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Journal of Prosthetic Dentistry

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

      An accurate implant impression is essential for a successful implant restoration, with various impression techniques being suggested.
      • Kim J.H.
      • Kim K.R.
      • Kim S.
      Critical appraisal of implant impression accuracies: a systematic review.
      The open tray (pick-up) impression technique has been recommended over the closed tray impression technique for improved accuracy,
      • Izadi 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.
      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.
      • Branemark P.I.
      • Zarb G.A.
      • Albrektsson T.
      Tissue integrated prostheses: Osseointegration in clinical dentistry.
      Splinting can be achieved in various ways,
      • Branemark P.I.
      • Zarb G.A.
      • Albrektsson T.
      Tissue integrated prostheses: Osseointegration in clinical dentistry.
      ,
      • Ivanhoe J.R.
      • Adrian E.D.
      • Krantz W.A.
      • Edge M.J.
      An impression technique for osseointegrated implants.
      including with dental floss and autopolymerizing resin or composite resin.
      • Ivanhoe J.R.
      • Adrian E.D.
      • Krantz W.A.
      • Edge M.J.
      An impression technique for osseointegrated implants.
      Placement of dental floss is cumbersome, and slippage may occur over the smooth surface of the impression coping.
      • Joshi 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.
      Joshi et al
      • Joshi 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.
      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.

      Technique

      • 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.
        Figure thumbnail gr1
        Figure 1A, Eight to ten-mm-diameter loop made with orthodontic wire. B, Loop placed around marked area of impression coping. C, Ends of orthodontic wire wrapped around impression coping. D, Ends of orthodontic wire twisted to lock loop.
      • 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 thumbnail gr2
        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.
      • 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.

      Acknowledgments

      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.

      References

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        • Kim K.R.
        • Kim S.
        Critical appraisal of implant impression accuracies: a systematic review.
        J Prosthet Dent. 2015; 114 (185-62)
        • Izadi 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.
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        • Zarb G.A.
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        Tissue integrated prostheses: Osseointegration in clinical dentistry.
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        • Gaikwad A.M.
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        Orthodontic elastomeric chain as an alternative to dental floss for splinting implant impression copings for complete-arch implant impressions.
        J Prosthet Dent. 2020; 123: 188-189