Особенности получения оттиска при изготовлении балочной системы на дентальных имплантатах при полном отсутствии зубов
Научно-практический журнал Институт Стоматологии №1 (110), апрель 2026
стр. 61-63
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Аннотация
Актуальность исследования. Успешное ортопедическое лечение пациентов с отсутствием зубов на нижней челюсти требует прецизионности и является актуальной задачей современной ортопедической стоматологии, поскольку пациенты рассчитывают на долговечность, функциональность и эстетичность своих ортопедических конструкций [5]. Особой группой являются съёмные ортопедические конструкции с опорой на балку и дентальные имплантаты. Данная протезная конструкция характеризуется малым количеством опор и жесткой винтовой фиксацией, что предъявляет повышенные требования к точности ее изготовления. Цель исследования. Выявить особенности двух методов получения оттисков при создании съёмных ортопедических конструкций с опорой на балку и дентальные имплантаты на нижней челюсти. Материалы и методы. Изготовлено 15 съёмных протезов с балочной фиксацией на дентальных имплантатах (Neo-biotech, Южная Корея). Для создания балок применялись две различные методики снятия оттисков: у 8 пациентов — классическая методика «открытой» ложки с использованием винилсилоксанэфира, а у 7 пациентов — интраоральный сканер Medit i700 (Medit Corp, Сеул, Южная Корея). Результаты исследования. В работе проведено клиническое исследование точности получения оттисков при изготовлении съёмных ортопедических конструкций с опорой на балку и дентальные имплантаты. Особое внимание уделено достижению «свободной посадки» (passive fit) как ключевому фактору долговечности и биологической стабильности протезов. Несмотря на технические сложности цифрового сканирования (большая площадь оцифровки, необходимость сшивания кадров, влияние клинических условий), оба метода обеспечили клинически приемлемую степень адаптации каркасов, подтвержденную тестом Шеффилда. Цифровой метод продемонстрировал преимущества в комфорте для пациента, тогда как традиционный подход требует большего количества клинико-лабораторных этапов. Заключение. Результаты исследования, полученные в группах 1 и 2, показали степень адаптируемости, признанную в научной литературе клинически приемлемой. Следовательно, оба метода получения оттисков имеют собственные особенности выполнения и не являются взаимоисключающими, а могут эффективно дополнять друг друга в зависимости от конкретной клинической ситуации.
Аннотация (англ)
The relevance of research. Successful orthopedic treatment of patients with missing teeth in the lower jaw requires precision and is an urgent task of modern orthopedic dentistry, since patients rely on the durability, functionality and aesthetics of their orthopedic structures [5]. Removable orthopedic structures with support on a bar and dental implants are a special group. This prosthetic design is characterized by a small number of supports and a rigid screw fixation, which places increased demands on the accuracy of its manufacture. Purpose of this study is to identify the features of two methods of obtaining impressions when creating removable orthopedic structures supported by a bar and dental implants on the lower jaw. Materials and methods. 15 removable dentures with bar fixation on implants were manufactured (Neo-biotech, South Korea). Two different impression techniques were used to create the support bars: in 8 patients, the classical «open» trays technique using vinylsiloxanester was used, and in 7 patients, the intraoral scanner Medit i700 (Medit Corp., Seoul, South Korea). The results of the study. The paper presents a clinical study of the accuracy of impression production in the manufacture of removable orthopedic structures supported by a bar and dental implants. Special attention is paid to achieving a «passive fit» as a key factor in the durability and biological stability of prosthetics. Despite the technical difficulties of digital scanning (large digitization area, the need for stapling frames, the impact of clinical conditions), both methods provided a clinically acceptable degree of adaptation of the frames, confirmed by the Sheffield test. The digital method has demonstrated advantages in patient comfort, whereas the traditional approach requires more clinical and laboratory steps. Conclusion. The results of the study obtained in groups 1 and 2 showed a degree of adaptability recognized in the scientific literature as clinically acceptable. Consequently, both methods of obtaining impressions have their own performance characteristics and are not mutually exclusive, but can effectively complement each other depending on the specific clinical situation.
