A simple open-tray implant impression technique Richard J. Windhorn, DMD, a and Thomas R. Gunnell, DDS b US Army Prosthodontic Residency Program, Ft. Gordon, Ga Obt ain ing an acc ura te imp ression of the implan t pos i- tion and surr oundi ng har d and sof t tis sue s is par amo unt to fabricatin g an esth etic and biolo gical ly func tional definitive restoration. There are 2 primary techniques for reg ist eri ng the positions of denta l imp lants, the closed-tray and open-tray impression techniques. Each of these impression techniques has variations. 1-5 Thi s art icl e des cri bes an open- tra y te chn ique for impressing implants that is inexpensive, clean, and easy to perform with materials commonly found in a restor- ative dental pr actice. Th e soft bo xi ng wa x is easytoappl y to the impr es si on tr ay and easi ly pe els of f. It confi nes the Blu-Mousse (Par kell, Inc, Edge woo d, NY) used arou nd the implant copings and allows the guide pins to pro- trude through the tray. Blu-Mousse is preferr ed around the imp res sio n cop ings bec aus e of its rig idi ty . 6 The Blu- Mousse is placed in the impression tray last because it polymerizes in 2 minutes, whereas most vinyl polysilox- ane impression materials polymerize in approximately 5 to 6 minutes. Other open-tray impression protocols recommend wiping off the excess impression material that extrudes through the hole in the tray with a gloved finger or injecting impression plaster through the hole(s) in the tray to fill the remaining void. 7,8 This may be messy to accomplish. Additionally, the powder on some gloves may inhi bit the polymeri zation of vinyl polysilo xane (VPS) impression materials. 9 Wax placed over the hole in the tray prevents contact of the impression material with the gloves. PROCEDURE 1. Fabricate a cust om acry lic re sin tray (Tri ad ; Dentsply Intl, York, Pa) or select an appropriately siz ed sto ck tra y fro m acc ura te dental cas ts and cre ate an opening in the area where the implant is located. 2. Remove the healing abutment(s) (Replace Select; Nobel Biocare, Yorba Linda, Calif) and screw on the implant impression coping(s) (Replace Select; Nobel Biocare) (Fig. 1, A ). 3. Eva lua te the imp res sio n tra y int raoral ly. Ens ure that it is we ll adapted and that al l th e impr es si on co pin gs pro tru de thr ough theopening (s) in thetray wit hout contacting the acrylic resin tray. 4. Remove the tray from the mouth and adapt a sec- tion of boxing wax (Dentsply Intl) over the open- ing(s) in the tray and seal the wax to the tray using a hot instrument. (Fig. 1, B ) 5. Paint tray adhesive (Kerr Corp, Orange, Calif) on th e insi de of the tray, ex ce pt wh er e the wa x is located, and allow to dry. 6. Inje ct ligh t-bo diedVPS impre ssio n mate rial (Tak e 1; Kerr Corp) aro und theimpressi oncoping(s) nea r the gingival tissues and into the interproximal areas be- tween tee th. Hav e an ass ist ant fill the tra y wit h eit he r medium- or heavy-bodied VPS impression material (Take 1; Kerr Corp) in all areas, except where the wax is located. Place Blu-Mousse Classic (Parkell, Inc) in the entire area where the wax is located. 7. Place the loaded tray intraorally and push on the wax until all impression coping guide pins have Fig. 1. A, Implant impression copings placed intraorally. B, Boxing wax sealed to impression tray. The views and opinions expressed herein are those of the authors and do not reflec t those of the United State s Army or the Depart- ment of Defens e. a Assistant Director. b Third-year Resident. J Prosthet Dent 2006;96:220-1. 220 THE JOURNAL OF PROSTHETIC DENTISTRY VOLUME 96 NUMBER 3