Accuracy of impressions and casts using different implant impression techniques in a multi-implant system with an internal hex connection

Abstract

The aim of this study was to investigate the deviations of the implant positions of both impressions and casts using different impression materials and techniques. Furthermore, the existence of a correlation between the deviations of the impression and those of the cast was investigated.A reference model was fabricated with 5 Frialit-2 implants parallel to each other. In a standardized experimental setting, 5 stone casts were produced with 5 different techniques using polyether (A) or polyvinyl siloxane (B through E). In 3 groups, a direct technique was used with a medium-viscosity material or a putty-tray material in combination with a light-viscosity syringe material (A to C). In 2 groups, an indirect technique (either 1-step [group D] or 2-step [group E] was used with a putty-tray material in combination with a light-viscosity syringe material. The center-to-center distances were measured for impressions and casts in the horizontal plane using a computer-aided microscope, and the relative and absolute deviations compared to the reference model were calculated. Analysis of variance followed by the post-hoc Scheffé test (parametric data) or the Kruskal-Wallis test followed by pair-wise Mann-Whitney tests (nonparametric data) were used for statistical analyses. Deviations of impressions were compared with their respective casts using paired t tests and the Pearson correlation coefficient.No significant differences for the relative deviations were found for impressions (-5 to -8 microm) or casts (+7 to +16 microm). Group E produced significantly higher absolute deviations for impressions (38 microm) and casts (39 microm) compared to the other groups (11 to 18 microm and 17 to 23 microm, respectively). A significant correlation between deviation of the impression and its respective cast was found for every group (r = 0.40 to 0.80) except group D.The distortions in the horizontal plane of the casts obtained from the impression techniques of groups A to D would probably not affect the clinical fit of implant-retained superstructures. Because of the high variation of deviations (-113 to +124 microm), the 2-step technique cannot be recommended. The method to measure both impression and cast provided a better understanding of how inaccuracies are caused.