SYSTEMATIC REVIEW

Critical appraisal of implant impression accuracies: A

systematic review
Jee-Hwan Kim, DDS, MSD, PhD,a Kyoung Rok Kim, DDS, MSD,b and Sunjai Kim, DDS, MSD, PhDc
The passive t of an implant
ABSTRACT
prosthesis is considered a sigStatement of problem. Different assessment methods have been used to measure the accuracy of
nicant factor in its long-term
implant impression techniques; therefore, the readers should understand the benets and limitasuccess, because mist intions of each assessment method used.
creases the risk of biologic and
Purpose. The purpose of this systematic review was to classify the implant impression studies by
mechanical failures.1,2 Althe assessment methods and techniques used and to understand the characteristics of each
though obtaining a completely
assessment method. The results of published studies were also analyzed to draw meaningful
passive t is difcult, it is
conclusions about the accuracy of the implant impressions.
important to minimize the
Material and methods. An electronic search of the MEDLINE/PubMed database was performed in
discrepancy of t.3 Errors in
February 2013 using specic search terms and predetermined criteria to identify and assess labthe implant impression proceoratory studies of the accuracy of implant impression techniques. A nal list of articles deemed to
dure during the fabrication of
be of interest was comprehensively reviewed by 2 reviewers to ensure that these were suitable for
the denitive cast can cause
the purpose of this review. The results of the current review were also compared with results from a
previous systematic review.
mist of the implant superstructure.4 Therefore, the fabResults. A total of 56 studies met the inclusion criteria for this review. Thirty-seven studies
rication of a precise denitive
measured the amount of linear distortion, and 17 studies compared the angular change to
cast that exactly transfers the
assess the accuracy. Most linear or angular distortions were only measured in 2 dimensions, and
3-dimensional analysis was rare. More than 80% of the studies compared nonsplinting versus
intraoral position of the imsplinting, direct versus indirect techniques, and different impression materials.
plant or abutment is essential
for the long-term stability of
Conclusions. In recent publications, the direct or splint technique showed more accurate results
than the indirect or nonsplinted technique. In contrast to external connection implants, inconsistent
the implant prosthesis.5
results were reported for internal connection implants. (J Prosthet Dent 2015;114:185-192)
The accuracy of a denitive
cast for the fabrication of an
implant prosthesis is inuenced by the impression
because the tray has an open window for unscrewing the
technique used,6 the parallel or nonparallel placement of
guide pins of the impression copings. These techniques can
implants,7,8 the depth of the implant position,9 the type
be subdivided into splinted and nonsplinted techof impression material used,10 the dimensional stability
niques.14,15 Indirect techniques are also known as closed
11
of the gypsum used to fabricate the cast, the die system
tray impression techniques. A previous systematic review of
used,12 and the length of the impression copings.13
implant impression accuracy concluded that numerous inImplant impression techniques can be classied as either
vestigations had compared the accuracy of different
direct (pick-up) or indirect (transfer). Direct techniques
impression techniques, different impression materials,
are also described as open tray impression techniques
various implant connection systems, and different implant

Assistant Professor, Department of Prosthodontics, Yonsei University Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea.
Captain, The Armed Forces Medical School; and Former graduate student, College of Dentistry, Yonsei University, Seoul, Korea.
c
Professor and Chairman, Department of Prosthodontics, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea.
b

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placement situations, but no consistent results had been

reported.16
Recently, an optical impression technique that uses
scannable healing abutments instead of impression
copings was introduced into clinical implant dentistry.17
Digital impression techniques seem to have several advantages, including patient comfort, removal of possible
errors associated with elastic materials, and increased
cost effectiveness.18 However, few studies have assessed
these techniques.19,20
Different measurement devices, including prole
projectors,21,22 micrometers,23-25 coordinate measuring
machines,26,27 strain gauges,28,29 and digital superimposition30 have been used to evaluate the accuracy of
implant impression techniques. However, even when the
same devices have been used, these have been applied
differently in different studies. To date, most implant
impression studies have just reported on the type of
impression technique that produces the most accurate
results. The benets and drawbacks of each method have
not been evaluated.
The purpose of the current systematic review was to
evaluate and compare the results of implant impression
studies based on the assessment methods used. The
distribution of the assessment methods and the characteristics of each measurement method were also
analyzed to evaluate the advantages and disadvantages
of each assessment.
MATERIAL AND METHODS
A MEDLINE/PubMed search was performed for laboratory studies published in dental journals from January 1,
1990, to February 28, 2013. The search was limited to
English language publications.
The following Medical Subject Headings (MeSH[*] )
or free text() words were used for the electronic search:
(dental implants* OR dental abutments* OR oral implants OR endosseous implants OR dental prosthesis,
implant supported* OR implant restoration) AND
(dental impression technique* OR dental impression
materials* OR dental models* OR master casts OR
denitive casts OR nal impression OR digital
impression OR digital scanning) AND (dimensional
measurement accuracy* OR three dimension OR
distortion OR displacement OR t).
All obtained titles and abstracts were screened independently by 2 reviewers (J.H.K. and S.K.). If the abstract
was not available, or if the title and the abstract did not
provide sufcient information regarding the inclusion
criteria, a full text article was acquired for screening. On
the basis of the chosen abstracts, full text articles were
selected for independent assessment by the reviewers. In
addition, references of the selected publications and of
previously published reviews relevant to the present

