Dentaltown June 2018 - 90

Open or Closed?
A discussion and case study clears up questions
in impression techniques for implant patients
by Dr. Gary M. Radz
Dr. Gary M. Radz maintains
a private practice in
downtown Denver and
a faculty appointment
at the University of
Colorado School of Dental
Medicine. He is a founding
member of Catapult
Education. Radz, who
speaks internationally on
cosmetic and restorative dentistry, also serves on
the editorial board of seven dental journals. He would
like to recognize the talents of the technicians at
Maverick Dental Labs in Monroeville, Pennsylvania.

90

JUNE 2018 // dentaltown.com

Open versus closed techniques
In modern implant cases, we have the
option of using a closed-tray technique, an
open-tray technique or a digital impression
scanner. Each technique has its positives and
negatives, and one technique usually works
better than another in certain situations.
To date, digital scanning technology
has less than 10 percent market penetration
in the U.S., so this article will focus on
the open- and closed-tray techniques. The
discussion will concentrate on when and
where to use each technique to maximize
clinical success, increase patient comfort
and minimize frustrations.
The restorative side of implant dentistry
is the culmination of many months of
planning and attention to detail to achieve

a precise final result. A keystone in the
restorative process is capturing the fi nal
impression. One of the important choices
the restorative dentist needs to make at
this point is whether to take the impression
with a closed- or open-tray technique. Both
can provide the desired result but in some
situations one can be preferable, or even
required, to get specific information.
In an open technique, the post extends
past the tray and will need to be unscrewed
before the impression can be removed from
the mouth. In a closed technique, the post
is captured within the impression; after it
is removed, the post is unscrewed from the
implant and reinserted.
Because the closed technique requires the
removal and reinsertion of the impression



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