Custom Impression Research Articles

Rehabilitation of patient with unilateral congenital anophthalmia using custom ocular prosthesis

This case report aims to detail the fabrication and implementation of a custom ocular prosthesis for a patient with unilateral congenital anophthalmia. This study highlights the innovative approach, the procedures undertaken, and the significant outcomes achieved. A detailed assessment of the patient's anophthalmic socket was conducted. A custom impression technique was used to fabricate the prosthesis, ensuring optimal fit and aesthetic appearance. The process included impression making, customized prosthesis design, and fitting sessions.The custom ocular prosthesis achieved excellent aesthetic integration, restoring facial symmetry and enhancing the patient's appearance. Follow-up assessments showed satisfactory prosthesis retention, minimal discomfort, and positive psychosocial impacts, including improved self-esteem and social interactions.This case underscores the importance of individualized prosthetic solutions in managing congenital unilateral anophthalmia.

Staged Extractions and Implant Placement for Maxillary Central Incisors: A Case Report

A patient sought treatment at a prosthodontics practice to replace mobile maxillary centrals and exposed defective veneer margins on the maxillary laterals. Staged extractions and immediate implant placement were offered as the treatment option to preserve the hard and soft tissue around the implants and maximize the esthetic outcome. Staged extraction of adjacent teeth and immediate implant placement was performed to the maxillary central incisors. After osseointegration, custom impression copings were made to capture the gingival contours. The implants were restored with implant retained ceramic crowns and the maxillary laterals were restored with ceramic veneers. Although treatment time is lengthened staged extraction of adjacent anterior teeth and immediate implant placement can provide a predictable and successful treatment option to manage soft tissues and achieve a highly esthetic outcome. Keywords: Implants; Esthetics; Immediate Implants; Immediate Provisionals; Staged Extractions; Prosthetic Dentistry

An Evaluation of Retention of Complete Denture Bases Made with a “Modified Single-stage Impression” Technique Using a Heat-moldable Tray

Abstract Aim: Although most dental schools teach complete denture definitive impression techniques consisting of secondary impressions in border-molded custom impression trays, it has been found that later, graduates in clinical practice abandon this step because of its complexity and attempts to seek easier alternatives. To simplify two-stage techniques, single-step border molding with elastomeric impression materials and light-cured resin materials has gathered acceptance among clinicians. The study aims to evaluate the retention of record bases made with a modified single-stage impression technique that uses elastomeric impression material in a heat moldable tray with modeling compound as material for border molding. Settings and Design: This was an in vivo preliminary cohort study. Materials and Methods: Thirteen completely edentulous patients requiring complete dentures were included in the study. A traditional two-stage impression was made using custom trays fabricated over diagnostic casts and further border molding done with a modeling compound, and the final impression was made to use zinc oxide–eugenol impression material. Additionally, a modified single-stage impression technique using heat moldable impression trays was made. Master casts from each technique were made, and further record bases were made on each master cast. Wire loops were adapted on the palatal aspect of record bases. The retention of each record base was evaluated using a force gauge. Statistical Analysis: The Kolmogorov–Smirnov test was used to analyze the normality of variables and later Wilcoxon signed-rank test was applied. Results: The double-stage technique exhibited retention values in the range of 0.6–66.7 units, whereas the single-stage technique showed a range of 0.15–78.55. The tests showed no significant difference between double-stage and single-stage techniques (P > 0.05). Conclusions: The single-stage technique using heat moldable trays with elastomeric impression material and modeling compound as a material for border molding can produce denture retention compared to the conventional technique that uses a two-step impression technique. The use of the modified single-stage technique can additionally save an extra appointment for patients, although it is better to use such a technique as an advanced impression technique and not as a training technique for beginners or students, as the material cost is substantially higher than the conventional two-stage technique.

