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Table of Contents
ORIGINAL ARTICLE
Year : 2020  |  Volume : 7  |  Issue : 1  |  Page : 5-7

A comparative evaluation of accuracy of three impression techniques in parallel and angulated multiple implant impressions: An in vitro study


1 Private Practitioner, Department of Prosthodontics, Vikrant's Dental and Dentofacial Center, Patna, Bihar, India
2 Private Practitioner, Department of Oral Surgery, Vikrant's Dental and Dentofacial Center, Patna, Bihar, India
3 Private Practitioner, Department of Prosthodontics, Dr Rajneesh' Dental Implant And Esthetic Center, Rohini, Delhi, India
4 Visiting Consultant, Department of Prosthodontics, Gdc, Aurangabad, Maharashtra, India
5 Assitant Professor, Department of Prosthodontics, Gdc, Aurangabad, Maharashtra, India
6 Tutor, Department of Oral Pathology, Dr Anchal's Classes For Pg Preparation, Aurangabad, Maharashtra, India

Date of Submission26-Nov-2019
Date of Acceptance29-Nov-2019
Date of Web Publication24-Mar-2020

Correspondence Address:
Rajneesh Kumar
Dr Rajneesh Dental Clinic and Implant Center, Plot No 238, Ground Floor, Pocket 8, Sector 24, Rohini, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/INPC.INPC_57_19

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  Abstract 


Introduction: Dental implants have become the treatment of choice in many situations where missing teeth require functional and esthetic replacements. The present study was conducted to evaluate and compare the accuracy of multiple implant impressions using different impression techniques such as open tray nonsplinted, open tray splinted, and closed tray in both parallel as well as angulated implants.
Materials and Methods: Two acrylic models were fabricated with four implant analogs placed in each model. Three impression groups, Group 1 (open-tray nonsplinted technique), Group 2 (open -tray splinted technique), and Group 3 (closed tray technique) were formed for each model. The post hoc Tukey's test was used for multiple comparisons.
Results: The results show that Group 3 is least accurate after that, Group 1 and Group 2 are most accurate techniques for impression making.
Conclusions: These results indicate that the open-tray (pickup) impression technique is more accurate as compared to the closed tray (reposition) technique in both Model A (parallel analogs) and Model B (angulated analogs).

Keywords: Accuracy, closed tray technique, impression techniques, multiple implant impressions, open-tray impression technique


How to cite this article:
Singh P, Pratap V, Kumar R, Pathak R, Kamble A, Srivastava A. A comparative evaluation of accuracy of three impression techniques in parallel and angulated multiple implant impressions: An in vitro study. Int J Prev Clin Dent Res 2020;7:5-7

How to cite this URL:
Singh P, Pratap V, Kumar R, Pathak R, Kamble A, Srivastava A. A comparative evaluation of accuracy of three impression techniques in parallel and angulated multiple implant impressions: An in vitro study. Int J Prev Clin Dent Res [serial online] 2020 [cited 2020 Jun 1];7:5-7. Available from: http://www.ijpcdr.org/text.asp?2020/7/1/5/281340




  Introduction Top


Dentists employ considerable clinical skills in an effort to cope with the consequences of partial and/or complete edentulism. Dental implants have become the treatment of choice in many situations where missing teeth require functional and esthetic replacements. It is important to place the implants parallel to each other wherever possible. The advantage of placing implants parallel to each other is, the polymerized impression can be removed from the mouth without significant resistance. Moreover, it is not always possible to place implants absolutely parallel to each other. The height and width of the residual alveolar ridge, the mandibular nerve, and the nasal and maxillary sinus are anatomic aspects to be considered in placing dental implants.[1],[2] Hence, some clinical situations require the placement of implants at certain angulations. In such cases, errors may be produced in impression making due to dimensional changes of impression material, inaccurate repositioning of impression copings, and improper connection of components.[3] Furthermore, different types of impression techniques such as open tray/direct technique and closed tray/indirect technique have been used for implant impressions. In indirect technique, the copings are connected to the implant and after the removal of impressions; they are retained on the implants. The direct technique can be further subdivided into splinted and nonsplinted techniques. Therefore, the present study was conducted to evaluate and compare the accuracy of multiple implant impressions using different impression techniques open tray nonsplinted, open tray splinted, and closed tray in both parallel as well as angulated implants.


  Materials and Methods Top


The study was conducted in the Department of Prosthodontics with the approval of the Institutional Ethical Committee appointed by the Maharashtra University of Health Sciences, Nashik. Two acrylic models were fabricated with four implant analogs placed in each model. In Model A, the analogs were placed parallel to each other, and in Model B, they were placed at an angulation of 15° to the long axis in lingual direction. The distances were measured, taking the references of the most anterior point of posterior implant and most posterior point of anterior implant on the left side (A1), between the two anterior analogs (A2) and the most anterior point of posterior implant and most posterior point of anterior implant on the right side (A3) on Model A. Similar measurements corresponding to distances B1, B2, and B3 were made for Model B. Three impression groups, Group 1 (open-tray nonsplinted technique), Group 2 (open-tray splinted technique), and Group 3 (closed tray technique) were formed for each model. A total of 30 impressions were made using polyvinyl siloxane impression material (Aquasil, Dentsply) using a putty-wash single-step technique. Three impression groups were formed as follows: Group 1 – open-tray nonsplinted technique, Group 2 – open-tray splinted technique, and Group 3 – closed tray technique. Ten impressions were made for each group (five each for models A and B, respectively). The means and standard deviations were calculated for statistical analysis of all the groups. Statistical analysis was carried out using statistical software, Statistical package for social science, SPSS version 22. The measurements of all the groups were compared with the respective master models using one-way ANOVA test to determine if there were significant differences between them. The post hoc Tukey's test was used for multiple comparisons.


