International Journal of Implant Dentistry

A prospective clinical study on implants impression accuracy

--Manuscript Draft--

Manuscript Number: IJID-D-19-00050

Full Title: A prospective clinical study on implants impression accuracy

Article Type: Research

Section/Category: Prosthetics

Funding Information:

Abstract: Background

Making an accurate impression is a significant factor in the long-term success of dental

implants. This investigation is to evaluate the clinical accuracy of the open and closed
implant impression techniques for partially edentulous patients with two adjacent
implants.

Material and methods

40 patients received Osstem Implants (Osstem Implant System, Seoul, Korea), and
following osseointegration; two impressions were made, one using an open tray and a
second with a closed tray technique for each patient. The horizontal distance between
two impression copings was made and compared to the horizontal distance on the
master casts. Under a stereomicroscope (AmScop14370, Myford Road, #150, Irvine,
CA 92606 USA) at a 50 X magnifications, the presence or absence of the marginal
discrepancies was evaluated.

Results

There were no differences between the two impression techniques regarding horizontal
measurements between impression copings an in the marginal relationship. There
were also no statistically significant differences in impression accuracy between
maxillary and the mandibular arches. The only statistically significant differences
detected were in the horizontal measurements, between the anterior and posterior
regions, for the closed tray technique.

Conclusions

Within the limitations of the present study, there were generally no differences in
impression accuracy between the open and closed tray techniques, in partially
edentulous jaws with two adjacent implants.

Corresponding Author: Neamat Hassan Abubakr, BDS, DSS, MDSc, PhD

University of Nevada Las Vegas
Las Vegas, Nevada UNITED STATES

Corresponding Author Secondary

Information:

Corresponding Author's Institution: University of Nevada Las Vegas

Corresponding Author's Secondary

Institution:

First Author: Motaz Osman, BDS, MSc

First Author Secondary Information:

Order of Authors: Motaz Osman, BDS, MSc

Ziada Hassan, BDS, Ph.D., FFD, FDS (Rest Dent) RCSI, PGDip T&L,

Ahmed Suliman, BDS, DSS, MDSc, Ph.D

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 Neamat Hassan Abubakr, BDS, DSS, MDSc, PhD

Order of Authors Secondary Information:

Author Comments: Dear Sir/Madam,

Following the successful acceptance of our previous laboratory Implant impression
accuracy evaluation, we are now would lime you to consider this clinical research on
the implant impression accuracy. We look forward to the review process of this
manuscript

Suggested Reviewers: Samar Alsaleh

King Saud university Riyadh
salsaleh@ksu.edu.sa
Knowledge of research in this filed

Ebtisam Al Madi
ELMdi@ksu.edu.sa
Knowledge of research design

Additional Information:

Question Response

<b>Is this study a clinical No

trial?</b><hr><i>A clinical trial is defined
by the World Health Organisation as 'any
research study that prospectively assigns
human participants or groups of humans
to one or more health-related
interventions to evaluate the effects on
health outcomes'.</i>

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A prospective clinical study on implants impression accuracy.

