a common source of
inaccuracy if care is not taken and the copings incorrectly seated.inaccuracy if care is not taken and the copings incorrectly seated.

Careful inspection of the impression will confirm theCareful inspection of the impression will confirm the
key features;key features;
 1. Stability of the impression coping1. Stability of the impression coping
can be tested with tweezers, if thecan be tested with tweezers, if the
movement is present in themovement is present in the
impression; it is recommended thatimpression; it is recommended that
impression be retaken.impression be retaken.
 2. An accurate record of all hard and2. An accurate record of all hard and
soft tissue Including teeth.soft tissue Including teeth.

 Master cast is constructed usuallyMaster cast is constructed usually
beginning with the soft tissue maskbeginning with the soft tissue mask
 A soft gingival mask has beenA soft gingival mask has been
constructed to reproduce the mucosalconstructed to reproduce the mucosal
cuffscuffs

Single tooth impressionsSingle tooth impressions

 Single tooth impression can be divided intoSingle tooth impression can be divided into
 Implant headImplant head
 Abutment level impressionAbutment level impression
Impression of preformed machined abutmentImpression of preformed machined abutment
Impression of prepable abutmentsImpression of prepable abutments

ImpressionImpression of Implant headof Implant head
 Most implant system provides aMost implant system provides a
premachined impression coping forpremachined impression coping for
recording an impression of the head of therecording an impression of the head of the
implant.implant.
 This is usually made up of two pieces; theThis is usually made up of two pieces; the
impression coping and the guide pin. Theimpression coping and the guide pin. The
impression coping seats directly on to theimpression coping seats directly on to the
implant head and is retained with the guideimplant head and is retained with the guide
pin.pin.

 A polymeric standard stock trayA polymeric standard stock tray
may be used and modified so thatmay be used and modified so that
the guide pin projects beyond thethe guide pin projects beyond the
adjacent teeth through headjacent teeth through he
impression tray.impression tray.
 when set, the guide screw iswhen set, the guide screw is
loosened and the impression trayloosened and the impression tray
is removed from the mouth withis removed from the mouth with
the coping picked up in thethe coping picked up in the

Impression of preformed machined abutmentImpression of preformed machined abutment

 Following removal of healing abutment,Following removal of healing abutment,
measurement from the head of the implant to themeasurement from the head of the implant to the
margin of the mucosal cuff will help determinemargin of the mucosal cuff will help determine
the height of the final abutment to be use in thethe height of the final abutment to be use in the
restorationrestoration
 The objective is to produce a submucosalThe objective is to produce a submucosal
margin of 1.5 -2mm from the crest of the gingivalmargin of 1.5 -2mm from the crest of the gingival
tissue and to provide sufficient interocclusaltissue and to provide sufficient interocclusal
distance from the top of the abutment to thedistance from the top of the abutment to the
opposing tooth.opposing tooth.
 A long cone periapical radiograph may be takenA long cone periapical radiograph may be taken
to ensure correct placement of the definitiveto ensure correct placement of the definitive
abutmentabutment

An impression is taken using a machined
plastic or metal impression coping that is
placed over the abutment.
A stock tray is used & modified so that the
impression coping projects beyond the
adjacent teeth & through the impression tray.

 A polyvinyl silicone or polyetherA polyvinyl silicone or polyether
impression material can be usedimpression material can be used
 After setting, the impression tray isAfter setting, the impression tray is
removed ,the impression coping pickedremoved ,the impression coping picked
up in the impressionup in the impression

Impression of prepable abutmentsImpression of prepable abutments
 Prepable abutments are usually supplied inPrepable abutments are usually supplied in
various materials such as alumina,various materials such as alumina,
zirconium and titanium.zirconium and titanium.
 The manufacturer typically supplies theseThe manufacturer typically supplies these
as stock shaped abutments, which can beas stock shaped abutments, which can be
placed directly on the implants andplaced directly on the implants and
modified by the clinician in the mouth.modified by the clinician in the mouth.

 The technique of preparing them is similar to traditionalThe technique of preparing them is similar to traditional
crown and bridge techniques.crown and bridge techniques.
 Preparation can be carried out directly in the mouth.Preparation can be carried out directly in the mouth.
 This will allow the margins of the abutment to follow theThis will allow the margins of the abutment to follow the
gingival contour.gingival contour.
 Utilizing standard crown and bridge principle, anUtilizing standard crown and bridge principle, an
impression can be recorded of the prepared abutmentsimpression can be recorded of the prepared abutments
directly in the mouth.directly in the mouth.

