Steps in Conventional Dental Implant Impressions

Conventional (analog) implant impressions are still a daily reality in many practices and labs. When the steps are followed carefully, analog workflows can deliver predictable, passive-fitting implant restorations. This guide breaks down the typical step-by-step process, with practical tips to reduce remakes and chair time.

Before you start: what you’re trying to capture

An implant impression is not just a copy of soft tissue. It must accurately transfer the 3D position and rotational orientation of the implant (or multi-unit abutment) from the mouth to a working cast.

That means you’re aiming to record:

• Implant platform position (x, y, z)

• Implant angulation

• Rotational indexing (for anti-rotational connections)

• Emergence profile and peri-implant soft tissue contours (when needed)

Step 1: confirm the prosthetic plan and components

Before placing any impression coping, verify the prosthetic “target.”

What to confirm chairside

• Restorative type: screw-retained vs cement-retained

• Level: implant-level vs abutment-level impression

• Tissue status: healed vs immediate vs provisionalized

• Platform/connection system and diameter

• Coping type: open-tray (pick-up) vs closed-tray (transfer)

Tip:If the case uses multi-unit abutments, you’ll usually impress at the multi-unit i.e at the abutment level (not the implant level). That changes which copings and screws you need.

Step 2: select the impression technique (open-tray vs closed-tray)

Both methods are used in analog implant dentistry. The choice depends on access, implant number, angulation, and your accuracy needs.

Before making the impression, gently evaluate the peri-implant tissue:

• Remove provisional restoration if present

• Clear excess cement (if any), plaque, or debris

• Rinse and dry around the platform

• Ensure hemostasis (bleeding can distort material flow and seating)

If the tissue is thick or mobile, consider whether you need a customized impression coping to capture emergence profile (more on that below).

Step 4: seat the impression coping correctly

This is one of the most critical steps.

Best-practice seating checklist

1. Place the coping and hand-tighten the coping screw.

2. Confirm full seating (no rocking).

3. Verify orientation (indexed connections must be aligned).

4. Take a periapical radiograph if seating is uncertain, especially subgingivally.

5. Retighten gently to manufacturer guidance (hand-tightening is enough for copings).

Tip: Many impression “inaccuracies” start as a coping that was 0.5 mm short of fully seated. When in doubt, confirm.

Step 5: prepare the tray (and tray window for open-tray)

For open-tray (pick-up) impressions

1. Use an open-tray implant impression tray or customize a stock tray. For more accuracy, use a customised acrylic tray after a preliminary impression (like in conventional complete denture impressions)

2. Create a window over each coping screw access.

3. Try-in the tray and confirm the coping screws protrude through the window without interference.

4. Block out undercuts and manage excess material escape.

For closed-tray (transfer) impressions

1. Select a tray with adequate rigidity.

2. Confirm clearance so the tray does not contact the coping during seating.

3. Consider adhesive coverage and tray extension for stability.

Step 6: apply tray adhesive and select impression material

Rigid, dimensionally stable materials are preferred in implant impressions.

Common choices

• PVS (polyvinyl siloxane): widely used, stable, clean handling

• Polyether: very accurate and stiff (can be harder to remove in undercuts)

Apply the correct tray adhesive for the selected material and allow it to dry according to the manufacturer’s instructions.

Step 7: consider splinting (especially for multiple implants)

Splinting open-tray copings can increase stability, particularly for multi-unit and full-arch cases.

A common analog splinting approach

1. Connect copings with floss or a prefabricated bar - even better, use old burs.

2. Apply pattern resin (or similar splint material).

3. Let it fully set.

4. Section the splint and re-lute to reduce polymerization shrinkage distortion.

This step can take longer, but it often pays off in fit accuracy.

Step 8: make the impression

Open-tray impression (pick-up) steps

1. Syringe light-body around each coping and the gingival margins.

2. Load the tray with heavy-body (or monophase).

3. Seat the tray evenly and keep it stable during set.

4. After set, loosen the coping screws through the tray window.

5. Remove the tray with copings “picked up” inside the impression.

Closed-tray impression (transfer) steps

1. Syringe light-body around the coping and tissue.

2. Load and seat the tray with heavy-body/monophase.

3. After set, remove the tray (copings remain in the mouth).

4. Unscrew the coping(s) from the mouth.

5. Attach each coping to the corresponding implant or lab analog.

6. Reinsert coping+analog into the impression, ensuring it fully seats and “clicks” into place.

Tip: For closed-tray impressions, a common error is incomplete re-seating of the coping into the impression. Confirm it is fully seated before sending to the lab.

Step 9: manage emergence profile when needed (custom impression coping)

If the patient had a provisional that shaped the tissue, a standard coping may not capture the exact contour.

One conventional method

1. Remove the provisional and place a standard coping.

2. Add flowable composite or acrylic around the coping to replicate the emergence profile.

3. Finish and polish the customized coping.

4. Proceed with the impression as usual.

This helps the lab reproduce the soft tissue contour more accurately on the model.

Step 10: inspect the impression immediately

Before dismissing the patient, inspect for:

• Voids around the coping and margins

• Tears at thin areas

• Coping movement inside the impression (open-tray)

• Distortion from tray flex

• Inadequate capture of soft tissue contours (if required)

If anything looks off, re-impress while everything is set up.

Step 11: place healing abutments or provisionals and document

After the impression:

• Replace healing abutment or provisional restoration

• Confirm occlusion (if provisional)

• Give post-op instructions if tissue was manipulated

Then document components used (system, platform, coping type, whether splinted) so the lab can match parts precisely.

Step 12: send complete information to the lab

A great impression can still lead to frustration if the lab lacks key details.

What to include with the case

• Impression (well-protected)

• Opposing model or opposing impression

• Bite registration

• Implant analogs (if not already inserted chairside, as per your protocol)

• Shade and material request

• Restoration type and torque/retention preference (screw vs cement)

• Photos (smile, retracted, occlusal) if possible

Common pitfalls (and how to avoid them)

• Coping not fully seated:verify clinically and radiographically if needed.

• Tray flex or poor adhesive:use rigid trays and proper adhesive drying time.

• Closed-tray coping not reseated:confirm complete seating into the impression.

• No splinting for long-span cases:consider splinting for multi-unit/full-arch accuracy.

• Soft tissue collapse after provisional removal:work efficiently or use customized coping strategies.

Where analog impressions still shine

Even with digital dentistry growing, analog implant impressions remain useful when:

• Intraoral scanning is difficult (blood, saliva, limited access, deep implants)

• Multiple metals and components complicate scanning

• You need a familiar, repeatable protocol across teams

Accuracy begins with verified components and a stable transfer

An implant impression must transfer three-dimensional position and rotational orientation, not merely copy soft tissue. Confirm implant system, platform, component seating and radiographic verification when clinically indicated. Open- versus closed-tray selection depends on implant number, divergence, access, transfer accuracy and retrievability.

Use with the complete impression armamentarium, multiunit abutment planning and functional implant considerations.

Frequently asked questions

When is an open-tray technique useful?

It is often selected for multiple or divergent implants where copings should remain locked in the impression.

Should impression copings be splinted?

Selective splinting may improve stability, but technique, polymerisation shrinkage and evidence should guide use.

Does an accurate impression guarantee passive fit?

No. Component, cast, framework and laboratory errors can still occur and require verification.