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2 Motaz Osman BDS, MSc
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4 Hassan Ziada. BDS, Ph.D., FFD, FDS (Rest Dent) RCSI, PGDip T&L, FHEA.
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6 Ahmed Suliman. BDS, MSc, Ph.D., FSMSB
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8 Neamat Abubakr Hassan. BDS, DSS, MDSc, Ph.D.
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14 Lecturer, Department of Oral Rehabilitation, Faculty of Dentistry, University of Khartoum,
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16 Khartoum. Sudan. motazdent@yahoo.com
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Visiting Associate Professor, Clinical Sciences, School of Dental Medicine
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21 University of Nevada, Las Vegas. hassan.ziada@unlv.edu
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25 Professor, Department of Oral Maxillofacial Surgery, University of Khartoum, Khartoum.
26 Sudan. newsulaiman@yahoo.com
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Visiting Associate Professor, Biomedical Sciences, School of Dental Medicine
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30 University of Nevada, Las Vegas. neamat.hassan@unlv.edu
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41 Corresponding author:
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43 Neamat Hassan Abubakr Hassan.
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45 Visiting Associate Professor, Biomedical Sciences, School of Dental Medicine
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47 University of Nevada, Las Vegas. E-mail: neamat.hassan@unlv.edu
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 A prospective clinical study on implants impression accuracy.
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3 Abstract:
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6 Background: Making an accurate impression is a significant factor in the long-term success
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9 of dental implants. This investigation is to evaluate the clinical accuracy of the open and
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11 closed implant impression techniques for partially edentulous patients with two adjacent
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implants.
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17 Material and methods: 40 patients received Osstem Implants (Osstem Implant System,
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19 Seoul, Korea), and following osseointegration; two impressions were made, one using an
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22 open tray and a second with a closed tray technique for each patient. The horizontal distance
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24 between two impression copings was made and compared to the horizontal distance on the
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master casts. Under a stereomicroscope (AmScop14370, Myford Road, #150, Irvine, CA
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29 92606 USA) at a 50 X magnifications, the presence or absence of the marginal discrepancies
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31 was evaluated.
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35 Results: There were no differences between the two impression techniques regarding
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37 horizontal measurements between impression copings an in the marginal relationship. There
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40 were also no statistically significant differences in impression accuracy between maxillary
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42 and the mandibular arches. The only statistically significant differences detected were in the
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44 horizontal measurements, between the anterior and posterior regions, for the closed tray
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47 technique.
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50 Conclusions: Within the limitations of the present study, there were generally no differences
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53 in impression accuracy between the open and closed tray techniques, in partially edentulous
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55 jaws with two adjacent implants.
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 Keywords: Implants impression accuracy, open tray technique, closed tray technique,
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2 marginal discrepancy.
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 Introduction
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2 Tooth loss reduces the masticatory ability, compromises esthetics and may consequently
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5 diminish social interactions, which could significantly impact on the quality of life of
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7 individuals [1-3]. Treatment options for teeth loss are continuously evolving, from the
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10 removable prosthesis to the increasing preference for fixed choices. Furthermore, the
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12 progress in the manufacturing of titanium implants added to their long-term success,
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15 increasing the fixed prosthetic options for replacement of missing teeth; making implants an
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17 essential part of contemporary dental practice and a popular choice for both patients and
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clinicians [4].
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22 An implant impression is primarily a three-dimensional record of the implant and the
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24 surrounding tissues. Impression accuracy is a significant factor in implants long-term success.
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27 Inaccuracies or errors at any stage of the superstructure construction may lead to lack of
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29 precision fit between the manufactured components. With the absence of potential
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32 compensatory readjustment, due to the absence of intervening periodontal ligament, may
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34 have the consequence of complications or failure [5, 6].
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The fit of superstructure is considered “passive” if it does not create any static loading
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39 within the prosthesis, or in the surrounding bone. Imperfections in precision fit of the
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41 superstructure may increase the incidence of mechanical problems or abutment loosening as
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44 well as possible fracture of the prosthetic or implant components. Furthermore, any resultant
