- 1.Remove the healing abutments (TS Fixture, Healing abutment; Osstem Implant Co, Ltd). Place the open tray impression copings (TS Fixture, Pick up impression coping; Osstem Implant Co, Ltd) and tighten to 10 Ncm. Make periapical radiographs to verify proper seating of the impression copings.
- 2.Take a short continuous orthodontic elastomeric chain (Dental Power E Chain; Pyrax Polymars) and pass it over the head of the impression copings (Fig. 1). Do not stretch the elastomeric chain to prevent elastic tension.
- 3.Apply bulk fill flowable light-polymerizing composite resin (Tetric N-Flow Bulk fill; Ivoclar Vivadent AG) over the elastomeric chain to stabilize the open tray impression copings (Fig. 2). Bulk fill flowable composite resin is preferred over a lower filler content composite resin to minimize polymerization shrinkage.
- 4.Apply additional composite resin and light polymerize in multiple small increments to minimize polymerization shrinkage. The application and polymerization of the composite resin should be initiated at the impression copings so that shrinkage will be in the direction of a rigid wall of the copings. If the composite resin is applied in bulk, it must be sectioned between 2 copings and rejoined by using an additional composite resin.7
- 5.Inject low viscosity impression material (Extreme Lite, Medicept) around impression copings. Fill the stock tray with a high viscosity impression material (Extreme putty, Medicept) and place intraorally (Fig. 3).
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