Classification and impression techniques of implants/ dentistry dental implants

Classification and impression techniques of implants
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Classification
Based upon
Placement within the tissues
Materials used
Attachment mechanism
Surface coating
Shape
Surgical stage
Mode of insertion
Tissue response & systemic toxicity effects of implants

Subperiosteal implants
Based upon the placement within the tissue

Subdivision of subperiosteal implant
Unilateral
Interdental
Total
circumferential

Unilateral subperiosteal implant
Interdental subperiosteal implant

Total subperiosteal implant
Circumferential subperiosteal implant

Transosteal implant
Also known as
Staple bone
Mandibular staple
Transmandibular

Transosteal implant

Endosteal implant

Root form
Blade/plate form
Ramus frame

Intramucosal inserts

Endodontic stabilizer implant

Based upon materials used
1.Metallic implants-commercially pure titanium
Titanium alloy
Cobalt chromium molybdenum
alloy
2.Nonmetallic implants-Ceramics
Carbon

Ceramic and titanium alloy implants

Based upon the attachment mechanism
1.Osseointegration
2.Fibro osseous integration

Based upon their surface coating
Titanium plasma sprayed
Hydroxyapatite coating
Grid blasting with TiO
SLA(sandblasted-largegrid-acidetched)
Acid etched
Machined surface

Based upon the shape

Contd.
Threaded,nonthreaded
Tapered,parallel
With vent holes,without vent holes
Hollow cylinder,solid screws
Root form,blade form

Based upon the surgical stage
Two stage implants
One stage implant

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

2.Laterally inserted(basal approach)

Based upon tissue response &systemic toxicity effects of implants
Biotolerant materials-polmethylmethacrylate
Bioinert materials-titanium and aluminium oxide
Bioactive materials-glass and calcium phosphate ceramic

Components of implant
Implant body

Cover screw
Healing abutment

Healing cap
Implant abutment

Impression posts

Laboratory analogs

IMPRESSION MATERIALS
Ideal Requirements
Complete plasticity before cureFluidity to record fine detailAbility to wet oral tissuesDimensional accuracyDimensional stabilityComplete elasticity after cureOptimal stiffness

Materials Used
Alginate Agar Polysulphide Polyether Condensation Silicone Addition Silicone

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

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

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

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

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

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

Dispensed as :
Manual mixing
Automixing system

Manual mixing
Putty Heavy body Monophase 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

Contd

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. Philips 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/ dentistry dental implants

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