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46 marginal discrepancies, as a result of inaccurate impressions, may enhance plaque
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49 accumulation, which would impact negatively on the soft and hard tissues around the implant
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51 [7]
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54 The research on the accuracy of implant impression techniques is mainly from in-vitro
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56 studies, which may be a contributing factor in the controversy as to which technique is more
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 superior [5, 8]. We hypothesize that clinically, there is no impact or differences in impression
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2 accuracy, using the open or closed tray techniques.
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5 The aim of the present clinical study was to evaluate the accuracy of the open and closed
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7 implant impression techniques for partially edentulous patients.
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 Materials and Methods
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2 The current study was conducted to investigate the accuracy of implant impression technique
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5 in partially edentulous patients with two adjacent implants; between the open and closed tray
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7 techniques. The ethical principals were adhered to, and ethical approvals to conduct the study
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10 were duly obtained from the local ethics committees.
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13 The participants' recruitment was inviting patients whose treatment plans included
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receiving two adjacent implants. The adequate sample to be with sufficient power for analysis
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18 was based on a previous clinical study by Stimmelyar in 2013 [9]. The suitable sample for
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20 this study, with a margin error of 10%, was 31 patients. The sample size was increased to 40
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23 participants, to allow for any drop-outs during the study.
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26 The inclusions criteria were patients over 18 years age and willing to participate. A
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prerequisite was a treatment plan that involves two adjacent implants. The patient should also
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31 be either category ASA I or ASA II medical history, according to the American Society of
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33 Anesthesiologists Classification. The study evaluation also projected that if any case showed
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36 evidence of bone loss around the implant or implant mobility, at the time of impression
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38 making, formed part of the exclusion criteria [10, 11].
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42 The procedure of written informed consents was made and participants who agreed to
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44 participate signed the consent form. For every patient, a surgical positioning guide was
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fabricated from a diagnostic wax-up, correlated to the anatomic conditions. The implant
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49 (Osstem Implant System, Seoul, Korea) installation direction was adjusted clinically
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51 according to the amount and status of the available bone [12]. A Specialist Oral Surgeon
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54 placed the implants using a standardized technique, and a Specialist Prosthodontist carried
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56 out the impressions making and the restoration procedures.
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 For making the impressions, individual trays checked, and the final impressions made, using
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2 Virtual Monophase vinyl polysiloxane impression material (Ivoclar Vivadent AG). Before
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5 impression making, the horizontal distance between the two impressions copings was
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7 measured, inside the patient's mouth using a digital caliper (HSL 246-15, Karl Hammacher
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10 GmbH, Germany) and recorded. The recorded intraoral horizontal distances would later be
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12 compared against similar horizontal measurements on the master casts, to evaluate
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15 discrepancies or horizontal displacements between the positions intraorally and the master
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17 casts. We used the same criteria for impression evaluation accuracy as in our previous study
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[8], that described by Lee et al. (2013), which as follows [13].
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23 1. There should be accurate imprints of the implant areas.
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26 2. There should be no voids in the occlusal, buccal, lingual and interproximal surfaces of the
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neighboring teeth.
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32 3. There should be a proper reproduction of the implant area.
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35 4. There should be no impression material in the analog-impression coping interfaces.
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5. The Impression material should not be separated from the custom tray.
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42 6. The transfer copings should not be displaced from the impression.
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45 Any impression not meeting these criteria was repeated until these criteria were met. Two
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48 secondary impressions were made for every patient, one using the open and a second with the
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50 closed tray technique, by the same clinician.
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53 For the analysis of accuracy in the vertical direction or marginal discrepancy,
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56 verification jigs were constructed to connect the two impression copings [14]. These
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 verification jigs were used to transfer the relationships between the two impression copings
