Impression technique for partially edentulous patients

Joseph Nissan, DMD,a Eitan Barnea, DMD,b Eytan Krauze, DMD,c and David Assif, DMDd

The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University,Tel Aviv, Israel

This article describes an implant impression technique for partially edentulous patients in which im-pression plaster and irreversible hydrocolloid are used. The technique ensures accuracy, ease of manip-ulation, and decreased working time. (J Prosthet Dent 2002;88:103-4.)

The use of implants is an accepted and predictableclinical method to treat partially edentulous patients.1To ensure acceptable fit of an implant-supportedprosthesis, an accurate impression is mandatory. Ahigh standard of fit is required because of the uniqueimplant/bone relationship and is considered criticalto the long-term success of a prosthesis.2-5 Thesplinted technique has gained popularity and hasproven to be an accurate method for making impres-sions.6-9

This article describes a splinted implant impressiontechnique for partially edentulous patients. Impres-sion plaster, which has been reported as an accuratematerial for the splinted technique,9 is used to bothsplint the transfer copings and make an impression ofthe implant-supported fixed partial denture; the re-mainder of the dentulous arch is recorded with irre-versible hydrocolloid. A partitioned tray incorporatesboth impression materials. Anatomic limitations, suchas bony undercuts in the implant area, should be con-sidered and blocked before the technique is initiated,if necessary.

TECHNIQUE1. Make an irreversible hydrocolloid impression (Blue-

print; Dentsply, Rome, Italy) of the treated arch.Fabricate an autopolymerizing resin custom tray onthe cast. Confine the implant area by separating theacrylic partitions, with access holes above the im-pression copings to allow easy and accurate place-ment of the loaded tray and removal of the copingscrews (Fig. 1).

2. Load the tray simultaneously with impressionplaster (Snow-White plaster No. 2; Kerr USA,Romulus, Mich.) in the confined implant area and

irreversible hydrocolloid (Blueprint; Dentsply) inthe remainder of the partitioned tray (Fig. 2, A).

3. Properly position the tray in the patient’s mouth,and allow the 2 impression materials to set.

aLecturer, Department of Prosthetic Dentistry.bInstructor, Department of Prosthetic Dentistry.cInstructor, Department of Prosthetic Dentistry.dAssociate Professor and Head, Department of Prosthetic Den-

tistry.

Fig. 1. A, Master cast with individual partitioned tray. B,Custom tray with access holes for impression copings (opentray).

JULY 2002 THE JOURNAL OF PROSTHETIC DENTISTRY 103

4. Remove the tray, connect the implant analogs (Fig.2, B), and pour a final working cast.

SUMMARY

This article described an implant impression tech-nique in which impression plaster and irreversible hy-drocolloid are used simultaneously in a custom tray. Thetechnique combines accuracy with ease of manipulationand decreases clinical working time.

REFERENCES1. Lekholm U, Gunne J, Henry P, Higuchi K, Linden U, Bergstrom C, van

Steenberghe D. Survival of Branemark implant in partially edentulous jaws:a 10-year prospective multicenter study. Int J Maxillofac Implants 1999;14:639-45.

2. Skalak R. Biomechanical considerations in osseointegrated prostheses. JProsthet Dent 1983;49:843-8.

3. Henry PJ. An alternative method for the production of accurate casts andocclusal records in osseointegrated implant rehabilitation. J Prosthet Dent1987;58:694-7.

4. Davis DM, Zarb GA, Chao Y. Studies on frameworks for osseointegratedprostheses: Part 1. The effect of varying the number of supporting abut-ments. Int J Oral Maxillofac Implants 1988;3:197-201.

5. Wee AG, Aquilino SA, Schneider RL. Strategies to achieve fit in implantprosthodontics: a review of the literature. Int J Prosthodont 1999;12:167-78.

6. Assif D, Fenton A, Zarb GA, Schmitt A. Comparative accuracy of implantimpression procedures. Int J Periodontics Restorative Dent 1992;12:112-21.

7. Assif D, Marshak B, Nissan J. A modified impression technique for implant-supported restoration. J Prosthet Dent 1994;71:589-91.

8. Assif D, Marshak B, Schmidt A. Accuracy of implant impression techniques.Int J Oral Maxillofac Implants 1996;11:216-22.

9. Assif D, Nissan J, Varsano I, Singer A. Accuracy of implant impressionsplinted techniques: effect of splinting material. Int J Oral Maxillofac Im-plants 1999;14:885-8.

Reprint requests to:DR JOSEPH NISSAN

DEPARTMENT OF PROSTHETIC DENTISTRY

THE MAURICE AND GABRIELA GOLDSCHLEGER SCHOOL OF DENTAL MEDICINE

TEL AVIV UNIVERSITY

TEL AVIV 69978ISRAELFAX: (972)3-640-9250E-MAIL: nissandr@post.tau.ac.il

Copyright © 2002 by The Editorial Council of The Journal of ProstheticDentistry.

0022-3913/2002/$35.00 � 0 10/1/127640

doi:10.1067/mpr.2002.127640

Fig. 2. A, Impression materials before tray loading. B, Finalimpression.

THE JOURNAL OF PROSTHETIC DENTISTRY NISSAN ET AL

104 VOLUME 88 NUMBER 1