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Volume 114 Issue 2

review were searched for eligible studies. In case of any

disagreement regarding inclusion, a consensus was
reached by discussion. Finally, a selection was made
based on the inclusion/exclusion criteria applied to the
full text articles.
The criteria for study inclusion were studies with at
least 3 implants for meaningful analysis, laboratory
studies, and studies comparing different impression
techniques. The criteria for study exclusion were clinical
or technical reports, only abstracts published in journals
or conference proceedings, studies comparing die materials or systems, studies with insufcient information,
review articles, and full text articles in languages other
than English.
A data extraction sheet was used by the reviewers to
extract the relevant data from the included articles. Information on several parameters was recorded including
authors, year of publication, implant system, implantabutment connection type (external, internal, hexagon,
conical), number of implants, impression level (implant
level or abutment level), impression technique, and
assessment method. Disagreements regarding data
extraction were resolved by discussion.
References from the selected studies were also
screened to identify pertinent literature. The initial data
search generated 389 articles. Based on the initial
screening of the titles and abstracts, 88 studies were
selected for full text evaluation. A total of 33 studies were
omitted based on the exclusion criteria, and the
remaining 55 articles were selected for assessment. One
article was included after additional assessment of the
articles and their references. In total, 56 articles were
selected for the analyses (Fig. 1, Table 1). Articles that
were not included in this study after full text reading are
listed in Table 2. For a detailed list of excluded studies,
see Supplemental Table 1 (available online).
RESULTS
The 56 selected studies were classied into 4 main groups
based on the assessment methods used. These measured
the extent of linear distortion of the implant (or abutment) head positions (n = 37), angular distortion of the
implant (or abutment) long axis (n=17), gap distances
between the cylinders of a master framework and of
replicas in test models (n=10), and the amount of strain
produced in a master framework (n=4).
Among the 4 assessment methods, investigators
preferred to assess the accuracy of the measurement of
linear distortion of implant impressions. More than 50%
of studies (n=37) compared the amount of linear distortion to evaluate the accuracy of implant impression
techniques.6,7,10,13,15,17,19,21,23,26,27 Of these 37 studies, 17
were included in a previous systematic review,16 and 20
were published after the review.

Kim et al

August 2015

187

Total studies identified from

electronic search (n = 389)

Studies excluded after

reading
of titles and/or
abstracts (n = 301)

Studies identified for screening

full text evaluation in the
initial phase (n = 88)
Studies excluded
after full text reading
based on exclusion
criteria (n = 33)

Studies included in the

second phase of evaluation (n = 55)

Studies added
by reviewing
the references
of 55 studies (n = 1)

Studies included in the final review

(n = 56)

Figure 1. Search strategy and history.

Seventeen studies compared the amount of angular

distortions.7,8,26,27,46-51,53-58 Sixteen studies measured the
amount of angular change of the implant or abutment
long axis, and 1 study measured the amount of implant
head rotation around the long axis.55 Eight studies were
included in the previous review,16 and the other 9 studies
were published after the review.
Ten studies measured the gap distance between the
cylinders in the master framework, which was fabricated
to t as passively as possible on the master model, and
the implant (abutment) head in test models.14,24,59-66
One study was published before the previous systematic review,16 and 9 studies were published between 2008
and February 2013.
Four studies compared the amount of strain produced
in the master framework.28,29,67,68 Strain gauges were
attached to the master framework, which was passively
tted when possible on the master model. All the studies
were reported before the previous systematic review,16
and no study published since met the inclusion criteria
for the present systematic review; therefore, recent researchers seemed to have little preference with regard to
the use of the master framework with strain gauges to
assess the accuracy of implant impression techniques.
Twenty-two studies compared the effects of splinting
or different splinting materials on the accuracy of implant
Kim et al

