Orthodontic wire loop for engaging dental floss or orthodontic elastomeric chain in the open tray implant impression technique

Abstract

An accurate implant impression is essential for a successful implant restoration, with various impression techniques being suggested.1Kim J.H. Kim K.R. Kim S. Critical appraisal of implant impression accuracies: a systematic review.J Prosthet Dent. 2015; 114 (185-62)Abstract Full Text Full Text PDF Scopus (31) Google Scholar The open tray (pick-up) impression technique has been recommended over the closed tray impression technique for improved accuracy,2Izadi A. Heidari B. Roshanaei G. Allahbakhshi H. Fotovat F. Comparative study of dimensional accuracy in three dental implant impression techniques: open tray, closed tray with impression coping, and snap cap.J Contemp Dent Pract. 2018; 19: 974-981Crossref PubMed Scopus (6) Google Scholar although splinting the open tray impression copings is essential to prevent micromovement and for accurate 3D transfer of the implant locations to the definitive cast.3Branemark P.I. Zarb G.A. Albrektsson T. Tissue integrated prostheses: Osseointegration in clinical dentistry.1st ed. Quintessence Publishing Co, Chicago1985: 253Google Scholar Splinting can be achieved in various ways,3Branemark P.I. Zarb G.A. Albrektsson T. Tissue integrated prostheses: Osseointegration in clinical dentistry.1st ed. Quintessence Publishing Co, Chicago1985: 253Google Scholar,4Ivanhoe J.R. Adrian E.D. Krantz W.A. Edge M.J. An impression technique for osseointegrated implants.J Prosthet Dent. 1991; 66: 410-411Abstract Full Text PDF PubMed Scopus (38) Google Scholar including with dental floss and autopolymerizing resin or composite resin.4Ivanhoe J.R. Adrian E.D. Krantz W.A. Edge M.J. An impression technique for osseointegrated implants.J Prosthet Dent. 1991; 66: 410-411Abstract Full Text PDF PubMed Scopus (38) Google Scholar Placement of dental floss is cumbersome, and slippage may occur over the smooth surface of the impression coping.5Joshi A.A. Gaikwad A.M. Nadgere J.B. Ram S.M. Orthodontic elastomeric chain as an alternative to dental floss for splinting implant impression copings for complete-arch implant impressions.J Prosthet Dent. 2020; 123: 188-189Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar Joshi et al5Joshi A.A. Gaikwad A.M. Nadgere J.B. Ram S.M. Orthodontic elastomeric chain as an alternative to dental floss for splinting implant impression copings for complete-arch implant impressions.J Prosthet Dent. 2020; 123: 188-189Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar presented an alternative technique for splinting open tray impression copings by using orthodontic elastomeric chain and light-polymerizing composite resin. The purpose of the present article was to present a straightforward procedure for fabricating an orthodontic wire loop for engaging dental floss or orthodontic elastomeric chain in the implant impression. The orthodontic loops can be welded to the open tray impression copings by the dentist or added by the dental laboratory technician. 1.Remove the healing abutments (Healing abutment [AO]; Megagen) after satisfactory healing of the peri-implant soft tissue around the implants.2.Place pick-up (open tray) impression copings (Pick up coping [AO]; Megagen) with 10-Ncm torque and make a periapical radiograph to verify proper seating of the impression copings.3.Mark the future location of the orthodontic loops on the pick-up impression copings by using a permanent marker. The authors recommend placing the loops on the mesial and distal surfaces. Placement on the buccal and lingual surface may interfere with seating the tray and may cause tongue irritation. Remove the impression copings for the attachment of loops.4.Select 60-mm, 23-gauge orthodontic arch wire (S304 Stainless steel; G&H), make 8 to 10mm-diameter loops (Fig. 1A), and place them in the marked locations (Fig. 1B), with the ends of the wire extending away from each other.5.Wrap both ends of the orthodontic wire around the impression coping (Fig. 1C) and twist both ends of the wire to lock the loop in its place and cut excess (Fig. 1D).6.Place the impression copings with orthodontic wire loop (Fig. 2A) and attach orthodontic E chain or pass floss (Fig. 2B) through the loop. Stabilize the impression coping with autopolymerizing resin (Pattern resin; GC) (Fig. 2C) or bulk-fill flowable composite resin.Figure 2A, Intraoral placement of open tray impression coping with orthodontic wire loop. B, Dental floss engaged around orthodontic wire loop. C, Open tray impression copings stabilized with autopolymerizing resin.View Large Image Figure ViewerDownload Hi-res image Download (PPT)7.Inject low-viscosity impression material (Extreme Lite; Medicept) around the impression copings. Fill the stock tray with a high-viscosity impression material (Extreme putty; Medicept) and seat intraorally. The authors thank Dr Sabita M. Ram, Director Research, MGM Institute of Health Sciences, Navi Mumbai, and Dr Naisargi Shah, HOD, Department of Prosthodontic and Crown & Bridge, Terna dental college and hospital, Navi Mumbai, for the guidance and support. They also wish to convey a special thank you to Mr Satish karkhile, Lab technician, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, for all the laboratory support provided during the procedure.