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Journal of Peking University (Health Sciences) ›› 2022, Vol. 54 ›› Issue (1): 187-192. doi: 10.19723/j.issn.1671-167X.2022.01.030

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Application evaluation of prefabricated rigid connecting bar in implants immediate impression preparation of edentulous jaw

WANG Juan1,YU Hua-jie1,SUN Jing-de2,QIU Li-xin1,△()   

  1. 1. Fourth Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
    2. Beijing D&E Medical Limited Company, Dental Digital & Esthetics Laboratory, Beijing 100176, China
  • Received:2021-09-23 Online:2022-02-18 Published:2022-02-21
  • Contact: Li-xin QIU E-mail:kqqiulixin@163.com
  • Supported by:
    Program for New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology(PKUSSNCT-19B05)

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Abstract:

Objective: To compare the operation complexity and accuracy of traditional splint impression technique and impression technique with prefabricated rigid connecting bar system for full-arch implants-supported fixed protheses in vitro. Methods: Standard mandibular edentulous model with six implant analogs was prepared. The implants were placed at the bone level and multiunit abutments screwed into the implants. Two impression techniques were performed: the traditional splint impression technique was used in the control group, and the rigid connecting bar system was used in the test group. In the control group, impression copings were screwed into the multiunit abutments and connected with autopolymerizing acrylic resin. Open tray impression was fabricated with custom tray and polyether. In the test group, cylinders were screwed into the multiunit abutments. Prefabricated rigid bars with suitable length were selected and connected to the cylinders with small amount of autopolymerizing acrylic resin, and open tray impression was obtained. Impression procedures were repeated 6 times in each group. The working time of the two impression methods were recorded and compared. Analogs were screws into the impressions and gypsum casts were poured. The gypsum casts and the standard model were transferred to stereolithography (STL) files with model scanner. Comparative analysis of the STL files of the gypsum casts and the standard model was carried out and the root mean square (RMS) error value of the gypsum casts of the control and test groups compared with the standard model was recorded. The trueness of the two impression techniques was compared. Results: The work time in the test group was significantly lower than that in the control group and the difference was statistically significant [(984.5±63.3) s vs. (1 478.3±156.2) s, P<0.05]. Compared with the standard model, the RMS error value of the implant abutments in the test group was (16.9±5.5) μm. The RMS value in the control group was (20.2±8.0) μm. The difference between the two groups was not significant (P>0.05). Conclusion: The prefabricated rigid connecting bar can save the chair-side work time in implants immediate loading of edentulous jaw and simplify the impression process. The impression accuracy is not significantly different from the traditional impression technology. The impression technique with prefabricated rigid connecting bar system is worthy of clinical application.

Key words: Dental implantation, Jaw, edentulous, Dental impression technique, Dental prosthesis retention

CLC Number: 

  • R783.6

Figure 1

prefabricated rigid connecting bar system A, 3D design of prefabricated rigid connecting bar; B, some stainless steel models of prefabricated rigid connecting bar system."

Figure 2

Standard mandibular edentulous model with six implants and abutments"

Figure 3

Impression procedure of traditional splint technique A, multiunit abutments and impression copings screwed into the implants; B, impression copings were connected with autopolymerizing acrylic resin; C, the autopolymerizing acrylic resin was cut off after solidified; D, small gap between two adjacent impression copings; E, reconnection of the impression copings with small amount of autopolymerizing acrylic resin; F, impression with custom tray and polyether."

Figure 4

Impression procedure with prefabricated rigid connecting bar system A, multiunit abutments and cylinders screwed into the implants; B, prefabricated rigid bars were connected to the cylinders; C, the rigid connecting bars and cylinders were fixed with small amount of autopolymerizing acrylic resin; D, impression with custom tray and polyether; E, analogs were screws into the impression; F, gypsum cast poured from the impression."

Figure 5

Example of 3D compare analysis of standard and test models"

Table 1

Impression work time and 3D error value comparison of two impression techniques (n=6)"

Groups Impression work time/s RMS value/μm
Traditional splint technique 1 478.3±156.2 16.9±5.5
Prefabricated rigid
connecting bar technique		 984.5±63.3 20.2±8.0
t 6.553 1.286
P <0.001 0.210

Figure 6

Immediate loading procedure of edentulous with prefabricated rigid connecting bar system A, implants insertion of edentulous jaw; B, multiunit abutments and cylinders screwed into the implants; C, prefabricated rigid bars were connected and fixed to the cylinders; D, impression and occlusal record were made simultaneously over the splinting structure; E, definitive impression and occlusal record with splinted rigid bars in it; F, implant analogs splinted with rigid connecting bars and occlusal relationship confirmed with the mandibular model; G, occlusal relationship transferred to the articulator; H, interim prosthesis fabricated with connecting bars embedded in; I, interim prosthesis screwed into the implants the same day after implant surgery."

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