Case Presentation: Implant Impression for Contoured Soft Tissues

This is a continuation of this case – A single central incisor implant.

The patient returned for the final impression after two months of healing. 

Since the provisional maintained the soft tissue profile, there was a lot of space around the impression coping when attached to the implant for the fixture-level impression.

In the past, when I’ve tried to register this “sulcus” with the wash material in my impression, it results in a somewhat fragile extension of the impression.  Furthermore, when I put the impression coping back into the impression (before sending it to the lab), it would often tear.  The extra wash material would also make it hard to visualize the inside of the impression to assure proper orientation.

I’m sure I learned this technique somewhere in my 33 year career and then forgot about it.  But, for some reason, it popped back into my head during this case.

Before taking the impression, I applied flowable composite into the “sulcus” around the impression coping and light-cured it.  I filled the sulcus with composite level to the gingiva.  Then I took the impression.

After removing the impression, I used a bur to mark the facial side of the coping for future reference.  Then I unscrewed the coping from the implant.  The composite “sulcus impression” stays with the coping.

Next, I screwed the coping and lab analog (implant replica) together.

Without any thin fragile wash material in the way, inserting the lab analog / coping assembly correctly into the impression was easy.

Off to the lab it goes!  What do you think?  Have any of you done this technique?