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Knowledge, Attitude, and Practice of Various Impression Techniques

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Knowledge, Attitude, and Practice of Various Impression Techniques Research Article Knowledge, Attitude, and Practice of Various Impression Techniques Available for Dental Implants among Dental Students and Dental Practitioners - A survey Fahmida Binti Abd Rahman1, Ashish R. Jain2* ABSTRACT Background: Dental implant is a surgical component that supports dental prosthesis such as crown, bridge, denture, and facial prosthesis to the bone or jaw of the skull. Osseointegration is a biologic process that acts as the basis for modern dental implant in which materials such as titanium form an intimate bond to bone. A variable impression technique can be used for this kind of procedure. Aim: This study aims to assess the knowledge, attitude, and practice of undergraduate students and dental practitioners toward different impression techniques used for implant procedure. Materials and Methods: The study was conducted as a descriptive survey of private dental practitioners in the Chennai city, Tamil Nadu, India. A self- administered questionnaire of 12 questions with multiple choice questions was prepared to obtain information about knowledge, attitude, and practice toward various impression techniques for dental implants. A total of 100 people involving 50 dental students and 50 dental practitioners were chosen as the participants. The responses from all students were collected as soon as they filled the questionnaire that had been distributed. The questionnaires were distributed manually to them. Statistical analysis was done using G power analysis method. Result: The specific sample study on dental students was a poor reflection when compared to dental practitioners in terms of knowledge, attitude, and practice on various impression techniques for dental implant patients. A total of 50 undergraduate dental students and 50 dental practitioners participated in this current study. Conclusion: Getting a highly stable and retentive implant had always been a problem associated for most of the prosthodontists. Proper tray selection, proper implant angulation, proper impression techniques, and coping modification are the factors that might influence the accuracy of the dental implants. Therefore, it should be considered carefully before this procedure had been started. KEY WORDS: Basis, Dental implants, Impression, Techniques INTRODUCTION fixed partial dentures. Actually, dental implants have been an optional treatment for dental prosthesis since Nowadays, millions of people tend to lose their teeth. late 1930, and the popularity of this treatment start It can be due to many causes such as decay, gum to increase when the concept of osseointegration had disease, wear and tear, or trauma. Loss of teeth can been introduced in dentistry.[1-5] This concept had been be quiet emotional experience since it may affect our introduced by Toronto implant in the 1980s to the North ability to speak and masticate food. Replacement of American dental community.[6-9] Based on statistic, it teeth will be more challenging as more number of was revealed that approximately 100,000–300,000 teeth is missing. In the past, clinicians and patients had dental implants are placed per year.[10] Sometimes, been struggling with options available to replace the failure still can occur even though predictable long- missing teeth until dental implant treatment had been term result can be obtained with implant treatment. discovered. Treatment options for replacement of This may be due to certain condition such as imprecise missing teeth have been evolved from acrylic dentures surgical or prosthodontics techniques. Based on to metal framework and removable partial dentures to glossary prosthodontics term, dental impression can be defined as the “negative imprint of an oral Access this article online structure used to produce a positive replica of the structure which is used either for permanent record Website: jprsolutions.info ISSN: 0975-7619 or production of dental restoration.”[11] An accurate 1Department of Prosthodontics, Saveetha Dental College and Hospital, Saveetha University, Chennai, Tamil Nadu, India, 2Department of Prosthodontics, Saveetha Dental College and Hospital, Saveetha University, Chennai, Tamil Nadu, India *Corresponding author: Ashish R. Jain, Department of Prosthodontics, Saveetha Dental College and Hospital, Saveetha University, Chennai, Tamil Nadu, India. Phone: +91-9884233423. E-mail: [email protected] Received on: 28-01-2017, Revised on: 25-02-2018, Accepted on: 14-04-2018 Drug Invention Today | Vol 10 • Issue 5 • 2018 611 Fahmida Binti Abd Rahman and Ashish R. Jain impression is compulsory to prevent prosthesis an opening cut on it. When the impression material misfit. Prosthesis misfit can lead to some mechanical has been set, the screw will be loosened, and the problems such as screw loosening, screw fracture, tray will be removed from patient’s mouth together implant fracture, and occlusal inaccuracy.