Comparative Evaluation of the Effect of Splinting Materials with Implant Impressions on All-On-Four Treatment Protocol: An In Vitro Study

PURPOSE OF THE STUDY: The present in vitro study was conducted to compare and evaluate the effect of splinting materials with implant impressions on all-on-four treatment protocol. MATERIALS AND METHOD: A reference model with four OSSTEM dummy implants were placed with the aid of surgical guide for All-on-four treatment protocol. Splinting techniques were divided into three groups, Group I; Floss was reinforced with pattern resin as a conventional splinting material compared with the other two materials. A newly launched flowable composite resin having super low flow was considered as Group II and orthodontic wires affixed with newly launched universal bonding agent was Group III. Medium body Polyether impression material was used to transfer impression and laboratory analogs were attached to the impression copings. The definitive casts were poured using Type IV dental stone. The retrieved casts were evaluated three dimensionally, the linear differences in inter-implant distances in x, y and z axes and inter-implant angulations in z axis were measured on the cast using a coordinate measuring machine. Data was obtained and the readings were statistically analyzed using one way ANOVA, multiple comparisons Post-hoc Tukey’s test and one sample T-test. RESULTS: For Group I, the inter implant relationship in x, y and z axes between reference model and definitive casts obtained by splinting floss reinforced with pattern resin was statistically significant in z-axis, angle 1, angle 2 and angle 3. The study revealed no significant results when comparing the inter implant relationship in three axes between reference model and definitive casts for floss reinforced with flowable composite and orthodontic reinforced with universal bonding agent. In comparison between groups, floss reinforced with pattern resin had shown more deviation than the other test groups. CONCLUSIONS: Within the limitations of the study, both floss reinforced with super low flow flowable composite and orthodontic wire affixed with universal bonding agent shown statistically similar results and near accurate implant impression transfer compared to floss reinforced with pattern resin