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2 and their implants from the patients’ mouths to the master casts.
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6 The impression copings for both the open and closed tray techniques were re-assembled and
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8 fixed into their corresponding implant analogs. Dental Stone Type IV (Elite Rock, Zhermack)
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11 was mixed according to the manufacturer instructions using vacuum machine for 30 seconds
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13 then poured using boxing technique over a vibrator, and casts were separated after 45 minutes
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according to manufacturer’s instruction [15, 16]. The master casts were then sectioned to a
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18 base of 20 mm, to allow their allocation under the stereomicroscope (AmScop14370, Myford
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20 Road, #150, Irvine, CA 92606 USA) to be examined at a 50 X magnifications, to evaluate the
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23 presence or absence of the marginal discrepancy and to record it for analysis [17, 8].
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26 Two examiners were involved in the evaluations, and inter-ratter reliability of 0.932 was
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obtained.
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35 Statistical Analysis:
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All the data was tabulated and statistically analyzed using IBM SPSS Statistics software
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41 version 22. Where data were not normally distributed, Wilcoxon Signed test used for
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43 numerical dependent data and paired data; Mann-Whitney test was used for independent
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46 numerical groups, Fisher Exact test for categorical data and Chi-Square for the association
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48 between categorical variable. The p-value set at p≤0.05 and regarded as statistically
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51 significant.
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 Results:
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2 Eighty impressions were made for 40 patients, using the open, then the closed impression
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5 technique. There were 18 impressions in the maxillary and 22 in the mandibular arch; of
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7 these, 13 in the anterior and 27 in the posterior region (Figure 1).
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10 To Mann-Whitney U test was used to evaluate the impression accuracy in the horizontal
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12 direction for each impression technique, according to arch. There were no statistically
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14 significant differences (P=0.107) between maxillary and mandibular arches, for the open tray
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17 technique. There were also no statistically significant differences (P=0.419) between
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19 maxillary and the mandibular impressions for the closed tray technique (Table 1).
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22 Mann-Whitney U test also showed no statistically significant difference (P=0.360) in the
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24 horizontal direction between the anterior and posterior regions for the open tray impression
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27 technique. Statistically significant differences (P=0.039) were detected in the horizontal
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29 direction, between the anterior and posterior regions in the closed tray impression technique
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(Table 2)
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34 For the open tray technique in the maxillary arch, marginal discrepancies (33.3%)
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36 occurred in 6 impressions, and 12 (66.70%) had no marginal discrepancies. In the mandibular
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39 arch, marginal discrepancies occurred in 2 impressions (9.10%), and 20 (90.9%) had no
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41 marginal discrepancies were detected. In the anterior region, 2 (15.40%) had marginal
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44 discrepancies, while 11 (84.60%) had no discrepancies. In the posterior region, 6 (22.80%)
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46 had marginal discrepancies, while 21 (77.80%) did not show marginal discrepancy (Fig 2).
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For the closed tray technique in the maxilla, marginal discrepancy occurred in 6 (33.30%)
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51 impressions and no discrepancies in 12 (66.70%). In the mandibular arch, there were
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53 marginal discrepancies in 6 (27.3%) impressions, and 16 (72.70%) did not show marginal
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56 discrepancies. In the anterior region, 3 (23.10%) impressions resulted in marginal
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 discrepancies, and 10 (76.90%) had no discrepancy. In the posterior region, nine impressions
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2 (33.30%) resulted in marginal discrepancies, while 18 (66.70%) had no discrepancies (Fig 3).
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5 To compare between the two impression techniques regarding marginal discrepancy
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7 occurrence, the Wilcoxon Signed Rank Test was used, and there were no significant
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10 differences between the open and closed tray implant impression techniques (P=0.365) (Table
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12 3).
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15 The Fisher exact test was used to associate between the presence or absence of
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17 marginal discrepancies differences and maxillary and mandibular arches and anterior and
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posterior regions. There were no statistically significant differences in marginal discrepancy
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22 between maxillary and mandibular arches (P=0.110) and anterior and posterior regions
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24 (P=0.613) in the open tray impression technique (Table 4). There were also no statistically