[12-14] Passive with the impression coping remained within the fit of the prosthesis and osseointegration is the factors impression. Later, an implant analog is tightened responsible for the success of implants.[15-17] The most to the impression coping with the same screw and important steps in achieving passive fit are during working cast is poured.[25,26] This technique enables impression taking. Selection of proper tray, proper the impression coping to retain in the impression. impression techniques, type of impression material, Therefore, it will prevent implant angulation, and angulation of impression may influence the deformation toward impression material on recovery [18-24] accuracy of dental implants. There are numerous of the mouth, and to eliminate the concern for the impression techniques available for dental implants. placement of the coping back to its specific space in The techniques can be divided into two major groups the impression. Some drawbacks of this technique are which are known as direct impression techniques and more parts need to be controlled during tightening, indirect impression techniques. Direct impression some rotational movement of the impression coping techniques include open tray or known as pick up will be presence when securing the implant analog, techniques, whereas indirect impression techniques and blind attachment of the implant analog to the involve closed tray and snap fit plastic impression coping. impression coping may cause misfit problem. Some clinical conditions or situations may require the use of Open tray technique or known as pick up technique closed tray technique instead of open tray technique. includes making an impression coping to the implant For example, when the patient has limited interarch together with screw that projects above the height of space, probability to gag, or when it is too challenging the coping and customized impression tray which has to access an implant located in the posterior area of Figure 1: Sample size calculation Figure 2: Percentage of results On various factors involved in accuracy of implant impression. 612 Drug Invention Today | Vol 10 • Issue 5 • 2018 Fahmida Binti Abd Rahman and Ashish R. Jain Table 1: The questionnaire for the current research Number of question 1. The accuracy of implant impression depends on? a. Tray selection, b. Implant angulation c. Impression technique d. Coping modification e. All of the above 2. Are you aware of various impression techniques available for dental implants? a. Yes b. No 3. Are you aware that open tray and closed tray techniques can be applied during impression making for dental implants? a. Yes b. No 4. For multiple implants what is choice of your impression technique? a. Open tray b. Closed tray 5. Which impression material would you prefer in case of multiple non-parallel implants? a. Vinyl polysiloxanes b. Polyether rubber base c. Alginate impression d. Condensation silicone 6. Which is the most commonly used impression materials in implant dentistry? a. Vinyl polysiloxanes b. Polyether rubber base c. Alginate impression d. Condensation silicone 7. Based on your experiences, misfit is common in which type of impression techniques? a. Open tray technique. b. Closed tray technique c. Both 8. Which components you will not use for single tooth restoration in impression procedure? a. Ball-top screw b. Straight abutment for cement - hexed c. Direct transfer coping screw d. One piece abutment for cement - non-hexed 9. Are you familiar with snap fit plastic impression coping technique? a. Yes b. No 10. During open tray impression technique, what would you prefer? a. Splinting the copings with GC pattern resin b. Splinting with acrylic resin c. Splinting with impression plaster d. Splinting with composite resin e. Non-splinting technique 11.Complication of misfit is more toward? a. Biological b. Mechanical c. Both 12. Which is the most often implant impression technique preferred? a. Implant level b. Abutment level c. Digital impressions the oral cavity.[27] Close tray technique involves the abutment level for single tooth implants. Commonly, use of single piece impression coping which attached closed tray technique will have discrepancies in intraorally toward the implant when the impression terms of axial rotation and inclination of the analogs. is removed from patients mouth. Then, this coping is Based on the previous study by Rodney et al., the removed from implant, fixed to the implant analog, results showed that a passive prosthesis could not be and repositioned to the impression with correct achieved either by pick up or transfer technique, but orientation. According
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