Chairside 3-D printed impression trays: a new approach to increase the accuracy of conventional implant impression taking? An in vitro study

PurposeA high transfer accuracy of the intraoral implant position to a model is required, to manufacture implant-supported restorations. However, clinically relevant deviations persist between the intraoral implant position and the model obtained, even for the benchmark conventional custom implant impressions with polyether. Thus, new approaches using 3-D printed impression trays may increase the transfer accuracy of implant impressions. The ability to adjust parameters such as the thickness of the layers and the influence of the openings in the impression tray could potentially affect accuracy.MethodsFour different types of impression trays (n = 10 for each group) for the conventional impression technique were investigated: conventional custom impression tray, customized foil tray, chairside 3-D printed impression tray with the SHERA system, and the Primeprint system using an implant master model with four implants in the posterior region and a reference cube. After plaster model casting, all models were measured using a coordinate measuring machine, and the deviation from the reference dataset was determined. A statistical ANOVA analysis was performed (p < 0.05).ResultsChairside 3-D printed impression trays showed the best results, followed by conventional custom impression trays. Implant impressions obtained using a customized foil tray exhibited the lowest accuracy. Statistically significant differences were observed between 3-D printed impression trays and conventional custom impression and customized foil trays (p < 0.05). Whereas, the implant position did not have any significant influence on accuracy (p > 0.05).ConclusionsChairside 3-D printed impression trays significantly increase the transfer accuracy for implant impression taking.Graphical

Dimensional Stability and Retention Strength of Impressions to Custom Impression Trays Fabricated Using Conventional Method and Additive Technology - An In-vitro Study.

3D printing technology is replacing manual fabrication in all fields. 3D-printed impression trays should be assessed as they could replace conventional impression trays in the future. In-vitro comparison and evaluation of the dimensional stability and retention strength of impressions to custom impression trays fabricated using conventional method and additive technology. A maxillary edentulous auto-polymerizing acrylic resin model served as the master model. Two moulds were prepared from the master model in order to obtain 12 casts. One cast was scanned for 3D printing digital light processing (DLP) and fused deposition modelling (FDM) 24 impression trays using polylactic acid (PLA). Twelve casts were used to fabricate light cure impression trays. Polyvinyl-siloxane impressions were made on the master model using 36 impression trays and 18 trays each were used to assess dimensional stability and retention strength. In dimensional stability analysis, one sample t-test revealed a statistically significant difference between each group and the master model followed by a one-way ANOVA. There were significant differences, but the difference was less with FDM trays (P < 0.05). In retention strength analysis, one-way Analysis of variance (ANOVA) revealed statistically significant difference between each group and post-hoc test revealed specific difference, the highest with FDM trays (P < 0.05). Dimensional changes were observed at 30 minutes and 72 hours. Lesser dimensional changes were observed when impressions were made using FDM trays followed by DLP and light cure trays. The mean retention strength seen in descending order was FDM, followed by DLP and light cure trays. The best retention strength was noticed when impressions were made using FDM trays.

Customized Preliminary Impression: A Novel Impression Technique for Severely Resorbed Edentulous Ridges

Patients with long-term edentulism and/or ill-fitting (poorly fitted) dentures are more likely to experience severe mandibular alveolar ridge resorption. Some of these patients have genial tubercles that rise over the mandibular residual ridge in the anterior region and protrude into the floor of the mouth. Typically, the most prominent portions of the resorbed mandibular edentulous ridge are in contact with the lingual flanges of the mandibular stock impression trays (i.e., genial tubercles and internal oblique lines). In these situations, it is advised that a preliminary custom impression tray be created to pour an initial impression, allowing for the fabrication of individual custom trays. In general, dental practice for the fabrication of the complete denture, the stock trays are used for making the preliminary impression and the custom trays for the final impression. The present article portrays an innovative and efficient clinical technique involving the fabrication of a customized preliminary impression tray for preliminary impression making particularly in unconventional situations, that is, pronounced mandibular alveolar ridge resorption.

Defining challenging areas of the preparation finish line by using an open-source 3D modeling computer program: A tip to simplify margin identification by the dental laboratory technician

