Dimensional Accuracy of Direct and Indirect Implant Impression Techniques for Completely Edentulous Patients

Abstract

Background: Accurate recording of implant location is required for a successful definitive restoration. Aim: This study was conducted to compare the accuracy of two implant impression techniques (direct and indirect) in transferring implant positions to the master casts in comparison to implant position in patients' mouth using radiographic imaging. Materials and Methods: Ten completely edentulous male patients were selected. 2 Root-form implants 3.7 mm in diameter and 16 mm in length were utilized in this study in the canine regions. For each patient two special trays were fabricated, one for the registration of direct impression technique and the other for the indirect impression technique. Cone beam computed tomography (CBCT radiograph) was done for all patients, the casts obtained from direct and indirect implant impression techniques were taken to evaluate the accuracy of the two impression techniques in comparison with the patients' radiographs regarding the distance between the implants. The horizontal dimensional accuracy of the impression techniques was determined by measuring the inter-implants' distance in the x-axis between the copings. Measurements were done on radiographic images of the following; casts obtained from direct impression technique, casts obtained from indirect implant impression technique and radiographs of patients. Results: The mean and SD values of casts radiographs obtained from both impression techniques and from patients' radiographs were calculated. Group I (Deviation of distance between direct impression technique and patients' radiograph) had a mean value of 1.45mm (SD 0.03); Group II (Deviation of distance between indirect impression technique and patients' radiograph) had a mean value of 2.08 mm (SD 0.04). The direct impression technique showed more accurate results. Conclusion: Casts obtained from the direct impression technique were significantly more accurate than those obtained from indirect impression technique. Comparison of both impression techniques retrieved from patients in relation to patients' CBCT provided more reliable results than in vitro studies. So this study suggests that direct impression technique is more accurate.

Dental implant considerations in patients with systemic diseases: An updated comprehensive review

“…Effective haemostatic therapy improves bleeding control, enabling patients to undergo numerous surgical operations without being inhibited, including implantology and oral surgery 357,358 . On the other hand, haemophilia was recognized as interference with the osseointegration of implants 359 and could relatively affect the prognosis of the implant procedure 360 as any potential bleeding or changes to the blood clot may impact early implant osseointegration 358,361 …”

“…356 Effective haemostatic therapy improves bleeding control, enabling patients to undergo numerous surgical operations without being inhibited, including implantology and oral surgery. 357,358 On the other hand, haemophilia was recognized as interference with the osseointegration of implants 359 and could relatively affect the prognosis of the implant procedure 360 as any potential bleeding or changes to the blood clot may impact early implant osseointegration. 358,361 According to a case study published by Calvo-Guirado et al, a 366,367 There are still some uncertainties regarding patients on direct oral anticoagulants; however, it is generally presumed that there is no need to interrupt their therapy, although seeking the advice of the haematologist overseeing the patient's care is recommended.…”