Ключевые Слова
съёмные ортопедические конструкции; полное отсутствие зубов; балочная система фиксации; изготовление балки; изготовление оттисков.
Ключевые Слова (англ)
removable orthopedic structures; complete absence of teeth; bar fixation system; bar manufacturing, making an impression.
Список литературы
1. Гветадзе, Р.Ш. Преимущества технологии CAD/CAM для изготовления прецизионных фрезерованных балочных конструкций с опорой на дентальные имплантаты / Р.Ш.Гветадзе, С.Е.Крючков // Институт Стоматологии. - 2021. - № 1 (90). - С. 104-107. - EDN EROUYB.
2. Попов, С.Н. Реабилитация пациента с помощью дентальных имплантатов при наличии отягощающих факторов. Клинический случай / С.Н.Попов, Т.О.Вартанов // Российский вестник дентальной имплантологии. - 2024. - № 2 (64). - С. 47-55. - EDN POTHDB.
3. Abdel-Azim T., Zandinejad A., Elathamna E., Lin W., Morton D. The influence of digital fabrication options on the accuracy of dental implant-based single units and complete-arch frameworks // Int J. Oral Maxillofac Implants. - 2014;29(6):1281-1288.
4. Andriessen F.S., van der Rijkens D.R., Wismeijer D.W. Applicability and accuracy of an intraoral scanner for scanning multiple implants in edentulous mandibles: a pilot study // J. Prosthet Dent. - 2014;111(3):186-194.
5. Bacchi A., Consani R.L., Mesquita M.F., Dos Santos M.B. Effect of framework material and vertical misfit on stress distribution in implant-supported partial prosthesis under load application: 3-D finite element analysis. Acta Odontol Scand. 2013;71(5):1243-1249.
6. Baig M.R. Accuracy of impressions of multiple implants in the edentulous arch: a systematic review // Int J. Oral Maxillofac Implants. - 2014;29(4):869-880.
7. Basaki K., Alkumru H., De Souza G., Finer Y. Accuracy of digital vs conventional implant impression approach: a three-dimensional comparative in vitro analysis // Int J. Oral Maxillofac Implants. - 2017;32(4):792-799.
8. Flügge T.V., Att W., Metzger M.C., Nelson K. Precision of dental implant digitization using intraoral scanners // Int J. Prosthodont. - 2016;29(3):277-283.
9. Goodacre BJ, Goodacre CJ. Using intraoral scanning to fabricate complete dentures: first experiences // Int J. Prosthodont. - 2018;31:166-170.
10. Guzelce Sultanoğlu E., Keleş B. Comparison of the accuracy and precision of digital scans for implant-supported maxillary hybrid prosthesis: an in vitro study // Niger J. Clin Pract. - 2024;27(11):1245-1251.
11. Jiménez B., Özcan M., Martínez-Rus F., Pradíes G. Accuracy of a digital implant impression system based on parallel confocal laser technology considering operator experience, implant angulation, and depth // International Journal of Oral & Maxillofacial Implants. - 2014;29(4):853-862.Michelinakis G., Apostolakis D., Tsagarakis A. et al. A comparison of accuracy of 3 intraoral scanners: a single-blinded in vitro study // J. Prosthet Dent. - 2020;124(5):581-588.
12. Michelinakis G, Apostolakis D, Tsagarakis A, et al. A comparison of accuracy of 3 intraoral scanners: a single-blinded in vitro study // J. Prosthet Dent. - 2020;124(5):581-588.
13. Moreira A.H., Rodrigues N.F., Pinho A.C., Fonseca J.C., Vilaça J.L. Accuracy comparison of implant impression techniques: a systematic review // Clin Implant Dent Relat Res. - 2015;17:e751-e764.
14. Mutwalli H., Braian M., Mahmood D., Larsson C. Trueness and precision of three-dimensional digitizing intraoral devices // Int J. Dent. - 2018;2018:5189761.
15. Papaspyridakos P., De Souza A., Finkelman M., Sicilia E., Gotsis S., Chen Y.W. et al. Digital vs conventional full-arch implant impressions: a retrospective analysis of 36 edentulous jaws // J. Prosthodont. - 2023;32(4):325-330.
