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Which impression technique and records are required for an Implant Crown and Bridge case?

Capturing accurate records is where most implant cases are won or lost. ROE supports three impression approaches for Implant Crown and Bridge cases (open-tray, closed-tray, and digital), and the right choice depends primarily on how many implants are involved and how parallel they are.

The three impression techniques

Open-tray impressions use pick-up copings whose retaining screws extend through an opening in the tray and are embedded in the impression, then unscrewed before the tray is removed. Closed-tray impressions use transfer copings that remain on the implants when the tray is removed, after which the copings are unscrewed and reseated into the impression. Digital impressions use scan bodies placed on the implants and captured with an intraoral scanner.

Technique Best suited for Accuracy note Key requirement
Open-tray More than one implant, all-on-four, multi-unit Most accurate per the literature for multiple non-parallel implants Posts splinted with acrylic resin or light-cured material; tray must not contact the posts
Closed-tray Simpler cases with sufficiently parallel implants Less accurate than open-tray per the literature Implants must be sufficiently parallel; may need a fit verification jig and an added appointment
Digital (scan bodies) Cases where all anatomy can be captured Effective when anatomy and scan body are fully duplicated Correct scan body matched to the implant system and connection

Why open-tray is preferred for multiple units

Open-tray technique is the most recommended method for anything more than one implant because it greatly reduces the chance of ill-fitting frameworks. The impression posts must be securely tightened and connected by resin or another splinting device, and the tray must not contact the posts, since any contact can torque the tray and compromise the fit.

With non-parallel implants, the greater the angulation differences, the higher the risk of distorting or tearing closed-tray impression material on removal, which is exactly the failure mode the open-tray approach eliminates.

Choosing and seating the scan body for digital cases

For digital impressions, choose the scan body that matches your specific implant system and screw connection, because different manufacturers have unique connection geometries that must be captured precisely. Seat the scan body with gentle pressure, confirm the tactile click of full engagement, and verify visually that there are no gaps at the implant platform.

Scan from buccal, lingual, and occlusal angles to eliminate blind spots, capture the bite in maximum intercuspation, then remove the scan body and place a healing abutment or interim crown.

Verify seating radiographically For any analog technique, take a periapical radiograph to verify complete seating of the impression copings on the implant platforms. This should be considered a mandatory step, because copings that were not fully seated during the impression will produce an inaccurate framework, bridge, or even single crown, leading to incorrect occlusion or contacts.

Clinical rule of thumb: a periapical radiograph confirming fully seated impression posts is non-negotiable, for single units and multi-unit cases alike.

Supporting records and submission Round out the case with the opposing model, bite registration, and shade selection. Stump shade references improve shade matching accuracy. Submit through the ROE upload portal at https://www.roedentallab.com/upload: for digital cases, submit scans through your IOS portal or export your .STLs and upload them; for analog cases, send the physical models and records. General record-submission guidance is covered in the ordering article.

 

Additional Resources

For more information concerning Implant Crown and Bridge:

Contact Information

For help with a Locator Fixed solution for your next case, contact ROE Dental Laboratory: