The following technique is for maintaining the tissue shape on an implant site when lab work is being done to customize the impression abutment.

maintaining tissue shape on an implant site image 1

maintaining tissue shape on an implant site image 2

I have tried a number of materials, some with success and some, not so much. Some holds the tissue in place but is hard to remove, or distorts upon removal. I discovered that simply placing an alginate plug into the abutment site works great.

I mixed up a looser mix than I normally would for an impression so that I could get it into a monojet syringe and express it into the site as soon as the provisional was removed. Once set, it is easily removed and replaced holding the tissue where it needs to be. I can now take my time fabricating and shaping the custom impression abutment without the worry of the tissue distorting and bleeding.

Mary Anne Salcetti, DDS, PC, Spear Education Visiting Faculty. www.maryannesalcettidds.com 


Comments

Commenter's Profile Image David Bentley
November 27th, 2013
What do you use for the custom impression abutment?
Commenter's Profile Image Gerald Benjamin
November 28th, 2013
This is a wonderful concept. The better choice of material might be MACH2. Alginate will shrink over time while MACH2 will remain stable.. This is a fabulous way to solve one of our persistent problems.
Commenter's Profile Image Arnie Mirza
November 28th, 2013
Thank you Mary Ann for the excellent idea and sharing it with everyone. Thank Gerald for your comment. It is of a great benefit.
Commenter's Profile Image Steve Lee
November 28th, 2013
Why not just duplicate the subgingival portion of the custom temporary or healing cap by taking an impression of it attached to the implant analog on? Then you can place the impression abutment/post into the analog and add material of choice (I use Duralay) to fill the space and duplicate the subgingival contours. The modified impression abutment now already has the proper subgingival contours-no need to "maintain the tissue shape".
Commenter's Profile Image Douglas Phillips
November 29th, 2013
I use Mach 2 also . Load it in a HO mini impression syringe to min waste.
Commenter's Profile Image Doug McMaster
December 21st, 2013
I like to quickly place the impression post, and immediately fill the area with bite registration material, then when ready, impress. If it is slightly under contoured on the model, carve it out to the contralateral outline.