Journal of Oral Implantology

Implant impression for full-banded orthodontic patient--Manuscript Draft--

Manuscript Number: aaid-joi-D-14-00285

Full Title: Implant impression for full-banded orthodontic patient

Short Title: Implant impression in orthodontics

Article Type: Clinical Case Letter

Keywords: orthodontic; dental implant; material impression.

Corresponding Author: Benito Rilo, Ph. D., M.D.Universidade de Santiago de CompostelaSantiago de Compostela, A Coruña SPAIN

Corresponding Author SecondaryInformation:

Corresponding Author's Institution: Universidade de Santiago de Compostela

Corresponding Author's SecondaryInstitution:

First Author: Benito Rilo

First Author Secondary Information:

Order of Authors: Benito Rilo

Laura Lago

Luis Da Silva

Noelia Fernández-Formoso

Order of Authors Secondary Information:

Abstract: This article proposes a simple method of obtaining a simple implant impression of anorthodontic patient. Using irreversible hydrocolloid and polyvinyl siloxane an easilyremoved and precise impression of the implant position is possible.

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Implant impression for full-banded orthodontic patient

Short title: Implant impression in orthodontics

Benito Rilo MD, PhDa

Laura Lago DDSb

Noelia Fernández DDS PhD b

Luis DaSilva MD, PhDa

Department of Prosthodontics, Faculty of Medicine and Dentistry, University of Santiago de

Compostela, Spain.

a Lecturer, Department of Prosthodontics, Faculty of Medicine and Dentistry, University of

Santiago de Compostela, Spain.

b Resident, Department of Prosthodontics, Faculty of Medicine and Dentistry, University of

Santiago de Compostela, Spain.

Corresponding author:

Dr. Benito Rilo,

Facultad de Odontología, c/ Entrerríos, s/n Santiago de Compostela 15705, Spain.

+34881812349

E-mail benitorilop@yahoo.es

Word Counts:

Text: 684

Title: 6

Key Words: orthodontic, dental implant, material impression.

Article File

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INTRODUCTION

Implant dentistry now forms an integral part of routine dental practice, and implants are used

in multidisciplinary treatment. Dental implants are becoming popular in orthodontic

treatment. They can be used to reposition natural teeth and to increase treatment options.1, 2

Treatment that combines orthodontics and implantology is now extensively used in dentistry.

In certain cases, implants replace teeth prior to termination of orthodontic treatment.

However, accurate impressions are difficult to obtain at this time because the bands and wires

trap the impression material. Also, orthodontic devices can tear the impression material. Few

techniques for implant impression in orthodontic patients have been reported. Lorton3

described a method to facilitate impressions of orthodontically banded teeth using strips of

occlusal indicator wax. Drago2 obtained intact, accurate irreversible hydrocolloid impressions

to make a maxillary splint. Sukotjo1 proposed the fabrication of a simple implant surgical

template to be used in implant therapy involving orthodontics devices. Maeda4 referred to a

method of mouth guard fabrication for orthodontic patients that allows reproduction of the

occlusal and incisal surfaces using irreversible hydrocolloid. However, with these methods, a

precise casting of the implant is not possible. Obtaining a precise impression with stable

dimensions of implant is necessary for passive fitness, and it demands precise transfer of the

spatial relationships of the implant from the mouth to the master cast to ensure passive fit of

implant framework. Irreversible hydrocolloid is useful in preliminary impressions, diagnostic

casts, mouth guards, bleaching trays and orthodontics casts.5 But in implant impressions, it

has the disadvantages of low dimensional stability and reduced capacity for detail

reproduction.6

On the other hand, the usual impression materials for implants are too rigid to

allow the removal from the mouth.

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This article proposes a simple impression implant technique for an orthodontic patient

without bracket remotion. Combining two types of impression materials makes it possible to

obtain an exact reproduction of the implant position, yet the material can be easily removed.

TECHNIQUE

A 60 year-old man in the course of full-banded orthodontic therapy needed repositioning of

his maxillary right canine using an osseointegrated implant.

Impression technique:

1. Manufacture a custom impression tray using light-polymerizing tray material (Triad

Tru-Tray; Dentsply International Inc). Perforate the tray for retention of impression

material and access to the implant impression coping.

2. After arch-wire remotion, the undercuts around the brackets must be blocked out with

modeling wax (Utility wax; Coltène/Whaledent) (Figure 1).

3. Place light-bodied polyvinyl siloxane impression material (Imprint; 3M ESPE) around

coping (Figure 2).

4. Mix irreversible hydrocolloid material (Orthoprint; Zhermack) according to the

manufacturer’s instructions and load the material into the tray (Figure 3).

5. Remove the tray and impression after setting.

6. Check the impression for presence of voids or pits and other artifacts (Figure 4).

DISCUSSION

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In the literature, several techniques to facilitate impression taking in orthodontics have been

described. Nevertheless, irreversible hydrocolloid is not recommended for implant impression

because it is inadequate for fine-detail reproduction and has low dimensional stability.

Current materials (polyvinyl siloxane, polyether) for implant impression are necessary to

obtain a master cast that exactly replicates the implant position. However, the above-

mentioned materials preclude removal from the mouth remotion due to their rigidity.

This report describes two impression materials. With the proposed method, a cast with

sufficient accuracy is possible. The first, irreversible hydrocolloid is elastic enough to access

the undercuts to reproduce the teeth, yet it allows removal from the mouth. On the other hand,

polyvinyl siloxane is the most suitable for implant reproduction.

The major disadvantage is tearing of the irreversible hydrocolloid, commonly

occurring on the buccal surfaces, although it is not a major problem. Another probable

disadvantage is the absence of adhesion between the materials that can result in displacement.

Nevertheless, penetration of the materials into the perforations of the tray can prevent this.

This article proposes a simple method to obtaining an accurate implant impression for use in

multidisciplinary cases involving orthodontic devices. Polyvinyl siloxane impression material

is set around the coping and then the irreversible hydrocolloid impression is made. The

method uses materials common in clinical practice, and an expensive digital appliance is not

necessary.

Acknowledgments

We thank Professor Javier González Porto for his work in translating this paper.

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REFERENCES

1. Sukotjo C, Bocage V. Simplified fabrication of surgical template for orthodontic-

implant treatment. J Prosthodont. 2006;15:59-61.

2. Drago CJ. Use of osseointegrated implants in adult orthodontic treatment: a clinical

report. J Prosthet Dent. 1999;82:504-509.

3. Lorton L. A method to facilitate impressions of orthodontically banded teeth. J

Prosthet Dent. 1982;48:356.

4. Maeda Y, Matsuda S, Tsugawa T, Maeda S. A modified method of mouthguard

fabrication for orthodontic patients. Dent Traumatol. 2008;24:475-478.

5. Nandini VV, Venkatesh KV, Nair KC. Alginate impressions: A practical perspective.

J Conserv Dent. 2008;1137-1141.

6. Rodrigues SB, Augusto CR, Leitune VC, Samuel SM, Collares FM. Influence of

delayed pouring on irreversible hydrocolloid properties. Braz Oral Res. 2012;26:404-

409.

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LEGENDS

Figure 1. View of implant impression coping and blocking brackets by modeling wax.

Figure 2. Light silicone around impression coping.

Figure 3. Individual tray loaded with irreversible hydrocolloid in mouth.

Figure 4. View of two-material impression, polyvinyl siloxane and irreversible hydrocolloid.

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