International Journal of Prosthodontics and Restorative Dentistry

Register      Login

VOLUME 14 , ISSUE 2 ( April-June, 2024 ) > List of Articles


A Comparison of Positional Accuracy of Multiple Implants Using Open-tray Impression Transfer with and without Splinting Using Different Splinting Materials: An In Vitro Study

Kashish Gupta, Sanjeev Mittal, Sonali Biswas, Satvika Prasad, Swati Kashyap, Preetica Sharma

Keywords : Implant level impressions, Implant prosthesis, Pattern resin, Splinting, Titanium bar

Citation Information : Gupta K, Mittal S, Biswas S, Prasad S, Kashyap S, Sharma P. A Comparison of Positional Accuracy of Multiple Implants Using Open-tray Impression Transfer with and without Splinting Using Different Splinting Materials: An In Vitro Study. Int J Prosthodont Restor Dent 2024; 14 (2):105-113.

DOI: 10.5005/jp-journals-10019-1453

License: CC BY-NC 4.0

Published Online: 29-06-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Purpose: To analyze and compare the positional accuracy of multiple implants using open-tray impression transfer with and without splinting using different splinting materials. Materials and methods: In this study, a heat-cured acrylic model was made with four implant analogs in left and right canine and first molar regions. The model was used to make multiple impressions for sample fabrication. A total of 40 open-tray impressions (10/group) were made. Based on the splinting material used, the groups were named as group A (titanium bar), group B (pattern resin), group C (cold cure acrylic resin), and group D (nonsplinting). Impressions were poured and casts were analyzed for the positional accuracy using coordinate measuring machine. The three-dimensional (3D) coordinates of each implant along the X-, Y-, and Z-axes were measured. One-way analysis of variance (ANOVA) and post hoc Tukey test were done to analyze the significant difference between the four implant analogs of each group with the master model. Results: The implant impressions made using the splinting techniques were more within clinical limits and closer to the reference model rather than nonsplinting technique. Interimplant distance obtained by splinting with cold cure acrylic resin (group C) demonstrated greater variations in X2-, X3-, Y-, and Z-axes. Splinting with pattern resin (group B) was found to be the most accurate method of splinting in the X- and Y-axes, with interimplant distances closer to the reference model. The difference between group B (pattern resin) and group A (titanium bar) was found to be statistically insignificant. Group D (nonsplinting) showed the largest differences when compared with reference model in Z-axis. Conclusion: Implant impressions made by splinting of impression copings provided better positional accuracy compared to those made without splinting. Pattern Resin provides best dimensional accuracy among the various splinting method tested. However, splinting impression copings with titanium bar was statistically similar to that of pattern resin.

