there are trays on the market that have pop-out sections for your convenience if you do not want
to go through the trouble of cutting holes in one of your stock trays here you can see that
the plastic blockout sleeves were each cut to the appropriate size and placed over the guide pins
today's case will demonstrate a full arch open tray impression similar to many patients that you
will see in your own office this patient presents with implants already placed and integrated prior
to today's appointment i have identified several things the specific type of implants which were
placed the diameters and if there is a restorative platform shift involved it is worth noting that
with some systems the diameter of the implant body is different from the restorative platform
for today's video i am going to demonstrate the very basics of taking an open tri impression
keep in mind that this is a preliminary impression using individual transfer copings and a stock tray
this impression will be utilized to provide our lab with valuable foundational information
once you have identified this information you will have to order the desired components
in this case a combination of both 3.5 millimeter and 4.5 millimeter platform inclusive
tapered implants were placed for this case we ordered inclusive open tray impression copings
here you can see that this item comes with several components a laboratory guide pin
which has less threads and is longer making it easy for the technician to utilize in the lab
an impression guide pin which has more threads and is shorter making it easier to utilize intraorally
a plastic block out sleeve this is placed over the guide pin to allow for clean and
easy identification of the copings throughout the impression the plastic component can
easily be cut to the appropriate height a transfer coping this coping has an engaging
component that allows you to capture the timing of the internal connection
now that we have identified the components let's take our impression the first step is removing the
healing abutments and inserting our impression copings as we remove each healing abutment the
soft tissue will start to collapse which can be uncomfortable for the patient to avoid collapse
of the soft tissue as each healing abutment is removed i immediately replace it with an
impression coping i like to take radiographs for confirmation that the copings are fully seated
and not caught on the soft tissue radiographically you are looking to see that the impression coping
is flush with the implant platform once all the copings are confirmed i then make adjustments to
the stock tray i like to mark the tray directly in the mouth to identify the location of the copings
utilizing a coarse cut carbide burr i then perforate holes into the tray accordingly
there are trays on the market that have pop-out sections for your convenience if you do not want
to go through the trouble of cutting holes in one of your stock trays here you can see that
the plastic block out sleeves were each cut to the appropriate size and placed over the guide pins
i always try the tray in at this point to verify that the transfer copings are correctly aligned
with the holes in the tray i make sure that i know my path of insertion which i have marked
here with a black line the last thing you want is for one of your transfer copings
to not pop through the tray and get lost in the impression material once i verify that there is
enough room around each coping i like to place a soft wax on top of the holes i just created
here i am using blue periphery wax this will keep my impression material in the tray making locating
the guide pins during the impression much easier at this point we are ready to take our impression
just like taking an impression on natural teeth we want to capture as much information as we can
i like to syringe a light body pvs material around the transfer copings while my assistant loads the
tray with a heavy body pvs be sure to fully seat the tray so the guide pins poke through the wax
before the pvs fully sets be sure you can identify the top of each transfer coping
once the impression material fully sets you can easily remove any impression material in
the plastic sleeve allowing for easy access to the top of the guide pin
unscrew and completely disengage each guide pin before removing the impression from the
patient's mouth as soon as the impression is removed replace the healing abutments right away
to avoid soft tissue collapse at this point the guide pins will have to be inserted back into the
impression or sent back to the lab where they will be used to attach the analog component prior to
the impression being poured this is an example of how to attach an analog to the impression coping
the analogs are ordered separately and can be attached using either of the provided guide pins
if you do not wish to attach the analogs yourself make sure that you send the guide
pins along with your impression to the lab thank you for joining us