16. Pera F., Pesce P., Bagnasco F., Pancini N., Carossa M., Baldelli L. et al. Comparison of milled full-arch implant-supported frameworks realised with a full digital workflow or from conventional impression: a clinical study. Materials (Basel). - 2023;16(2):833.
17. Rech-Ortega C., Fernández-Estevan L., Solá-Ruíz M.F., Agustín-Panadero R., Labaig-Rueda C. Comparative in vitro study of the accuracy of impression techniques for dental implants: direct technique with an elastomeric impression material versus intraoral scanner // Med Oral Patol Oral Cir Bucal. - 2019;24(1):e89-e95.
18. Selvaraj S., Dorairaj J., Mohan J., Simon P. 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.
19. Sultanoğlu E.G., Eroğlu B.K. Evaluating the accuracy of intraoral scanners used in single-unit implant prosthesis construction. Int Dent Res. - 2023;13(S1):32-37.
20. Vieira S.N.V., Lourenço M.F., Pereira R.C., França E.C., Vilaça Ê.L., Silveira R.R. et al. Conventional and digital impressions for fabrication of complete implant-supported bars: a comparative in vitro study. Materials (Basel). - 2023;16(11):4176.
21. Wulfman C., Naveau A., Rignon-Bret C. Digital scanning for complete-arch implant-supported restorations: a systematic review // J. Prosthet Dent. - 2020;124(2):161-167.
References:
1. Gvetadze R.Sh., Kryuchkov S.E. Advantages of CAD/CAM technology for the fabrication of precision-milled bar-supported constructions on dental implants // Institute of Dentistry. - 2021;1(90):104-107. EDN: EROUYB.
2. Popov S.N., Vartanov T.O. Rehabilitation of a patient using dental implants in the presence of complicating factors: a clinical case // Russian Bulletin of Dental Implantology. - 2024;2(64):47-55. EDN: POTHDB.
3. Abdel-Azim T., Zandinejad A., Elathamna E., Lin W., Morton D. The influence of digital fabrication options on the accuracy of dental implant-based single units and complete-arch frameworks // Int J. Oral Maxillofac Implants. - 2014;29(6):1281-1288.
4. Andriessen F.S., van der Rijkens D.R., Wismeijer D.W. Applicability and accuracy of an intraoral scanner for scanning multiple implants in edentulous mandibles: a pilot study // J. Prosthet Dent. - 2014;111(3):186-194.
5. Bacchi A., Consani R.L., Mesquita M.F., Dos Santos M.B. Effect of framework material and vertical misfit on stress distribution in implant-supported partial prosthesis under load application: 3-D finite element analysis // Acta Odontol Scand. - 2013;71(5):1243-1249.
6. Baig M.R. Accuracy of impressions of multiple implants in the edentulous arch: a systematic review // Int J. Oral Maxillofac Implants. - 2014;29(4): 869-880.
7. Basaki K., Alkumru H., De Souza G., Finer Y. Accuracy of digital vs conventional implant impression approach: a three-dimensional comparative in vitro analysis // Int J. Oral Maxillofac Implants. - 2017;32(4):792-799.
8. Flügge T.V., Att W., Metzger M.C., Nelson K. Precision of dental implant digitization using intraoral scanners // Int J. Prosthodont. - 2016;29(3):277-283.
9. Goodacre B.J., Goodacre C.J. Using intraoral scanning to fabricate complete dentures: first experiences // Int J. Prosthodont. - 2018;31:166-170.
10. Guzelce Sultanoğlu E., Keleş B. Comparison of the accuracy and precision of digital scans for implant-supported maxillary hybrid prosthesis: an in vitro study // Niger J Clin Pract. - 2024;27(11):1245-1251.
11. Jiménez B., Özcan M., Martínez-Rus F., Pradíes G. Accuracy of a digital implant impression system based on parallel confocal laser technology considering operator experience, implant angulation, and depth // International Journal of Oral & Maxillofacial Implants. - 2014;29(4):853-862.