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27 significant differences between maxillary and mandibular for the closed tray technique
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29 (P=0.677). Also, no statistically significant difference detected (P=0.507) between the
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32 anterior (13 impressions) and posterior (27 impressions) regions for the open tray technique
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34 (Table 4).
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 Discussion
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3 Impression accuracy at the implant level is believed to have a higher degree of accuracy,
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5 compared to abutment level impressions [18]. However, studies reporting on impression
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8 accuracy in implant dentistry may vary, and there are several possible explanations for these
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10 variations. One reason is the splinting together of copings for pick-up impressions compared
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the to non-splinting of copings. Secondly, the edentulous spans evaluated may differ between
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15 studies; thirdly, marginal discrepancy evaluation may use magnifying visual assessment as in
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17 the current investigation, or a superimposition of digital models as in Stimmelmayr et al.
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20 2013 [9].
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22 Most of the data on implant impression accuracy is from in-vitro studies, with a small
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25 number conducted in a clinical setting. The limited number of clinical studies was highlighted
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27 in a systemic review by Papaspyridakos et al. 2014; where from the 76 studies reviewed, only
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30 four were in a clinical setting [19]. Baig 2014, also in a report on the accuracy of multiple
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32 implants impressions of edentulous arches, found only 3 of the 56 studies reviewed, to be in a
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clinical setting [7]. Also when the same author conducted a systematic review, only one study
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37 out of the 34 selected for the systematic review was a clinical study [20].
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39 This prospective clinical investigation found no significant differences between open
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42 and closed tray techniques, in agreement with Gallucci et al. 2011[21]. In our in-vitro study,
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44 we also found that the open and closed tray implant impression techniques showed a similar
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47 level of accuracy [8]. In that study, all the impressions were in the posterior maxillary region,
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49 while the current study had variations of anterior, posterior, maxillary and mandibular.
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However, the current study is in disagreement with Stimmelmayr et al. 2013, where they
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54 found the splinted implants open tray more accurate than the closed tray technique [9].
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56 Regarding the influence on the accuracy of the implant position within the dental arch; the
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59 current study found that the implant position in the dental arch had no influence or impact on
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 impression accuracy, similar to the report by Gallucci et al. 2011 [21]. However, and in
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2 contrast, Papaspyridakos et al. found that the position in the dental arch influenced accuracy
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5 [19]. However, the Papaspyridakos et al. study involved utilizing the open tray technique
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7 only and used splinted impression copings. Furthermore, Polyether impression was the
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10 material used in their study, and accuracy evaluation was through superimposition of optical
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12 scans, and perhaps these differences may have contributed to the variance in outcomes.
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15 The current study also reported no statistically significant differences in the marginal
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17 discrepancy between both impression techniques, in particular for the maxillary arch. This is
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contrary to the findings of Papaspyridakos et al. 2011, where statistically significant
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22 differences were found concerning marginal discrepancy between the groups studied [22].
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24 Any stage of implant prosthesis fabrication may contribute to positional distortion or
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27 imprecision. Decreasing distortion factors in the horizontal and vertical dimension may
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29 reduce the potential on impressions misfits of implant superstructures. Several methods may
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32 be used to evaluate the presence or absence of the marginal discrepancy or discrepancy; in
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34 the current study, the one screw test with a verification jig was used, since it has been widely
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used to determine marginal discrepancies [14,23-25].
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39 One of the limitations of our study is the lack of matching arches and regions. This
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41 may have yielded variable data and would have perhaps influenced the outcomes of implant
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44 impression accuracy. A further limitation is that specialists undertook the management of the
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46 patients in this study, and it would have been interesting to evaluate the effect of clinical
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49 experience on impression accuracy; though that would have probably required a larger
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51 sample to obtain the appropriate power to assess these variables. A further limitation is the
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54 effect of implant angulations on the accuracy was not assessed in this study. Also, this study