PDF Share
  1. Jo SH, Kim KI, Seo JM, et al. Effect of impression coping and implant angulation on the accuracy of implant impressions: an in vitro study. J Adv Prosthodont 2010;2(4):128–133. DOI: 10.4047/jap.2010.2.4.128
  2. Sahin S, Çehreli MC. The significance of passive framework fit in implant prosthodontics: current status. Implant Dentistry 2001;10(2):85–92. DOI: 10.1097/00008505-200104000-00003
  3. Shankar RY, Sahoo S, Krishna MH, et al. Accuracy of implant impressions using various impression techniques and impression materials. J Dent Implants 2016;6(1):29–36. DOI: 10.4103/0974-6781.190384
  4. Hariharan R, Shankar C, Rajan M, et al. Evaluation of accuracy of multiple dental implant impressions using various splinting materials. Int J Oral Maxillofac Implants 2010;25(1):38–44.
  5. Cabral LM, Guedes CG. Comparative analysis of 4 impression techniques for implants. Implant Dentistry 2007;16(2):187–194. DOI: 10.1097/ID.0b013e3180587b3f
  6. Faria JC, Neves AC, Miranda ME, et al. Evaluation of the accuracy of different transfer impression techniques for multiple implants. Braz Oral Res 2011;25:163–167. DOI: 10.1590/s1806-83242011000200011
  7. Kaur T, Singla S, Kumar L. Comparison of accuracy of hexed and nonhexed pickup impression copings in a multiple variable impression setup for recording multiple straight and angulated implant positions: an in vitro study. J Indian Prosthodont Soc 2023;23(1):21–29. DOI: 10.4103/jips.jips_218_22
  8. Del’Acqua MA, Chávez AM, Castanharo SM, et al. The effect of splint material rigidity in implant impression techniques. Int J Oral Maxillofac Implants 2010;25(6):1153–1158.
  9. Selvaraj S, Dorairaj J, Mohan J, et al. Comparison of implant cast accuracy of multiple implant impression technique with different splinting materials: an in vitro study. J Indian Prosthodont Soc 2016;16(2):167–175. DOI: 10.4103/0972-4052.167937
  10. Choi JH, Lim YJ, Kim CW. Evaluation of the accuracy of implant-level impression techniques for internal-connection implant prostheses in parallel and divergent models. Int J Oral Maxillofac Implants 2007;22(5):761–768.
  11. Joseph TM, Ravichandran R, Lylajam S, et al. Evaluation of positional accuracy in multiple implants using four different splinting materials: an in vitro study. J Indian Prosthodont Soc 2018;18(3):239–247. DOI: 10.4103/jips.jips_27_18
  12. Saini HS, Jain S, Kumar S, et al. Evaluating the effect of different impression techniques and splinting methods on the dimensional accuracy of multiple implant impressions: an in vitro study. J Contemp Dent Pract 2018;19(8):1005–1012. DOI: 10.5005/jp-journals-10024-2373
  13. Lee H, So JS, Hochstedler JL, et al. The accuracy of implant impressions: a systematic review. J Prosthet Dent 2008;100(4):285–291. DOI: 10.1016/S0022-3913(08)60208-5
  14. De Avila ED, de Matos Moraes F, Castanharo SM, et al. Effect of splinting in accuracy of two implant impression techniques. J Oral Implantol 2014;40(6):633–639. DOI: 10.1563/AAID-JOI-D-12-00198
  15. Shankar SD, Doddamani S. To evaluate and compare the accuracy of definitive casts using various splinting methods on implant level impressions in All-on-Four treatment: an in vitro study. J Indian Prosthodont Soc 2020;20(2):193–201. DOI: 10.4103/jips.jips_210_19
  16. Agnihotri RR, Naik S, Vaishnav K, et al. Comparative analysis of different implant impression techniques: an in vitro study. Adv Hum Biol 2023;13(5):44–51. DOI: 10.4103/aihb.aihb_140_22
  17. Del’Acqua MA, Arioli-Filho JN, Compagnoni MA. Accuracy of impression and pouring techniques for an implant-supported prosthesis. Int J Oral Maxillofac Implants 2008;23(2):226–232.
  18. Lee SJ, Cho SB. Accuracy of five implant impression technique: effect of splinting materials and methods. J Adv Prosthodont 2011;3(4):177–185. DOI: 10.4047/jap.2011.3.4.177
  19. Moreira AH, Rodrigues NF, Pinho AC, et al. Accuracy comparison of implant impression techniques: a systematic review. Clin Implant Dent Relat Res 2015;17:e751–e764. DOI: 10.1111/cid.12310
  20. Sorrentino R, Gherlone EF, Calesini G, et al. Effect of implant angulation, connection length, and impression material on the dimensional accuracy of implant impressions: an in vitro comparative study. Clin Implant Dent Relat Res 2010;12:e63–e76. DOI: 10.1111/j.1708-8208.2009.00167.x
  21. Stimmelmayr M, Erdelt K, Güth JF, et al. Evaluation of impression accuracy for a four-implant mandibular model—a digital approach. Clin Oral Investig 2012;16:1137–1142. DOI: 10.1007/s00784-011-0622-z
  22. Fernandez MA, Paez de Mendoza CY, Platt JA, et al. A comparative study of the accuracy between plastic and metal impression transfer copings for implant restorations. J Prosthodont 2013;22(5):367–376. DOI: 10.1111/jopr.12015
  23. Alikhasi M, Siadat H, Monzavi A, et al. Three-dimensional accuracy of implant and abutment level impression techniques: effect on marginal discrepancy. J Oral Implantol 2011;37(6):649–657. DOI: 10.1563/AAID-JOI-D-09-00112.1
  24. Gallucci GO, Papaspyridakos P, Ashy LM, et al. Clinical accuracy outcomes of closed-tray and open-tray implant impression techniques for partially edentulous patients. Int J Prosthodont 2011;24(5):469–472.
  25. Balouch F, Jalalian E, Nikkheslat M, et al. Comparison of dimensional accuracy between open-tray and closed-tray implant impression technique in 15° angled implants. J Dent 2013;14(3):96–102.
  26. Inturregui JA, Aquilino SA, Ryther JS, et al. Evaluation of three impression techniques for osseointegrated oral implants. J Prosthet Dent 1993;69(5):503–509. DOI: 10.1016/0022-3913(93)90160-p
  27. Phillips KM. The accuracy of three implant impression techniques: a three-dimensional analysis. Int J Oral Maxillofac Implants 1994;9:533–540.
  28. Burawi G, Houston F, Byrne D, et al. A comparison of the dimensional accuracy of the splinted and unsplinted impression techniques for the Bone-Lock implant system. J Prosthet Dent 1997;77(1):68–75. DOI: 10.1016/s0022-3913(97)70209-9
  29. Assif D, Nissan J, Varsano I, et al. Accuracy of implant impression splinted techniques: effect of splinting material. Int J Oral Maxillofac Implants 1999;14(6):885–888.
  30. Vigolo P, Fonzi F, Majzoub Z, et al. An evaluation of impression techniques for multiple internal connection implant prostheses. J Prosthet Dent 2004;92(5):470–476. DOI: 10.1016/j.prosdent.2004.08.015
  31. Naconecy MM, Teixeira ER, Shinkai RS, et al. Evaluation of the accuracy of 3 transfer techniques for implant-supported prostheses with multiple abutments. Int J Oral Maxillofac Implants 2004;19(2):192–198.
  32. Assuncao WG, Gennari Filho H, Zaniquelli O. Evaluation of transfer impressions for osseointegrated implants at various angulations. Implant Dent 2004;13(4):358–366. DOI: 10.1097/
  33. Papaspyridakos P, Benic GI, Hogsett VL, et al. Accuracy of implant casts generated with splinted and non-splinted impression techniques for edentulous patients: an optical scanning study. Clin Oral Implants Res 2012;23(6):676–681. DOI: 10.1111/j.1600-0501.2011.02219.x
  34. Filho HG, Mazaro JV, Vedovatto E, et al. Accuracy of impression techniques for implants. Part 2 - comparison of splinting techniques. J Prosthodont 2009;18(2):172–176. DOI: 10.1111/j.1532-849X.2008.00325.x
  35. Patil P, Madhav VN, Alshadidi AA, et al. Comparative evaluation of open tray impression technique: investigating the precision of four splinting materials in multiple implants. BMC Oral Health 2023;23(1):844. DOI: 10.1186/s12903-023-03583-x
  36. Rutkunas V, Bilius V, Simonaitis T, et al. The effect of different implant impression splinting techniques and time on the dimensional accuracy: an in vitro study. J Dent 2022;126:104267. DOI: 10.1016/j.jdent.2022.104267
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.