12. Michelinakis G., Apostolakis D., Tsagarakis A. et al. A comparison of accuracy of 3 intraoral scanners: a single-blinded in vitro study // J. Prosthet Dent. - 2020;124(5):581-588.
13. Moreira A.H., Rodrigues N.F., Pinho A.C., Fonseca J.C., Vilaça J.L. Accuracy comparison of implant impression techniques: a systematic review // Clin Implant Dent Relat Res. - 2015;17:e751-e764.
14. Mutwalli H., Braian M., Mahmood D., Larsson C. Trueness and precision of three-dimensional digitizing intraoral devices // Int J. Dent. - 2018;2018:5189761.
15. Papaspyridakos P., De Souza A., Finkelman M., Sicilia E., Gotsis S., Chen Y.W. et al. Digital vs conventional full-arch implant impressions: a retrospective analysis of 36 edentulous jaws // J. Prosthodont. - 2023;32(4):325-330.
16. Pera F., Pesce P., Bagnasco F., Pancini N., Carossa M., Baldelli L. et al. Comparison of milled full-arch implant-supported frameworks realised with a full digital workflow or from conventional impression: a clinical study. Materials (Basel). - 2023;16(2):833.
17. Rech-Ortega C., Fernández-Estevan L., Solá-Ruíz M.F., Agustín-Panadero R., Labaig-Rueda C. Comparative in vitro study of the accuracy of impression techniques for dental implants: direct technique with an elastomeric impression material versus intraoral scanner // Med Oral Patol Oral Cir Bucal. - 2019;24(1):e89-e95.
18. Selvaraj S., Dorairaj J., Mohan J., Simon P. 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.
19. Sultanoğlu E.G., Eroğlu B.K. Evaluating the accuracy of intraoral scanners used in single-unit implant prosthesis construction. Int Dent Res. - 2023;13(S1):32-37.
20. Vieira S.N.V., Lourenço M.F., Pereira R.C., França E.C., Vilaça Ê.L., Silveira R.R. et al. Conventional and digital impressions for fabrication of complete implant-supported bars: a comparative in vitro study. Materials (Basel). 2023;16(11):4176.
21. Wulfman C., Naveau A., Rignon-Bret C. Digital scanning for complete-arch implant-supported restorations: a systematic review // J. Prosthet Dent. - 2020;124(2):161-167.
2. Попов, С.Н. Реабилитация пациента с помощью дентальных имплантатов при наличии отягощающих факторов. Клинический случай / С.Н.Попов, Т.О.Вартанов // Российский вестник дентальной имплантологии. - 2024. - № 2 (64). - С. 47-55. - EDN POTHDB.
3. Abdel-Azim T., Zandinejad A., Elathamna E., Lin W., Morton D. The influence of digital fabrication options on the accuracy of dental implant-based single units and complete-arch frameworks // Int J. Oral Maxillofac Implants. - 2014;29(6):1281-1288.
4. Andriessen F.S., van der Rijkens D.R., Wismeijer D.W. Applicability and accuracy of an intraoral scanner for scanning multiple implants in edentulous mandibles: a pilot study // J. Prosthet Dent. - 2014;111(3):186-194.
5. Bacchi A., Consani R.L., Mesquita M.F., Dos Santos M.B. Effect of framework material and vertical misfit on stress distribution in implant-supported partial prosthesis under load application: 3-D finite element analysis. Acta Odontol Scand. 2013;71(5):1243-1249.
6. Baig M.R. Accuracy of impressions of multiple implants in the edentulous arch: a systematic review // Int J. Oral Maxillofac Implants. - 2014;29(4):869-880.
7. Basaki K., Alkumru H., De Souza G., Finer Y. Accuracy of digital vs conventional implant impression approach: a three-dimensional comparative in vitro analysis // Int J. Oral Maxillofac Implants. - 2017;32(4):792-799.
8. Flügge T.V., Att W., Metzger M.C., Nelson K. Precision of dental implant digitization using intraoral scanners // Int J. Prosthodont. - 2016;29(3):277-283.
