Seif Merna M, Hakim Ahmed A Abdel, Abouelkheir Hassan M, Negm Rana A
Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Champollion St., Azarita, Alexandria, 21527, Egypt.
Department of Oral Medicine, Periodontology, and Radiology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
BMC Oral Health. 2025 Jun 6;25(1):928. doi: 10.1186/s12903-025-06304-8.
BACKGROUND: Accurate impression registration is essential for transferring the three-dimensional (3D) implant position to the definitive cast, ensuring passivity of the final prosthesis. Various impression techniques have been developed to optimize accuracy, particularly for angulated implants. This study aimed to evaluate and compare the accuracy of open-tray impression copings, clips impression copings, and hexed implant mounts in transferring implant positions for both straight and angulated implants. METHODS: Five implants with different angulations (three at 0°, one at 15°, and one at 25°) were placed in an epoxy resin model, reflecting angulations commonly encountered in clinical practice. Thirty impressions were made using three types of impression copings: open-tray, clips (closed-tray), and hexed implant mounts (closed-tray), with ten impressions per group. Impressions were poured, and CBCT scans of the reference model and casts were obtained. The resulting DICOM files were converted to STL format using reverse engineering software to evaluate implant position accuracy based on shoulder deviation, apical deviation, angular deviation, and vertical shift. A significance level of p < 0.05 was set. One-way ANOVA and post hoc tests were performed; Tukey's HSD was applied when variance homogeneity was met, while the Games-Howell test was used when this assumption was violated. RESULTS: The study revealed that among the three coping types, the hexed implant mount demonstrated significantly higher angular deviation (p < 0.001), apical deviation (p = 0.003), and vertical shift (p < 0.001) for 25° angulated implants compared to the open-tray and clips copings. There were no significant differences between the open-tray and clips groups at this angulation. At 15° angulation, the hexed implant mount showed a significantly greater vertical shift (p = 0.011) compared to the open-tray coping, while no significant difference was observed between the clips and open-tray copings. For straight implants (0° angulation), all three coping types-open-tray, clips, and hexed implant mounts-showed no significant differences in any measured parameter. CONCLUSIONS: Open-tray and clips impression copings provide reliable implant position transfer for straight and angulated implants up to 25°. The hexed implant mount is accurate up to 15° angulation but shows increased deviations at 25°.
背景:准确的印模记录对于将三维(3D)种植体位置转移到最终模型上至关重要,可确保最终修复体的被动就位。已开发出各种印模技术以优化准确性,特别是对于成角种植体。本研究旨在评估和比较开放托盘印模帽、夹子印模帽和带六角形的种植体基台在转移直形和成角种植体位置时的准确性。 方法:将五颗具有不同角度的种植体(三颗0°、一颗15°和一颗25°)植入环氧树脂模型中,以反映临床实践中常见的角度。使用三种类型的印模帽制作30个印模:开放托盘、夹子(封闭托盘)和带六角形的种植体基台(封闭托盘),每组10个印模。灌注印模,并对参考模型和模型进行CBCT扫描。使用逆向工程软件将所得DICOM文件转换为STL格式,以根据肩部偏差、根尖偏差、角度偏差和垂直移位评估种植体位置准确性。设定显著性水平为p < 0.05。进行单因素方差分析和事后检验;当满足方差齐性时应用Tukey's HSD检验,当该假设不成立时使用Games-Howell检验。 结果:研究表明,在三种基台类型中,与开放托盘和夹子基台相比,对于25°成角种植体,带六角形的种植体基台在角度偏差(p < 0.001)、根尖偏差(p = 0.003)和垂直移位(p < 0.001)方面表现出显著更高的偏差。在该角度下,开放托盘组和夹子组之间无显著差异。在15°角度时,与开放托盘基台相比,带六角形的种植体基台显示出显著更大的垂直移位(p = 0.011),而夹子和开放托盘基台之间未观察到显著差异。对于直形种植体(0°角度), 所有三种基台类型——开放托盘、夹子和带六角形的种植体基台——在任何测量参数上均无显著差异。 结论:开放托盘和夹子印模帽可为直形和成角达25°的种植体提供可靠的种植体位置转移。带六角形的种植体基台在角度达15°时是准确的,但在25°时偏差增加。
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