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56 investigated impression accuracy in relationship to adjacent implants, and the results should
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be viewed regarding adjacent implants only, and that spaced, and divergent implants would
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 possibly yield different outcomes.
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2 Conclusion:
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5 Within the limitation of this study, there were no differences in the impression accuracy
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7 between the open and closed tray techniques, in partially edentulous jaws with two adjacent
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10 implants. Also, there were no differences between the two impression techniques regarding
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12 marginal discrepancy. The position of the implant, in the maxilla or mandible, had no effect
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15 on impression accuracy of both techniques.
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 1
2 Ethics approval and consent to participate:
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5 The ethical principals were adhered to, and ethical approvals to conduct the study were duly
6 obtained from the from the Ethical Committee of the Minsitry of Health, Khartoum State,
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Khartoum Teaching Dental Hopsital
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10 - Consent for publication:
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13 All authors read and approved the final manuscript and consent to the publication.
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15 - Availability of data and material
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The authors declare that they have full control on all data and materials of this study.
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20 - Competing interests
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23 Motaz Osman, Hassan Ziada, Ahmed Suliman and Neamat Abubakr declare that they have
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no competing interests
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28 - Funding
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31 No funding (not applicable)
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33 - Authors' contributions
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36 Motaz Osman carried out the recruitment and impression making, measurements, data
37 collection, and drafting of the manuscript. Hassan Ziada performed the analysis and
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interpretation of data and participated in drafting and preparing of the manuscript. Ahmed
40 Suliman participated in the design of the study and discussion of the results. Neamat Abubakr
41 participated in the conception and design of the study and participated in the preparation
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43 and revision of the manuscript.
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45
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47 Acknowledgement
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The authors would like to acknowledge the statistical support provided by Dr. Abdlaal Fadol
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 9. Stimmelmayr M, Guth JF, Erdelt K, Happe A, Schlee M, Beuer F. Clinical study
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11 Int J Oral Maxillofac Implants. 2007; 22: 743-54.
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14 11. Martin W, Lewis E, Nicol A. Local risk factors for implant therapy. Int J Oral Maxillofac
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16 Implants. 2009; 24 Suppl:28-38.
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20 12. Sethi A, Kaus T, Sochor P. The use of angulated abutments in implant dentistry: five-year
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22 clinical results of an ongoing prospective study. Int J Oral Maxillofac Implants. 2000;15:
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25 801-10.
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28 13. Lee SJ, Gallucci GO (2013) Digital vs. conventional implant impressions: efficiency
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30 outcomes. Clin Oral Implants Res 24, 111-115.
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34 14. Kan JY, Rungcharassaeng K, Bohsali K, Goodacre CJ, Lang BR. Clinical methods for
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36 evaluating implant framework fit. J Prosthet Dent.1999; 81:7-13.
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39 15. Vigolo P, Millstein PL. Evaluation of master cast techniques for multiple abutment
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42 implant prostheses. Int J Oral Maxillofac Implants. 1993;8:439-46.
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45 16. Wadhwa SS, Mehta R, Duggal N, Vasudeva K. The effect of pouring time on the
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48 dimensional accuracy of casts made from different irreversible hydrocolloid impression
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50 materials. Contemp Clin Dent. 2013;4:313-18.
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53 17. Papaspyridakos P, Benic GI, Hogsett VL, White GS, Lal K, Gallucci GO. Accuracy of
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56 implant casts generated with splinted and non-splinted impression techniques for edentulous
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58 patients: an optical scanning study. Clin Oral Implants Res. 2012;23:676-81.
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 18. Bartlett DW, Greenwood R, Howe L. The suitability of head-of-implant and conventional
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2 abutment impression techniques for implant-retained three unit bridges: an in vitro study. Eur
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5 J Prosthodont Restor Dent. 2002;10:163-66.
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8 19. Papaspyridakos P, Chen CJ, Gallucci GO, Doukoudakis A, Weber HP, Chronopoulos V.
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11 Accuracy of implant impressions for partially and completely edentulous patients: a
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13 systematic review. Int J Oral Maxillofac Implants. 2014; 29:836-45.
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16 20. Baig MR. Accuracy of impressions of multiple implants in the edentulous arch: a
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19 systematic review. Int J Oral Maxillofac Implants. 2014;29:869-80.
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22 21. Gallucci GO, Papaspyridakos P, Ashy LM, Kim GE, Brady NJ, Weber HP. Clinical
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accuracy outcomes of closed-tray and open-tray implant impression techniques for partially