9. Goodacre BJ, Goodacre CJ. Using intraoral scanning to fabricate complete dentures: first experiences // Int J. Prosthodont. - 2018;31:166-170.
10. Guzelce Sultanoğlu E., Keleş B. Comparison of the accuracy and precision of digital scans for implant-supported maxillary hybrid prosthesis: an in vitro study // Niger J. Clin Pract. - 2024;27(11):1245-1251.
11. Jiménez B., Özcan M., Martínez-Rus F., Pradíes G. Accuracy of a digital implant impression system based on parallel confocal laser technology considering operator experience, implant angulation, and depth // International Journal of Oral & Maxillofacial Implants. - 2014;29(4):853-862.Michelinakis G., Apostolakis D., Tsagarakis A. et al. A comparison of accuracy of 3 intraoral scanners: a single-blinded in vitro study // J. Prosthet Dent. - 2020;124(5):581-588.
12. Michelinakis G, Apostolakis D, Tsagarakis A, et al. A comparison of accuracy of 3 intraoral scanners: a single-blinded in vitro study // J. Prosthet Dent. - 2020;124(5):581-588.
13. Moreira A.H., Rodrigues N.F., Pinho A.C., Fonseca J.C., Vilaça J.L. Accuracy comparison of implant impression techniques: a systematic review // Clin Implant Dent Relat Res. - 2015;17:e751-e764.
14. Mutwalli H., Braian M., Mahmood D., Larsson C. Trueness and precision of three-dimensional digitizing intraoral devices // Int J. Dent. - 2018;2018:5189761.
15. Papaspyridakos P., De Souza A., Finkelman M., Sicilia E., Gotsis S., Chen Y.W. et al. Digital vs conventional full-arch implant impressions: a retrospective analysis of 36 edentulous jaws // J. Prosthodont. - 2023;32(4):325-330.
16. Pera F., Pesce P., Bagnasco F., Pancini N., Carossa M., Baldelli L. et al. Comparison of milled full-arch implant-supported frameworks realised with a full digital workflow or from conventional impression: a clinical study. Materials (Basel). - 2023;16(2):833.
17. Rech-Ortega C., Fernández-Estevan L., Solá-Ruíz M.F., Agustín-Panadero R., Labaig-Rueda C. Comparative in vitro study of the accuracy of impression techniques for dental implants: direct technique with an elastomeric impression material versus intraoral scanner // Med Oral Patol Oral Cir Bucal. - 2019;24(1):e89-e95.
18. Selvaraj S., Dorairaj J., Mohan J., Simon P. 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.
19. Sultanoğlu E.G., Eroğlu B.K. Evaluating the accuracy of intraoral scanners used in single-unit implant prosthesis construction. Int Dent Res. - 2023;13(S1):32-37.
20. Vieira S.N.V., Lourenço M.F., Pereira R.C., França E.C., Vilaça Ê.L., Silveira R.R. et al. Conventional and digital impressions for fabrication of complete implant-supported bars: a comparative in vitro study. Materials (Basel). - 2023;16(11):4176.
21. Wulfman C., Naveau A., Rignon-Bret C. Digital scanning for complete-arch implant-supported restorations: a systematic review // J. Prosthet Dent. - 2020;124(2):161-167.
References:
1. Gvetadze R.Sh., Kryuchkov S.E. Advantages of CAD/CAM technology for the fabrication of precision-milled bar-supported constructions on dental implants // Institute of Dentistry. - 2021;1(90):104-107. EDN: EROUYB.
2. Popov S.N., Vartanov T.O. Rehabilitation of a patient using dental implants in the presence of complicating factors: a clinical case // Russian Bulletin of Dental Implantology. - 2024;2(64):47-55. EDN: POTHDB.
3. Abdel-Azim T., Zandinejad A., Elathamna E., Lin W., Morton D. The influence of digital fabrication options on the accuracy of dental implant-based single units and complete-arch frameworks // Int J. Oral Maxillofac Implants. - 2014;29(6):1281-1288.