Intraoral data acquisition and computer-aided design and computer-aided manufacturing (CAD-CAM) systems have simplified and expedited the fabrication of dental prostheses. 1 Van Noort R. The future of dental devices is digital. Dent Mater. 2012; 28: 3-12 Crossref PubMed Scopus (801) Google Scholar ,2 Giuliodori G. Rappelli G. Aquilanti L. Intraoral scans of full dental arches: an in vitro measurement study of the accuracy of different intraoral scanners. Int J Environ Res Public Health. 2023; 20: 4776 Crossref Scopus (0) Google Scholar Contemporary dental CAD-CAM provides the freedom to design and fabricate diverse dental devices, including custom impression trays, surgical templates, and removable and fixed dental prostheses. 1 Van Noort R. The future of dental devices is digital. Dent Mater. 2012; 28: 3-12 Crossref PubMed Scopus (801) Google Scholar ,3 Revilla-León M. Özcan M. Additive manufacturing technologies used for processing polymers: current status and potential application in prosthetic dentistry. J Prosthodont. 2019; 28: 146-158 Crossref PubMed Scopus (217) Google Scholar ,4 Turkyilmaz I. Wilkins G.N. Varvara G. Tooth preparation, digital design and milling process considerations for CAD/CAM crowns: understanding the transition from analog to digital workflow. J Dent Sci. 2021; 16: 1312-1314 Crossref Scopus (8) Google Scholar These dental appliances are created from a digital file that recreates the surface geometry of the target object, typically a standard tessellation language (STL) file. 5 Grant G.T. Campbell S.D. Masri R.M. Andersen M.R. The American college of prosthodontist digital dentistry glossary development task force. Glossary of digital terms. J Prosthodont. 2016; 25: S2-S9 Crossref PubMed Scopus (27) Google Scholar A prerequisite for accurate manufacture is the exact capture and identification of the fine details in the target intraoral structures. An accurate capture can be challenging when the preparation finish line is subgingival, when abundant bleeding or salivation occurs, or when operator scanning skills and speed are still developing. 6 Mangano F. Gandolfi A. Luongo G. Logozzo S. Intraoral scanners in dentistry: a review of the current literature. BMC Oral Health. 2017; 17: 149 Crossref PubMed Scopus (308) Google Scholar Additionally, the location of fine details can be challenging for the dental laboratory technician to visualize when the CAD file is outsourced for the manufacture of the definitive restoration, since STL files lack attributes such as color and texture. 5 Grant G.T. Campbell S.D. Masri R.M. Andersen M.R. The American college of prosthodontist digital dentistry glossary development task force. Glossary of digital terms. J Prosthodont. 2016; 25: S2-S9 Crossref PubMed Scopus (27) Google Scholar These features help differentiate the tooth from its surrounding tissues when finish lines are subgingival or when displacement is limited. The present article presents a straightforward workflow that defines challenging areas of the preparation finish line by using an open-source 3D modeling computer program. This procedure can be used to communicate the finish line observed to the dental laboratory technician when STL files are used to design the definitive restoration and stops the technician guessing the finish line, since the hard-to-see areas are defined by the clinician. Additionally, this approach has advantages over the margin tracing and sculpting tools available in most 3-dimensional (3D) CAD computer programs since it allows selecting the critical areas around the finish line considering the mesh geometry of the 3D file. Visualizing the 3D mesh permits a more precise selection, which can minimize distortion as even the smallest changes in the mesh surface can be observed if transformation or sculpting procedures are used.

Customized implant impression copings: provisional cast technique

Dental UpdateVol. 50, No. 6 Technique TipsCustomized implant impression copings: provisional cast techniqueHannah Bradley, William Keys, Andrew MacInnesHannah Bradleyemail: E-mail Address: [email protected]StR in Restorative Dentistry, Glasgow Dental Hospital and SchoolSearch for more papers by this author, William KeysConsultant in Restorative Dentistry, Edinburgh Dental InstituteSearch for more papers by this author, Andrew MacInnesConsultant in Restorative Dentistry, Glasgow Dental Hospital and SchoolSearch for more papers by this authorHannah Bradley; William Keys; Andrew MacInnesPublished Online:13 Jun 2023https://doi.org/10.12968/denu.2023.50.6.538AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View article References Furze D, Byrne A, Alam S, Wittneben JG. Esthetic outcome of implant supported crowns with and without peri-implant conditioning using provisional fixed prosthesis: a randomized controlled clinical trial. Clin Implant Dent Relat Res 2016 Dec; 18(6):1153-1162. https://doi.org/10.1111/cid.12416 Medline, Google ScholarPolack MA. Simple method of fabricating an impression coping to reproduce peri-implant gingiva on the master cast. J Prosthet Dent 2002; 88: 221–223. https://doi.org/10.1067/mpr.2002.127895 Medline, Google ScholarHinds KF. Custom impression coping for an exact registration of the healed tissue in the esthetic implant restoration. Int J Periodontics Restorative Dent 1997; 17: 584–591. Medline, Google ScholarBreeding LC, Dixon DL. Transfer of gingival contours to a master cast. J Prosthet Dent 1996; 75: 341–33. https://doi.org/10.1016/s0022-3913(96)90497-7 Medline, Google Scholar FiguresReferencesRelatedDetails 2 June 2023Volume 50Issue 6ISSN (print): 0305-5000ISSN (online): 2515-589X Metrics History Published online 13 June 2023 Published in print 2 June 2023 Information© MA Dentistry Media LimitedAcknowledgementsWe thank Sharon Weir, Dental Technician, at Glasgow Dental Hospital and School for her prosthodontic work.PDF download

