Classification and impression techniques of implants (39

Classification andClassification and
impression techniques ofimpression techniques of
implantsimplants
INDIAN DENTAL ACADEMY
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ClassificationClassification
► Based uponBased upon
1.1. Placement within the tissuesPlacement within the tissues
2.2. Materials usedMaterials used
3.3. Attachment mechanismAttachment mechanism
4.4. Surface coatingSurface coating
5.5. ShapeShape
6.6. Surgical stageSurgical stage
7.7. Mode of insertionMode of insertion
8.8. Tissue response & systemic toxicity effects of implantsTissue response & systemic toxicity effects of implants

►Subperiosteal implantsSubperiosteal implants
Based upon the placement withinBased upon the placement within
the tissuethe tissue

Subdivision of subperiosteal implantSubdivision of subperiosteal implant
o UnilateralUnilateral
o InterdentalInterdental
o TotalTotal
o circumferentialcircumferential

Unilateral subperiosteal implant
Interdental subperiosteal
implant

Total subperiosteal implant
Circumferential
subperiosteal implant

Transosteal implantTransosteal implant
 Also known asAlso known as
o Staple boneStaple bone
o Mandibular stapleMandibular staple
o TransmandibularTransmandibular

Transosteal implantTransosteal implant

Endosteal implantEndosteal implant

Root form
Blade/plate form
Ramus frame

Intramucosal insertsIntramucosal inserts

Endodontic stabilizer implant

Based upon materials usedBased upon materials used
1.Metallic implants-commercially pure titanium1.Metallic implants-commercially pure titanium
Titanium alloyTitanium alloy
Cobalt chromium molybdenumCobalt chromium molybdenum
alloyalloy
2.Nonmetallic implants-Ceramics2.Nonmetallic implants-Ceramics
CarbonCarbon

Ceramic and titanium alloy implants

Based upon the attachmentBased upon the attachment
mechanismmechanism
1.Osseointegration
2.Fibro osseous
integration

Based upon their surface coatingBased upon their surface coating
o Titanium plasma sprayedTitanium plasma sprayed
o Hydroxyapatite coatingHydroxyapatite coating
o Grid blasting with TiOGrid blasting with TiO
o SLA(sandblasted-largegrid-acidetched)SLA(sandblasted-largegrid-acidetched)
o Acid etchedAcid etched
o Machined surfaceMachined surface

Based upon the shapeBased upon the shape

Contd….Contd….
o Threaded,nonthreadedThreaded,nonthreaded
o Tapered,parallelTapered,parallel
o With vent holes,without vent holesWith vent holes,without vent holes
o Hollow cylinder,solid screwsHollow cylinder,solid screws
o Root form,blade formRoot form,blade form

Based upon the surgical stageBased upon the surgical stage
Two stage implantsTwo stage implants One stage implant

Based upon mode of insertionBased upon mode of insertion
1.Axially inserted (crestal1.Axially inserted (crestal
approach)approach)

2.Laterally inserted(basal
approach)

Based upon tissue responseBased upon tissue response
&systemic toxicity effects of implants&systemic toxicity effects of implants
o Biotolerant materials-polmethylmethacrylateBiotolerant materials-polmethylmethacrylate
o Bioinert materials-titanium and aluminiumBioinert materials-titanium and aluminium
oxideoxide
o Bioactive materials-glass and calciumBioactive materials-glass and calcium
phosphate ceramicphosphate ceramic

Components of implantComponents of implant
Implant bodyImplant body

Cover screw Healing abutment

Healing cap Implant abutment

Impression posts

Laboratory analogs

IMPRESSION MATERIALS
Ideal Requirements
•Complete plasticity before
cure
•Fluidity to record fine detail
•Ability to wet oral tissues
•Dimensional accuracy
•Dimensional stability
•Complete elasticity after cure
•Optimal stiffness

Materials Used
o Alginate
o Agar
o Polysulphide
o Polyether
o Condensation Silicone
o Addition Silicone

ALGINATE
o Poor dimensional stability
o Poor dimensional accuracy
o Poor tear strength
o Poor stiffness
o Interferes with setting of
gypsum

AGAR
o Interferes with setting of gypsum
o Dimensional instability
o Elaborate equipment needed
o Low tear resistance

