Precision of fit between implant impression coping and implant replica pairs for three implant systems.

STATEMENT OF PROBLEM: The fabrication of an accurately fitting implant-supported fixed prosthesis requires multiple steps, the first of which is assembling the impression coping on the implant. An imprecise fit of the impression coping on the implant will cause errors that will be magnified in subsequent steps of prosthesis fabrication. PURPOSE: The purpose of this study was to characterize the 3-dimensional (3D) precision of fit between impression coping and implant replica pairs for 3 implant systems. The selected implant systems represent the 3 main joint types used in implant dentistry: external hexagonal, internal trilobe, and internal conical. MATERIAL AND METHODS: Ten impression copings and 10 implant replicas from each of the 3 systems, B (Brånemark System), R (NobelReplace Select), and A (NobelActive) were paired. A standardized aluminum test body was luted to each impression coping, and the corresponding implant replica was embedded in a stone base. A coordinate measuring machine was used to quantify the maximum range of displacement in a vertical direction as a function of the tightening force applied to the guide pin. Maximum angular displacement in a horizontal plane was measured as a function of manual clockwise or counterclockwise rotation. Vertical and rotational positioning was analyzed by using 1-way analysis of variance (ANOVA). The Fisher protected least significant difference (PLSD) multiple comparisons test of the means was applied when the F-test in the ANOVA was significant (α=.05). RESULTS: The mean and standard deviation for change in the vertical positioning of impression copings was 4.3 ±2.1 µm for implant system B, 2.8 ±4.2 µm for implant system R, and 20.6 ±8.8 µm for implant system A. The mean and standard deviation for rotational positioning was 3.21 ±0.98 degrees for system B, 2.58 ±1.03 degrees for system R, and 5.30 ±0.79 degrees for system A. The P-value for vertical positioning between groups A and B and between groups A and R was <.001. No significant differences were found for vertical positioning between groups B and R. The P-value for rotational positioning between groups A and B and between groups A and R was <.001. No significant differences were found for rotational positioning between groups B and R. CONCLUSIONS: The results of the study confirmed that implant systems differ in precision of fit. Vertical precision between paired implant components is a function of joint type and the tightening force applied to the guide pin. The magnitude of vertical displacement with applied torque is greater for conical connections than for butt joint connections. The rotational freedom between paired components is unique to the implant system and is presumably related to the machining tolerances specified by the manufacturer.

Functional impressions for complete denture fabrication. A modified jump technique.

Tissue conditioners are used with great success in dentistry as functional impression materials for rebasing removable prostheses. In the rebase procedure, a functional impression is made in an existing denture to create a master cast. The orientation of the occlusal surface to the underlying tissue surface is captured with a reline jig or denture flask and transferred to the new denture base in what is called a "jump" in laboratory jargon. Functional impression methods are not commonly considered, however, for the fabrication of new dentures despite their popularity and ease of use. This article describes a modified jump technique for remaking complete dentures. The method uses functional impressions in existing maxillary and mandibular dentures to create master casts and to act as stabilized carriers for jaw relation records. More precise esthetic and phonetic assessments of the existing prostheses are accommodated, and prescriptive changes may be referenced to the current tooth arrangement.