Impression techniques

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Impression techniques

  1. 1. Level II: Advanced Implant Placement and Restoration Course Dr. David Dalise Dr. Gary McCabe Ross
  2. 2. Impression Techniques
  3. 3. Impression Techniques <ul><li>Closed Tray </li></ul><ul><ul><ul><li>May be least accurate for multi unit cases. </li></ul></ul></ul><ul><ul><li>Stock Trays </li></ul></ul><ul><ul><li>Custom Trays </li></ul></ul><ul><li>Open Trays </li></ul><ul><ul><ul><li>May be more accurate for multi unit impressions </li></ul></ul></ul><ul><ul><ul><li>May be required due to implant/abutment angulations and path of insertion withdrawal. </li></ul></ul></ul><ul><ul><li>Stock Trays </li></ul></ul><ul><ul><ul><li>Modifications required </li></ul></ul></ul><ul><ul><li>Custom Trays </li></ul></ul>
  4. 4. Impression Materials <ul><li>PVS </li></ul><ul><ul><li>Minor bone toxicity </li></ul></ul><ul><ul><li>Very stable </li></ul></ul><ul><ul><li>Multiple viscosities available </li></ul></ul><ul><li>Polyether </li></ul><ul><ul><li>Toxic to bone </li></ul></ul><ul><ul><li>Very rigid </li></ul></ul><ul><ul><li>Very Stable </li></ul></ul><ul><ul><li>Most hydrophilic </li></ul></ul><ul><li>Rubber base </li></ul><ul><ul><li>Toxic to bone </li></ul></ul><ul><ul><li>Relatively Stable </li></ul></ul><ul><ul><li>Slow set </li></ul></ul><ul><ul><li>Unpleasant taste to patient </li></ul></ul><ul><li>Others (hydrocolloids) </li></ul><ul><ul><li>Least stable </li></ul></ul><ul><ul><li>Low tear strength </li></ul></ul><ul><ul><li>Least desirable to use due to limitations of material </li></ul></ul>
  5. 5. Considerations, Complications, and Solutions <ul><li>What material and why </li></ul><ul><ul><li>Use a material suitable to situation and operator familiarity </li></ul></ul><ul><li>Managing difficult patients or situations </li></ul><ul><ul><li>High anxiety/apprehension </li></ul></ul><ul><ul><ul><li>IV sedation </li></ul></ul></ul><ul><ul><ul><li>Non-IV conscious sedation </li></ul></ul></ul><ul><ul><li>Gag reflex </li></ul></ul><ul><ul><ul><li>Salt on tongue </li></ul></ul></ul><ul><ul><ul><li>Non-IV conscious sedation </li></ul></ul></ul><ul><ul><li>Medical complications </li></ul></ul><ul><ul><ul><li>Have emergency kit in office and appropriate training for use for doctor and staff </li></ul></ul></ul><ul><ul><ul><li>Bleeding </li></ul></ul></ul><ul><ul><ul><ul><li>Direct pressure </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Vasoconstrictor </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Vessel ligation </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Appropriate referral/911 </li></ul></ul></ul></ul>
  6. 6. What to send to the Lab? <ul><ul><li>Lab prescription </li></ul></ul><ul><ul><ul><li>Detailed with all required prosthetic design and case details. </li></ul></ul></ul><ul><ul><li>Appropriate and accurate impressions </li></ul></ul><ul><ul><ul><li>Implant level </li></ul></ul></ul><ul><ul><ul><li>Abutment level </li></ul></ul></ul><ul><ul><li>Preoperative mounted models </li></ul></ul><ul><ul><li>Diagnostic wax up </li></ul></ul><ul><ul><li>Necessary restorative components for implant </li></ul></ul><ul><ul><ul><li>Implant analog </li></ul></ul></ul><ul><ul><ul><li>Impression analog </li></ul></ul></ul><ul><ul><ul><li>Necessary abutment screws </li></ul></ul></ul><ul><ul><ul><li>Temporary abutments </li></ul></ul></ul>
  7. 7. Pre Op X-ray
  8. 8. Periapical X-ray
  9. 13. #8 HS Bur
  10. 15. Pilot Drill w/out Drill Stops
  11. 19. Periapical X-ray
  12. 20. Tissue Punch
  13. 21. Removal of Tissue Plug
  14. 23. Countersink Drill
  15. 24. 3.3mm Osteotome
  16. 27. 3.5mm Osteotome
  17. 30. ISI 4mm x 12mm CB
  18. 31. Placement of ISI with Ultem Cap
  19. 32. Ratchet Wrench Seating ISI Implant
  20. 33. ISI Ratcheted to Final Seating
  21. 34. Torqued to 40+ N/Cm
  22. 36. Periapical X-ray
  23. 37. 4.0 TRIP and 4.0 AC
  24. 38. TRIP “Snapped” Into Margin
  25. 93. THANK YOU Questions?

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