Polysulphide
o Base-polusulfide polymer, Catalyst- lead
dioxide
o High tear strength
o Messy,unpleasant odour
o Long setting time
o Poor dimensional stability
o Hydrophobic

Condensation silicone
o Cheaper
o Good tear strength, accuracy & elastic
properties
o Dimensional instability,due to loss of
ethyl alcohol
o Poured quickly

Addition silicone
o Shorter setting time
o Easy to mix- automatic mixing devices
o Adequate tear strength
o Extremely high accuracy
o Dimensional stability even after 1 week
o Least distortion on removal
o Hydrophilic
o Good compatibility with gypsum

Polyether
o Good dimensional stability & accuracy
o Short setting time
o Material very rigid
o Not available in all consistencies
o Most expensive

Dispensed as :
Manual mixing
Automixing system

Manual mixing
o Putty
o Heavy body
o Monophase
o Light body

Automixing equipment & materials

Two basic impression techniques for implants are
1. indirect technique or closed tray technique
2.direct or pick-up or open tray technique.

Indirect impression technique

Contd…

Direct impression technique

Indirect method

Direct method

Related articles
Tautin(1985)presented a technique to accurately,
transfer and reproduce the relationship between
implant dentures , in which no preliminary
impression or acrylic resin custom tray were needed.
He used modeling compound to form a custom tray
by adapting it over transfer copings,pressing the
compound over the superior aspect of the coping so
that its circular outline is seen through the
compound.After trimming the outline of the coping
showing through the top of the tray an impression
plaster is used to record and transfer the coping to
the impressions

Loos(1986)presented a detail technique for the
fabrication of a fixed prosthesis supported by
implants.His technique incorporated plugging the
incisal end of the transfer coping with beading
wax(to prevent impression material from flowing
into it)splinting the transfer copings with orthodontic
ligature wire and Duralay acrylic resin,use of a
plastic perforated impression tray with incisal
window to access the transfer coping and making
the final impression with putty light body addition
silicone.

Rasmussen(1987)presented a technique in
which the existing denture is modified using tissue
conditioning material is used instead of healing
caps after second stage surgery ,eliminating the
use of impression copings at the final impression.

Humphries et al (1990) evaluated the
accuracy of implant master casts constructed from
transfer impressions using three techniques.The
techniques used were splinted square polymer
copings,unsplinted square polymer copings and
unsplinted hydrocolloid copings.Tapered
hydrocolloid copings were more accurate than the
other two methods.

Carr (1991) compared impression techniques for
five implant mandibular model by both indirect and
direct transfer coping techniques and found that for
the models used ,the direct method produced more
accurate working casts.

Vigolo et al(2000)evaluated the accuracy in
transferring the position of the hexagonal head of a
single implant to the working cast, and concluded
that the sandblasting and coating the roughened
surface of the impression coping with an
impression adhesive will result in more accurate
orientation of the implant replicas in the laboratory
master casts in single tooth implant restorations.

Conclusion
Success with implant prosthodontics requires a
careful attention to each and every step from
diagnosis and treatment planning. Several
implant systems are available , selection of
appropriate one is mandatory. The prosthesis fit
can be accurate only if a proper impression is
made. Thus usage of correct impression
technique and material are important.

References
1. contemporary implant dentistry , Carl E. Misch
2. Implants in dentistry , Michael,John and Luis.
3. Implant prosthodontics Stevens & freidrickson
4. Dental implants- Fundamental & advanced laboratory
technology , Robert Winkleman &Kenneth orth.

References contd…
5. Philip’s science of dental materials
6. Contemporary fixed prosthodontics, Rosentiel
7. Principles & practice of implant dentistry, Weiss
8. Theory & practice of ossteointegration, Hobo
9. Carr AB. Int J Oral Maxillofac Implants. 1991;6(4):448-55
10. Assif etal. Int J Oral Maxillofac Implants. 1999;14(6):885-88
11. Loos Larry G. J Prosthet Dent 1986;55:232-42
12. Rasmussen Eric J. J Prosthet Dent. 1987;57:198-203
13. Tautin Francis S. J Prosthet Dent. 1985;54:250-51
14. Vigolo etal. J Proshtet Dent. 2000;83:562-66

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Classification and impression techniques of implants (39

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