Impressions duringImpressions during
maintenance of removablemaintenance of removable
superstructuresuperstructure

 Maintenance of these is usually confined to rebasing theMaintenance of these is usually confined to rebasing the
denture and or replacement of the teeth , and adjusting ordenture and or replacement of the teeth , and adjusting or
replacing retainers.replacing retainers.
 The basic principle of the procedure is to record anThe basic principle of the procedure is to record an
impression of the underlying soft tissue, and theirimpression of the underlying soft tissue, and their
relationship with implants and the denturerelationship with implants and the denture
 It must be remembered that the impression will not onlyIt must be remembered that the impression will not only
record the changes in the soft tissue contours since therecord the changes in the soft tissue contours since the
denture was made, but also modify the relationshipdenture was made, but also modify the relationship
between these and occlusal plane of the denture.between these and occlusal plane of the denture.

Impressions for solderingImpressions for soldering
the frameworksthe frameworks

 It may be necessary to solder a framework in certain situation.It may be necessary to solder a framework in certain situation.
 If the fit of the framework on the abutments is not exact or If anIf the fit of the framework on the abutments is not exact or If an
abutment must be replaced by one of a different length.abutment must be replaced by one of a different length.
 If the fit is poor, an impression of the separate sections of theIf the fit is poor, an impression of the separate sections of the
framework must be made for solderingframework must be made for soldering..

Impressions forImpressions for
maxillofacial implantsmaxillofacial implants

ConclusionConclusion
 Measurable distortion results from the transfer of implantMeasurable distortion results from the transfer of implant
positions as recorded with various impression techniquespositions as recorded with various impression techniques
 The magnitude of the distortion was similar with theThe magnitude of the distortion was similar with the
techniques evaluated.techniques evaluated.
 In addition to dimensional changes in the materials used,In addition to dimensional changes in the materials used,
positional errors were also attributed to the mechanicalpositional errors were also attributed to the mechanical
components used in the transfer process.components used in the transfer process.
 The objective is to achieve a passively fitting prosthesis.The objective is to achieve a passively fitting prosthesis.
Further work is indicated to isolate a technique that willFurther work is indicated to isolate a technique that will
reliably and predictably reproduce the intraoral relationshipreliably and predictably reproduce the intraoral relationship
of implant fixtures.of implant fixtures.

ReferencesReferences
Color atlas and text of – dental and maxillofacial implantologyColor atlas and text of – dental and maxillofacial implantology mosby-mosby-
wolfewolfe John A Hobkrick, Roger M WatsonJohn A Hobkrick, Roger M Watson
““Color atlas of dental medicine implantologyColor atlas of dental medicine implantology” Theime Publishers” Theime Publishers..
Hubertus SpiekermannHubertus Spiekermann
Color atlas the Branemark system of oral reconstructionColor atlas the Branemark system of oral reconstruction ishiyakuishiyaku
euroamerica, inceuroamerica, inc. Richard A Rasmussen. Richard A Rasmussen
Dental implant prostheticsDental implant prosthetics"" Mosby.Mosby. Carl E. MischCarl E. Misch
““Dental implants the art and scienceDental implants the art and science” W.B. Saunder” W.B. Saunder
Charles BabbushCharles Babbush

““Implant dentistryImplant dentistry”” 22ndnd
edition, Mosby.edition, Mosby. Carl E. MischCarl E. Misch
Implants in dentistryImplants in dentistry.. SaundersSaunders Michael, John Kent ,LuisMichael, John Kent ,Luis
Introducing dental implantsIntroducing dental implants Churchill LivingstoneChurchill Livingstone John A HobkrickJohn A Hobkrick
Roger M WatsonRoger M Watson
Osseointegration and occlusal rehabilitationOsseointegration and occlusal rehabilitation”” QuintessenceQuintessence
Publishing.-Publishing.- Hobo, Ichida, GarciaHobo, Ichida, Garcia
Restorative dentist manualRestorative dentist manual

Impression tecnique for implant supported rehabilitation/ dental courses

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