It is advisable that the abutment of choice be placed and removed a minimum number of times or if possible, not at all. It is critical that the soft tissue architecture has been developed with the provisional restoration and has matured to the point that minimal change will occur. Of equal importance in the impressioning of the implant is the capturing of the soft tissue. In the screw retained option the utilization of a custom or stock angulated abutment (allows for a screw from the lingual surface) or the angulated screw channel approach (ASC). If the impression is to be at the abutment level this can be a custom, multi-unit or stock abutment (can be either cement or screw retained). The literature is conclusive that all procedures have some form inaccuracy that must be expected. Verification of proper component seating via radiograph is recommended. Of note: the accuracy of the final impression is dependent on the complete seating any of impression components. The critical part of the impression is the capturing of the internal geometry of the implant (i.e.: NobelReplace Select tri-lobe, external hex or the Conical Connection internal hex design) insuring the final restoration is oriented correctly. This approach is becoming increasingly more popular and potentially will reduce costs and reduce treatment times. With the increasing use of the digital realm it is possible through the use of scan bodies or specific healing abutments to capture the location and orientation of the implant architecture without the use of impression material. Since space is less an issue in the anterior zone, intra-oral scanners are more readily used. The literature is also conclusive on this subject, impression materials of those previously mentioned categories are all suitable with no one product demonstrable better. The material should be one that would be utilized in conventional fixed dental prosthesis construction (polyethers, polyvinylsiloxanes, putty – wash combinations, etc). Material choice is again dependent upon the preferences of the restorative dentist. This is dependent upon a number factors, including: position of the implant relative to adjacent structures (teeth or implants), depth of soft tissue, morphology of the soft tissue, restorative space, posterior inter-occlusal space and dentist preference.Īs space is not normally a limiting factor in the anterior zone an open or closed tray technique are both options. The first choice the restorative dentist must make is whether the impression will be performed at the abutment or fixture level.

Implant level impression dental