Trueness of the Combined Intra- and Extraoral Scanning Technique for Transferring Subgingival Contours from Provisional Restorations to Definitive Restorations

To compare the morphologic trueness of provisional and definitive restorations constructed with conventional custom impression techniques to those constructed with intra- and extraoral scanning (IEOS), which can digitally transfer the subgingival morphology of the provisional restoration to the definitive restoration. Provisional restorations were fabricated on typodonts in which implants were placed. In the conventional method, a customized impression coping was produced by using polymethyl methacrylate resin to transfer the subgingival contour of the provisional restoration. Impressions were taken with silicone impression material, and definitive restorations were made by CAM. The IEOS technique was performed as previously reported. In brief, three individually scanned stereolithography (STL) files were superimposed in CAD software to transfer the morphology of the provisional restoration to the definitive restoration. Definitive restorations were then made by CAM. The provisional and definitive restorations were both scanned by IOS. Scanned data files were superimposed with morphometry software, and the distortions were measured. Student t test was used for statistical analysis. The subgingival morphologies of definitive restorations prepared by the conventional method showed significant negative distortions compared to definitive restorations prepared by the IEOS technique. The IEOS technique can more accurately transfer the subgingival contour of provisional restorations to definitive restorations compared to the conventional customized impression coping technique.

COMPARATIVE EVALUATION OF THE EFFECT ON THE RETENTION OF MAXILLARY DENTURE BASE BY USING TWO DIFFERENT BORDER MOLDING TECHNIQUES AND TWO DIFFERENT MATERIALS- AN IN VIVO STUDY

Purpose: This study was undertaken to compare the retention between sectional border molding using low fusing greenstick compound and single step border molding using condensation silicone (putty) impression material in two stages- A. After final impression and B. With the temporary denture base. Materials &amp; Methods: In this study evaluation of retentive values of sectional border molding (Group I) (custom impression trays border molded with green stick compound ) and single step border molding (Group II) ( border molding with condensation silicone (putty) impression material ). In both techniques definitive wash impression were made with light body condensation silicone and denture base with auto- polymerization resin. Results: Group 1B was significantly higher (mean- 2.176) than Group 1A (mean- 1.798) in test-1. The t-value (6.023) infers that there was significant difference between Group 1A and Group 1B (p =0.001). Group 2B was significantly higher (mean- 2.344) than Group 2A (mean-2.111) in test -2. The t-value (2.852) infers that there was significant difference between Group 2A and Group 2B (p=0.001). Conclusion: Within the limitations of this clinical study border molding using custom tray with low fusing green stick compound provided significant difference for retention as compared to condensation silicone at border moulding and denture base stage.

Effect of Plastic Impression-Transfer Copings on the Dimensional Accuracy of Implant Impressions

Purpose: The purpose of this in vitro study was to evaluate the effect of plastic impression transfer copings on the dimensional accuracy of close tray implant impressions. Methods: A master model was constructed using autopolymerizing acrylic resin. Five parallel holes were drilled for implant analogs. Custom impression trays were made with autopolymerizing polymethyl methacrylate resin. The study consisted of 2 groups (n=5): (group 1) Impression was obtained with using plastic impression transfer coping (group 2) Impression was obtained without using plastic impression transfer coping. Vinylpolysiloxane impression material was used for both groups. After the impression were obtained, casts were made by type IV dental stone. Casts were scanned with the lab-type scanner and transferred to the measurement program. Measurements were made from a specific reference corner for each analog to ensure standardization. Data were saved as millimeters and pairwise comparisons were made with Welch's t-test analysis. Results: The effect of plastic caps was evaluated by applying the t-test to each distance. For all distances, the distortion seen in the measurements taken without the cap is higher than the measurements taken with the cap, but no significant differences were found (p&amp;gt;0.05). Conclusions: In the anterior-posterior distances, the distortions were found compression type, in the right-left distances the distortions were found as expansion-type. There is a dimensional change in the measurements taken without a cap, but no clinically significant differences were found.

