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Background <p>Accurate transfer of implant positions is critical for achieving passive fit in full-arch prostheses. Although splinting of impression copings enhances accuracy, the optimal chairside splinting method remains uncertain. Orthodontic elastomeric chains have been proposed as a practical alternative to floss-resin splinting, but their dimensional accuracy has not been quantitatively validated.</p> Purpose <p>The purpose of this in-vitro study was to compare the accuracy of full-arch implant impressions made with three techniques non-splinted (NS), dental-floss with light-polymerizing resin (FR), and orthodontic elastomeric chain with light-polymerizing resin (CR) and to determine whether the chain-resin technique provides comparable or superior trueness.</p> Methods <p>A mandibular master model with six parallel implants (Bio3 GmbH, Pforzheim, Germany) and multiunit abutments torqued to 25&#xa0;N cm was used to fabricate 21 casts (<i>n</i> = 7 per group). Open-tray impressions were made with polyvinyl siloxane (Zhermack, Italy). In the FR and CR groups, copings were splinted with dental floss or a closed-type orthodontic chain, respectively, reinforced with light-polymerizing pattern resin (Motif, Dokuz Kimya, Turkey), sectioned with a 0.3-mm diamond disk, and rejoined before impression making. Definitive casts with gingival masks were produced in type IV stone. Digital scan bodies were attached, and casts were scanned with a laboratory scanner (3Shape, Denmark). Linear inter-implant distances (positions 1–6) and inter-axis (3D) angulations were measured in <i>Geomagic Design X 2022.0</i> (3D Systems, USA). Examiner reliability was ensured by repeating 10% of the measurements (intraclass correlation &gt; 0.95). Normality was assessed using the Shapiro–Wilk test, and homogeneity of variances was evaluated using Levene’s test. According to the results of these assumption checks, global comparisons were performed using either one-way ANOVA or the Kruskal–Wallis test. Thereafter, false discovery rate (FDR) correction was applied to the global-test P values. Finally, a power analysis was conducted to evaluate the effect sizes and achieved power associated with the obtained results. All statistical analyses were performed at a significance level of <InlineEquation ID="IEq4"> <EquationSource Format="TEX">\(\alpha=0.05\)</EquationSource> </InlineEquation>.</p> Results <p>Significant differences (<i>P</i> &lt; 0.05) were observed for 6 of 10 metrics (Distance 1–3, 1–4, 1–5, 1–6; Angulation 1–2, 1–6). The CR group exhibited the lowest pooled deviation (8.549) compared with FR (9.106) and NS (9.914). FR achieved the highest number of per-metric wins (4 of 6 significant comparisons). The non-splinted technique consistently produced the largest deviations.</p> Conclusions <p>Within the limitations of this in vitro study, splinting implant impression copings with an orthodontic elastomeric chain reinforced with light-polymerizing resin showed favourable performance in the pooled absolute deviation analysis, whereas the floss–resin method demonstrated comparable consistency by performing better in the per-metric winner assessment. In contrast, the non-splinted technique did not show favourable performance compared with the other groups. Therefore, both the orthodontic elastomeric chain reinforced with light-polymerizing resin and the floss–resin techniques may be considered practical chairside alternatives for full-arc h implant impressions. In particular, the chain–resin splinting approach may represent a simplified, time-efficient, and clinically feasible option for achieving accurate full-arch implant impressions.</p>

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Dimensional accuracy of three techniques for full-arch implant impressions: orthodontic elastomeric chain versus floss-resin and non-splinted methods

  • 期刊论文

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  • 发表日期：

    2026年5月13日

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  • Ayşe Gözde Türk,
  • Nazlıcan Güneş,
  • Fırat Mavi,
  • Olkan Gürbüz,
  • Mübin Ulusoy,
  • İbrahim Etem Saklakoğlu

摘要

Background

Accurate transfer of implant positions is critical for achieving passive fit in full-arch prostheses. Although splinting of impression copings enhances accuracy, the optimal chairside splinting method remains uncertain. Orthodontic elastomeric chains have been proposed as a practical alternative to floss-resin splinting, but their dimensional accuracy has not been quantitatively validated.

Purpose

The purpose of this in-vitro study was to compare the accuracy of full-arch implant impressions made with three techniques non-splinted (NS), dental-floss with light-polymerizing resin (FR), and orthodontic elastomeric chain with light-polymerizing resin (CR) and to determine whether the chain-resin technique provides comparable or superior trueness.

Methods

A mandibular master model with six parallel implants (Bio3 GmbH, Pforzheim, Germany) and multiunit abutments torqued to 25 N cm was used to fabricate 21 casts (n = 7 per group). Open-tray impressions were made with polyvinyl siloxane (Zhermack, Italy). In the FR and CR groups, copings were splinted with dental floss or a closed-type orthodontic chain, respectively, reinforced with light-polymerizing pattern resin (Motif, Dokuz Kimya, Turkey), sectioned with a 0.3-mm diamond disk, and rejoined before impression making. Definitive casts with gingival masks were produced in type IV stone. Digital scan bodies were attached, and casts were scanned with a laboratory scanner (3Shape, Denmark). Linear inter-implant distances (positions 1–6) and inter-axis (3D) angulations were measured in Geomagic Design X 2022.0 (3D Systems, USA). Examiner reliability was ensured by repeating 10% of the measurements (intraclass correlation > 0.95). Normality was assessed using the Shapiro–Wilk test, and homogeneity of variances was evaluated using Levene’s test. According to the results of these assumption checks, global comparisons were performed using either one-way ANOVA or the Kruskal–Wallis test. Thereafter, false discovery rate (FDR) correction was applied to the global-test P values. Finally, a power analysis was conducted to evaluate the effect sizes and achieved power associated with the obtained results. All statistical analyses were performed at a significance level of \(\alpha=0.05\) .

Results

Significant differences (P < 0.05) were observed for 6 of 10 metrics (Distance 1–3, 1–4, 1–5, 1–6; Angulation 1–2, 1–6). The CR group exhibited the lowest pooled deviation (8.549) compared with FR (9.106) and NS (9.914). FR achieved the highest number of per-metric wins (4 of 6 significant comparisons). The non-splinted technique consistently produced the largest deviations.

Conclusions

Within the limitations of this in vitro study, splinting implant impression copings with an orthodontic elastomeric chain reinforced with light-polymerizing resin showed favourable performance in the pooled absolute deviation analysis, whereas the floss–resin method demonstrated comparable consistency by performing better in the per-metric winner assessment. In contrast, the non-splinted technique did not show favourable performance compared with the other groups. Therefore, both the orthodontic elastomeric chain reinforced with light-polymerizing resin and the floss–resin techniques may be considered practical chairside alternatives for full-arc h implant impressions. In particular, the chain–resin splinting approach may represent a simplified, time-efficient, and clinically feasible option for achieving accurate full-arch implant impressions.