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