Fabrication of additively manufactured custom impression copings based on stock abutments

This article describes a dental implant impression technique using custom impression copings. The implant impression coping was designed by using a dental computer-aided design software program and manufactured by using additive methods. The impression copings were cemented to stock abutments, and the assemblies were used to make the definitive pick-up impression.

Digital Custom Impression Technique to Record Emergence Profile and Fabrication of an Esthetic Implant Supported Restoration.

One of the challenges in esthetic implant supported restorations is to replicate the emergence profile of soft tissue contours created by provisional restorations. Various analog techniques have been used to achieve the most esthetic and natural emergence profile in final restorations. The evolution of digital dentistry has made dentistry easier and efficient albeit with a learning curve. The technique described here uses digital technology to describe a complete digital workflow from the provisional stage to the final restoration.

Determination of the lingual border of lower complete dentures: How to use a silicone impression material?

This study aimed to clarify the efficacy of a border-moulding procedure with low-flow silicone impression material compared with a conventional compound to complete denture fabrication. It also aimed to evaluate the influence of various functional tasks during the lingual-side moulding procedure regarding the depth and width of the border. Ten dentate subjects (three men, seven women; average age 30years) were enrolled in this study after giving informed consent. A specially designed custom impression tray for the mandibular lingual side was fabricated for each subject. With the tray and heavy-body-type silicone material, lingual border moulding was performed that included four functional tasks: tongue protrusion (TP), licking the upper lip with the tongue (UL), swallowing (SW), and placing the tongue tip to the palate (PP). Within the limitations of this study, the results suggested that heavy-body silicone impression material is satisfactory for use in the border-moulding procedure, giving reproducible results. There were no significant differences among the functional tasks regarding the depth and width of the lingual flange except for swallowing, which exhibited the largest values.

To evaluate the effect of storage temperature on the linear dimensional accuracy of delayed and repeat pours of two addition silicone impression materials

Background: Addition silicone elastomers are the most commonly used impression materials for making final impression for fixed partial dentures, implants, and removable partial dentures. The dimensional stability and accuracy of addition silicone impression material is influenced by the storage time, temperature, and repeat pour. Aim and Objectives: The aims and objectives of this study were to evaluate the accuracy of two different types of addition silicone elastomeric impression materials, stored at different temperatures; to evaluate the accuracy of two different types of addition silicone elastomeric impression materials after delayed and repeated pour; and to compare the linear dimensions of two different types of addition silicone elastomeric impression materials with a control die. Materials and Methods: A machined standard steel master die and a metal custom impression tray were made for making a final impression of machined standard steel master die. The final impression was made by using two different brands of addition silicone impression materials (Aquasil™ Ultra Impression material, Dentsply/Caulk, Milford, DE, USA, and 3M™ ESPE™). Double-step putty light-body impression technique was used for making the final impression. In this manner, a total of eighty impressions were made, and they were divided into two groups namely Group I and Group II. To study the effect of delayed pours and storage temperature, the two groups were further divided into four subgroups, with ten impressions each. All the ten impressions of each subgroup were stored in an acrylizer at 40°C, −10°C for 24 h, −2°C for 48 h, and 0°C for 1 week inside a refrigerator in sealed plastic bags before being poured with type IV dental stone. To study the effect of repeat pours on the accuracy of stone casts, all the ten impressions of each subgroup were immediately re-poured with type IV die stone after the removal of the first set of casts. Thus, again a fresh set of eighty casts were obtained having forty casts to each group. Results: When the impressions were stored in the acrylizer at 40°C, −10°C for 24 h, −2°C for 48 h, and 0°C for 1 week, the addition silicone impression materials did not show any significant change when compared to the control samples. Conclusion: Both the types of addition silicone elastomeric impression materials maintained their accuracy after delayed pours and repeat pours. Storing impressions under different conditions caused no adverse effect upon the accuracy of both types of addition silicone elastomeric impression materials. There was no significant change in the dimensions of stone casts obtained from both impression materials as compared to the dimensions of the master die. Even though if the addition silicone impression material is delayed, i.e. poured up to 1 week, repeat poured, and exposed from − 10°C to 40°C, the linear dimensional accuracy will not be adversely affected.

A Technique to Simultaneously Fabricate Multiple Custom Impression Posts for Implant-Supported Restorations in the Esthetic Zone.

