Course Objectives (2 CE Credits)
Achieving a passive fit of the prosthesis is critical when dealing with implant-borne restorations. Thanks to CAD/CAM technology, extremely accurate implant frameworks can now be virtually designed and milled from a solid block of titanium. To optimize the fit of the prosthesis, clinical and laboratory procedures must mirror this high level of accuracy. Outlining a simple procedure for obtaining accurate full-arch implant impressions, this Clinical Tip describes how to:
- Create a sectioned implant verification jig (IVJ)
- Fabricate a custom impression tray
- Lute the sectioned IVJ together intraorally
- Verify the fit of the IVJ
- Take the final impression
- Fabricate the master cast
Even though CAD/CAM implant frameworks have greatly improved and simplified restoring full-arch cases, an extremely accurate impression and master cast are still critical for achieving a passive fit of the prosthesis. Detailed is a highly predictable technique for obtaining accurate full-arch impressions.
CAUTION: When viewing the techniques, procedures, theories and materials that are presented, you must make your own decisions about specific treatment for patients and exercise personal professional judgment regarding the need for further clinical testing or education and your own clinical expertise before trying to implement new procedures.
- Taylor TD. Prosthodontic problems and limitations associated with osseointegration. J Prosthet Dent. 1998;79(1):74-8.
- Goodacre CJ, Kan JY, Rungcharassaeng K. Clinical complications of osseointegrated implants. J Prosthet Dent. 1999;81(5):537-52.
- Jemt T, Book K. Prosthesis misfit and marginal bone loss in edentulous patients. Int J Oral Maxillofac Implants. 1996;11:620-5.
- Kan JY, Rungcharassaeng K, Bohsali K, Goodacre CJ, Lang BR. Clinical methods for evaluating implant framework fit. J Prosthet Dent. 1999 Jan;81(1):7-13.
- Skalak R. Biomechanical considerations in osseointegrated prostheses. J Prosthet Dent. 1983 Jun;49(6):843-8.
- Brånemark PI. Osseointegration and its experimental background. J Prosthet Dent. 1983 Sep;50(3):399-410.
- Zarb GA, Schmitt A. The longitudinal clinical effectiveness of osseointegrated dental implants: the Toronto study. Part III: problems and complications encountered. J Prosthet Dent. 1990;64:185-94.
- Cobb GW Jr, Metcalf AM, Parsell D, Reeves GW. An alternate treatment method for a fixed-detachable hybrid prosthesis: a clinical report. J Prosthet Dent. 2003 Mar;89(3):239-43.
- Misch CE. Contemporary implant dentistry. 2nd ed. St Louis: Mosby; 1999. p. 549-93.
- Watzek G. Endosseous implants: scientific and clinical aspects. Chicago: Quintessence Pub.; 1996. p. 342-54.
- Ortorp A, Jemt T, Back T, Jalevik T. Comparisons of precision of fit between cast and CNC-milled titanium implant frameworks for the edentulous mandible. Int J Prosthodont. 2003;16:194-200.
- Lee H, So JS, Hochstedler JL, Ercoli C. The accuracy of implant impressions: a systematic review. J Prosthet Dent. 2008 Oct;100(4):285-91.
- Chee W, Jivaj S. Impression techniques for implant dentistry. Br Dent J. 2006;201(7):429-32.
- Cabral LM, Guedes CG. Comparative analysis of 4 impression techniques for implants. Implant Dent. 2007 Jun;16(2):187-94.
- Assif D, Marshak B, Schmidt A. Accuracy of implant impression techniques. Int J Oral Maxillofac Implants. 1996 Mar-Apr;11(2):216-22.
- Carr AB. Comparison of impression techniques for a five-implant mandibular model. Int J Oral Maxillofac Implants. 1991;6:448-55.