4. Andriessen F.S., van der Rijkens D.R., Wismeijer D.W. Applicability and accuracy of an intraoral scanner for scanning multiple implants in edentulous mandibles: a pilot study // J. Prosthet Dent. - 2014;111(3):186-194.
5. Bacchi A., Consani R.L., Mesquita M.F., Dos Santos M.B. Effect of framework material and vertical misfit on stress distribution in implant-supported partial prosthesis under load application: 3-D finite element analysis // Acta Odontol Scand. - 2013;71(5):1243-1249.
6. Baig M.R. Accuracy of impressions of multiple implants in the edentulous arch: a systematic review // Int J. Oral Maxillofac Implants. - 2014;29(4): 869-880.
7. Basaki K., Alkumru H., De Souza G., Finer Y. Accuracy of digital vs conventional implant impression approach: a three-dimensional comparative in vitro analysis // Int J. Oral Maxillofac Implants. - 2017;32(4):792-799.
8. Flügge T.V., Att W., Metzger M.C., Nelson K. Precision of dental implant digitization using intraoral scanners // Int J. Prosthodont. - 2016;29(3):277-283.
9. Goodacre B.J., Goodacre C.J. Using intraoral scanning to fabricate complete dentures: first experiences // Int J. Prosthodont. - 2018;31:166-170.
10. Guzelce Sultanoğlu E., Keleş B. Comparison of the accuracy and precision of digital scans for implant-supported maxillary hybrid prosthesis: an in vitro study // Niger J Clin Pract. - 2024;27(11):1245-1251.
11. Jiménez B., Özcan M., Martínez-Rus F., Pradíes G. Accuracy of a digital implant impression system based on parallel confocal laser technology considering operator experience, implant angulation, and depth // International Journal of Oral & Maxillofacial Implants. - 2014;29(4):853-862.
12. Michelinakis G., Apostolakis D., Tsagarakis A. et al. A comparison of accuracy of 3 intraoral scanners: a single-blinded in vitro study // J. Prosthet Dent. - 2020;124(5):581-588.
13. Moreira A.H., Rodrigues N.F., Pinho A.C., Fonseca J.C., Vilaça J.L. Accuracy comparison of implant impression techniques: a systematic review // Clin Implant Dent Relat Res. - 2015;17:e751-e764.
14. Mutwalli H., Braian M., Mahmood D., Larsson C. Trueness and precision of three-dimensional digitizing intraoral devices // Int J. Dent. - 2018;2018:5189761.
15. Papaspyridakos P., De Souza A., Finkelman M., Sicilia E., Gotsis S., Chen Y.W. et al. Digital vs conventional full-arch implant impressions: a retrospective analysis of 36 edentulous jaws // J. Prosthodont. - 2023;32(4):325-330.
16. Pera F., Pesce P., Bagnasco F., Pancini N., Carossa M., Baldelli L. et al. Comparison of milled full-arch implant-supported frameworks realised with a full digital workflow or from conventional impression: a clinical study. Materials (Basel). - 2023;16(2):833.
17. Rech-Ortega C., Fernández-Estevan L., Solá-Ruíz M.F., Agustín-Panadero R., Labaig-Rueda C. Comparative in vitro study of the accuracy of impression techniques for dental implants: direct technique with an elastomeric impression material versus intraoral scanner // Med Oral Patol Oral Cir Bucal. - 2019;24(1):e89-e95.
18. Selvaraj S., Dorairaj J., Mohan J., Simon P. 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.
19. Sultanoğlu E.G., Eroğlu B.K. Evaluating the accuracy of intraoral scanners used in single-unit implant prosthesis construction. Int Dent Res. - 2023;13(S1):32-37.
20. Vieira S.N.V., Lourenço M.F., Pereira R.C., França E.C., Vilaça Ê.L., Silveira R.R. et al. Conventional and digital impressions for fabrication of complete implant-supported bars: a comparative in vitro study. Materials (Basel). 2023;16(11):4176.
21. Wulfman C., Naveau A., Rignon-Bret C. Digital scanning for complete-arch implant-supported restorations: a systematic review // J. Prosthet Dent. - 2020;124(2):161-167.
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