  Results Top


[Table 1] shows individual pair-wise comparisons within the three impression groups with respect to distances A1, A2, and A3 for model A (parallel analogs) by Tukey's post hoc procedures. Table signifies that there is a statistically significant difference in the measurements between Group 2 versus Group 3 in A1, Group 1 versus Group 3 and Group 2 versus Group 3 in A2, and Group 2 versus Group 3 in A3. [Table 2] shows post hoc Tukey's table to determine the order of best techniques (Group 1, Group 2, and Group 3) with respect to distances A1, A2, and A3 for model A (parallel analogs). As the results show that Group 3 is least accurate after that, Group 1 and Group 2 are most accurate techniques for impression making. [Table 3] shows individual pair-wise comparisons within the three impression groups with respect to distances A1, A2, and A3 for model A (parallel analogs) by Tukey's post hoc procedures. Table signifies that there is statistically significant difference in the measurements between Group 1 versus Group 3 and Group 2 versus Group 3 in B1, Group 1 versus Group 2 and Group 2 versus Group 3 in B2, and Group 2 versus Group 3 in B3.
Table 1: Post hoc test for individual pair-wise comparisons

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Table 2: Post hoc Tukey's table to determine the order of best technique

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Table 3: Post hoc test for individual pair.wise comparisons for Model B

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  Discussion Top


These results indicate that the open-tray (pickup) impression technique is more accurate as compared to the closed tray (reposition) technique in both model A (parallel analogs) and model B (angulated analogs). This is supported by various studies which also concluded the same.[4],[5],[6] The reason for this being that the pickup impression allows the copings to be removed along with the impression by unscrewing, and the implant analogs are directly connected to these copings to fabricate the definitive cast. However, in contrast to this, in the closed tray (repositioning) technique, the impression copings are removed and manually positioned back in the impression at their respective sites. Carr[7] concludes that the direct technique produced more accurate working casts as compared to the indirect technique. Lee et al.[8] compared 14 studies for the accuracy of pickup and transfer impression techniques. Assif et al.[9] studied that more accurate results were obtained with techniques, in which autopolymerizing acrylic resin or impression plaster (rather than dual-polymerizing acrylic resin) was used as the splinting material. Vigolo et al.[10] conducted a study and results showed that improved accuracy of the master cast was achieved when the impression technique involved impression copings joined with autopolymerizing resin. Lee et al.[8] compared 17 studies of that accuracy between splint and nonsplint techniques, in which seven advocated splint, whereas three advocated nonsplint technique, and seven reported no difference between splint and nonsplint technique. Hence, according to the present study, open-tray splinted technique is more accurate as compared to open-tray nonsplinted technique, and closed tray is least accurate for impression making in parallelly placed and angulated multiple implants.


  Conclusions Top


Within the limitations of this in vitro study, these results indicate that the open-tray (pickup) impression technique is more accurate as compared to the closed tray (reposition) technique in both Model A (parallel analogs) and Model B (angulated analogs).

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Schroeder A, Sutter F, Krekeler G. Orale Implantologie. Stuttgart: Georg Thieme Verlag; 1988.  Back to cited text no. 1
    
2.
Branemark PI, Zarb GA, Albrektsson T. Tissue-Integrated Prostheses, Osseointegration in Clinical Dentistry. Berlin, Chicago, London, Rio de Janeiro and Tokyo: Quintessence; 1985.  Back to cited text no. 2
    
3.
Conrad HJ, Pesun IJ, DeLong R, Hodges JS. Accuracy of two impression techniques with angulated implants. J Prosthet Dent 2007;97:349-56.  Back to cited text no. 3
    
4.
Daoudi MF, Setchell DJ, Searson LJ. A laboratory investigation of the accuracy of two impression techniques for single-tooth implants. Int J Prosthodont 2001;14:152-8.  Back to cited text no. 4
    
5.
Mostafa TM, Elgendy MN, Kashef NA, Halim MM. Evaluation of the precision of three implant transfer impression techniques using two elastomeric impression materials. Int J Prosthodont 2010;23:525-8.  Back to cited text no. 5
    
6.
Akça K, Cehreli MC. Accuracy of 2 impression techniques for ITI implants. Int J Oral Maxillofac Implants 2004;19:517-23.  Back to cited text no. 6
    
7.
Carr AB. Comparison of impression techniques for a five-implant mandibular model. Int J Oral Maxillofac Implants 1991;6:448-55.  Back to cited text no. 7
    
8.
Lee H, So JS, Hochstedler JL, Ercoli C. The accuracy of implant impressions: A systematic review. J Prosthet Dent 2008;100:285-91.  Back to cited text no. 8
    
9.
Assif D, Nissan J, Varsano I, Singer A. Accuracy of implant impression splinted techniques: Effect of splinting material. Int J Oral Maxillofac Implants 1999;14:885-8.  Back to cited text no. 9
    
10.
Vigolo P, Majzoub Z, Cordioli G. Evaluation of the accuracy of three techniques used for multiple implant abutment impressions. J Prosthet Dent 2003;89:186-92.  Back to cited text no. 10
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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