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30 22. Papaspyridakos P, Lal K, White GS, Weber HP, Gallucci GO. Effect of splinted and
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33 nonsplinted impression techniques on the accuracy of fit of fixed implant prostheses in
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35 edentulous patients: a comparative study. Int J Oral Maxillofac Implant. 2011;26:1267-72.
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23. Kim S, Nicholls JI, Han CH, Lee KW. Displacement of implant components from
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41 impressions to definitive casts. Int J Oral Maxillofac Implants. 2006;21:747-55.
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44 24. Papaspyridakos P, Hirayama H, Chen CJ, Ho CH, Chronopoulos V, Weber HP. Full-arch
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47 implant fixed prostheses: a comparative study on the effect of connection type and
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49 impression technique on accuracy of fit. Clin Oral Implants Res. 2016;27:1099-105.
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25. Presotto AG, Bhering CL, Mesquita MF, Barao VA. Marginal fit and photoelastic stress
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 Figure Legends:
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3 Figure 1: Distribution of the sample according to arch and position.
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5 Figure 2: Marginal discrepancy distribution in the open tray technique.
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Figure 3: Marginal discrepancy distribution in the closed tray impression technique.
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Table legends:
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16 Table 1: Impression techniques accuracy in the maxilla and mandible, using the Mann-
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18 Whitney U test.
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21 Table 2: Impression techniques accuracy in the anterior and posterior regions using the
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23 Mann-Whitney U test.
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Table 3: Evaluation of the impression techniques (Wilcoxon test).
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28 Table 4: Marginal discrepancy for the impression techniques.
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40 Maxilla Mandible Anterior Posterior
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42 67.50%
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44 55%
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46 45%
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48 32.50%
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56 Maxilla Mandible Anterior Posterior
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58 Figure 1: Distribution of the sample according to arch and position.
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 100.00%
1 90.90%
2 90.00% 84.60%
3 77.80%
80.00%
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5 67.70%
70.00%
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7 60.00% Marginal
8 Discrepancy
50.00%
9 No Marginal
10 40.00% 33.30% Discrepancy
11 30.00%
12 22.80%
13 20.00% 15.40%
14 9.10%
10.00%
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16 0.00%
17 Maxilla Mandible Anterior Posterior
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19 Open Tray
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22 Figure 2: Marginal discrepancy distribution in the open tray technique.
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 1 90.00%
2 80.00% 76.90%
3 72.70%
4 70.00% 66.70% 66.70%
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6 60.00%
7 Marginal
8 50.00%
Discrepancy
9 40.00%
10 33.30% 33.30%
27.30% No Marginal
11 30.00% 23.10% Discrepancy
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13 20.00%
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15 10.00%
16 0.00%
17 Maxilla Mandible Anterior Posterior
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19 Closed Tray
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Figure 3: Marginal discrepancy distribution in the closed tray impression technique.
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 1
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Median P
4 Techniques Variables N Mean SD
5 value
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8 Maxilla 18 0.040 0.0833 0.076
9 Open Tray 0.107
10 Mandible 22 0.030 0.0464 0.054
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13 Maxilla 18 0.040 0.0756 0.076
14 Closed Tray 0.419
15 Mandible 22 0.040 0.0945 0.0104
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18 Table 1: Impression techniques accuracy in the maxilla and mandible, using the Mann-
19 Whitney U test.
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 1
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Techniques Variables N Median Mean SD P value
4
5 Anterior 13 0.04 0.0569 0.0497
6 Open Tray 0.360
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8 Posterior 27 0.03 0.0659 0.0737
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10 Anterior 13 0.03 0.0515 0.0571
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Closed Tray 0.039*
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13 Posterior 27 0.04 0.1026 0.1013
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15 Table 2: Impression techniques accuracy in the anterior and posterior regions
16
using the Mann-Whitney U test.
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 1
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Technique N Median Mean SD P value
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5 Open Tray 40 0.040 0.03230 0.0663 0.365
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8 Closed Tray 40 0.040 0.0437 0.918
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10 Table 3: Evaluation of the impression techniques (Wilcoxon test).
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 1
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No
4 Marginal
5 Techniques Variables Marginal Total P value
6 discrepancy
7 Discrepancy
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10 Maxilla 6 (33.3%) 12 (66.7%) 18 (100%)
11 0.110
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Mandible 2 (9.1%) 20 (90.9%) 22 (100%)
14 Open Tray
15 Anterior 2 (15.4%) 11 (84.6%) 13 (100%)
16 0.613
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18 Posterior 6 (22.2%) 21 (77.8%) 27 (100%)
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20 Maxilla 6 (33.3%) 12 (66.7%) 18 (100%)
21 0.677
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23 Mandible 6 (27.3%) 16 (72.7%) 22 (100%)
24 Closed Tray
25 Anterior 3 (23.1%) 10 (76.9%) 13 (100%)
26 0.507
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28 Posterior 9 (33.3%) 18 (66.7%) 27 (100%)
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30 Table 4: Marginal discrepancy for the impression techniques.
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