Peri-implant transmucosal tissue, an essential element of peri-implant esthetics, is critical to the success of prostheses in the esthetic zone. The optimal transmucosal tissue profile can be transferred to the master cast with the aid of custom impression posts. In this clinical technique, the initial cast used to fabricate provisional prostheses was conveniently used to aid in the time-efficient fabrication of multiple custom impression posts simultaneously using self-cured acrylic resin. This technique also applies to single restorations. In addition, the use of an initial cast as holder makes it easy to transfer custom impression posts to the mouth accurately and efficiently.

Customized Bolus for Orbital Tumors Created with 3D Photogrammetry and Rapid Prototyping

Children with orbital tumors, such as retinoblastoma or sarcoma, are often treated with radiotherapy. There are many techniques, including en face electron beams, conformal and intensity-modulated radiation therapy. For tumors close to the skin, bolus is overlaid to avoid underdosing the superficial portions of the target. If bolus is separated from the skin by an air gap, this may lead to treatment inaccuracy, which is magnified by larger gaps and smaller field sizes. Commercial tissue equivalent bolus is difficult to conform around the eyes and bridge of the nose, and custom impression material requires experience to create a uniform bolus without air cavities. We describe a technique with 3D photogrammetry at consultation to rapidly prototype a custom bolus prior to simulation. Children with orbital tumors, such as retinoblastoma or sarcoma, are often treated with radiotherapy. There are many techniques, including en face electron beams, conformal and intensity-modulated radiation therapy. For tumors close to the skin, bolus is overlaid to avoid underdosing the superficial portions of the target. If bolus is separated from the skin by an air gap, this may lead to treatment inaccuracy, which is magnified by larger gaps and smaller field sizes. Commercial tissue equivalent bolus is difficult to conform around the eyes and bridge of the nose, and custom impression material requires experience to create a uniform bolus without air cavities. We describe a technique with 3D photogrammetry at consultation to rapidly prototype a custom bolus prior to simulation. The 3D printed bolus was manufactured within a day after completing the STL file. The conformality of the 3D bolus to the phantom was compared to SuperFlab and the VPS bolus with computed tomography. SuperFlab was the least conformal and the 3D bolus was intermediate. Ridges on the surface of the 3D bolus from manufacturing increased the bolus-phantom gap. The VPS bolus material was the most malleable and conformal, but was not uniformly thick and had some internal air voids. Photogrammetry is an old technique to obtain patient contours, which we modernized to create a 3D file for rapid prototyping. The resulting bolus was created quickly and fit with excellent conformality, but was the most expensive. Over time, as rapid prototyping innovates, this method will become easier, more efficient, and increasingly available with a greater choice of materials and vendors. Until then, this process is useful now for a few small and irregular sites in the head and neck region, but routine and widespread application will not benefit most patients.

A Technique for Duplicating the Contours of an Interim Implant Supported Crown to Fabricate a Custom Impression Coping and the Definitive Prosthesis.

The purpose of the presented technique is to enable the clinician to replicate the contours of the interim prosthesis. A clinical case report is presented where this novel technique was implemented. A stone base and a silicone index were used to duplicate the contours of an interim prosthesis, so that the definitive restoration can have similar contours. The definitive prosthesis was fabricated based on the acquired soft tissue architecture and the contours of the interim restoration. The presented technique may assist clinicians in replicating the contours of interim restorations into the definitive prosthesis.

CAD/CAM produced complete dentures with the «Digital Denture Professional System».

The article describes the medical and dental procedures for four treatment sessions with the Digital Denture Professional (DDP) system. First, conventional preliminary dental impressions of the full arch are taken to achieve accurate jaw positioning records. The study models and patient data are digitalised using a laboratory scanner. The dental lab technician then constructs and mills custom impression trays and a mount as an intraoral instrument. A closed-mouth impression is then taken to record vertical dimensions and central relation position. After this is digitalised in the laboratory, DDP add-on software is used to virtually design the full dental implants and mill monolithic test implants. These can be tested for aesthetics, function and phonetics in the third session. The testing phase can also be skipped on request. In the last session, the final dental implants are fitted for the patient. The patient’s individual data are precisely recorded and digitally processed, which ensures the results are always as planned. The patient benefits from the spared time and costs. The range of care will be expanded in future to include reconstructions using implants. The digitalisation of the technique would be ideal for the planning and provision of digital implant prosthetics.

Technique for adapting a spacer for a custom impression tray

A method of adapting a spacer for the custom trays used to make a definite impression for complete dentures is presented. The technique can be used under a variety of conditions and offers several advantages.