impressions.6,8,14,21,23,24,26-28,30,31,37,41-43,45,46,50,52,59,62,63 In
the previous review,16 4 studies reported that the splinted
impression technique was more accurate,8,21,24,28 and only
1 study reported that the nonsplinted impression was
more accurate.46 Eleven further studies were included in
the present systematic review, 7 of which reported a
preference for a splinted technique over a nonsplinted
technique.6,14,30,50,52,59,62 No study reported that nonsplinted techniques resulted in more accurate impressions.
The next common study designs were comparisons of
direct versus indirect impression techniques and different
impression materials. Seventeen studies compared the
impression accuracy achieved with direct and indirect
techniques.6,8,13,23,24,30,34,37,41,43,45,46,51,53,57,61,63 In the
previous review,16 4 studies reported that the direct
impression technique was more accurate.24,34,45,46 Five
studies reported no dimensional difference between the
techniques, and only 1 study43 reported that the indirect
impression technique was more accurate. Since the review, 6 further studies have reported that the direct
impression technique is more accurate,6,13,23,41,61,63 and 3
have reported no difference in accuracy between the
techniques.30,51,53 No study has reported that the indirect
impression technique is more accurate.
Sixteen studies compared the accuracy of polyether
and polyvinyl siloxane.7,8,10,32,38,41-43,45,47,49,55,56,68 Nine
studies were published before the previous review, none
of which reported any signicant difference between the
2 materials. Since then, however, 2 studies have reported
a preference for polyvinyl siloxane over polyether,41,49
and 1 study has reported a preference for polyether.7 A
recent study reported that polyether was more accurate
than polyvinyl siloxane in the parallel location of implants and that polyvinyl siloxane was more accurate
than polyether in the nonparallel location of implants.32
Five studies investigated the effect of implant parallelism on impression accuracy.8,13,51,57,58 Before the previous review, 1 study advocated the parallelism of
implants,8 and another study57 reported no difference in
accuracy based on the parallelism or nonparallelism of
implants. Since the review, 2 studies have advocated
parallel implants,51,58 but another study has reported no
difference in accuracy between parallel and nonparallel
implants.13
One study compared the accuracy of denitive casts
fabricated by conventional or digital impression techniques.17 The study concluded that conventional nonsplinted pick-up produced more accurate denitive casts
than digital impression. Kwon et al54 compared the
accuracy of implant impression with or without impression copings and concluded that implant impression
without copings was less accurate than direct impression
technique.
Among 56 studies included in this review, more than
80% compared the accuracy of implant impressions using
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Volume 114 Issue 2

Table 1. Selected articles in this review

Authors

Implant

Implant/Abutment
Connection

No. of
implants

Implant Alignment

Splint

Assessment

Humphries et al43

Brnemark

EXT

Spector et al44

Brnemark

EXT

Carr et al34

Brnemark

EXT

Assif et al24

Brnemark

EXT

Barrett et al45

Brnemark

EXT

AAR

LD

Hsu et al31

Brnemark

EXT

AAR

LD

Liou et al55

Brnemark

EXT

Parallel

Phillips et al46

Brnemark

EXT

10 degrees labial

Assif et al28

Brnemark

EXT

Carr et al35

Brnemark

EXT

AAR

LD

Burawi et al36

Bone Lock Implant

INT

AAR

LD

Assif et al67

Brnemark

EXT

AAR, dual cure

resin, IP

STRAIN

Herbst et al37

Southern Implant

EXT

AAR

LD

Lorenzoni et al56

Friarit 2

INT

Wee38

Brnemark

EXT

De La Cruz et al39

Steri Oss

EXT

Vigolo et al21

3i

INT

Akca and Cehreli47

Straumann

INT

Assuncao et al8

Conexao

EXT

Parallel

AAR

LD

AAR

LD

Less than 15 degrees

LD
GAP

More than 15 degrees

3 parallel and
2 8-degree lingual

AD
AAR

LD, AD

AAR

STRAIN

AD
LD
Parallel

AAR, LCR

LD

AAR

LD

AAR

AD

LD, AD
90, 80, 75, 65 degrees to
horizontal plane

Naconecy et al29

Brnemark

EXT

AAR, AS, PE

STRAIN

Vigolo et al72

3i

INT

AAR

LD

Ortorp et al48

Brnemark

EXT

Cehreli and Akca68

Straumann

INT

Kim et al27

Brnemark

EXT

Parallel

Conrad et al57

3i

EXT

90, 85, 80, 75 degrees to

horizontal plane

Holst et al10

Sky Implant

INT

Dullabh et al23

Brnemark

EXT

Walker et al40

Replace

INT

Aguilar et al49

Paragon

EXT

10 degrees labial

Assuncao et al58

Conexao

EXT

90, 80, 75, 65 degrees to

horizontal plane

AAR, CS

DelAcqua et al59

Conexao

EXT

Parallel

LCR, AAR

GAP

DelAcqua et al60

Conexao

EXT

Parallel

Metal bur with

AAR, AAR

GAP

DelAcqua et al66

Conexao

EXT

Parallel

AAR

GAP

Hariharan et al26

Replace

INT

Jo et al13

Osstem

INT

90, 90, 80 degrees to

horizontal plane

Lee et al61

Brnemark

EXT

90, 75, 65 degrees to

horizontal plane

Mostafa et al41

Microdent Implant System

EXT

Sorrentino et al32

WinSix

INT

90, 95, 85 degrees to

horizontal plane

Yamamoto et al62

Conexao

EXT

Parallel

Faria et al63

Titamax Implant

EXT

Kwon et al54

Warantec

EXT

Lee and Cho15

Brnemark

EXT

Simeone et al50

Camlog

INT

45 degrees to each other

AAR, LCR

LD, AD

Al Quran et al6

Pitt Easy

INT

Parallel

AAR

LD

Chang et al42

Sybron Pro

INT

Parallel

AAR

LD

DelAcqua et al64

Conexao

EXT

Parallel

AAR

Eliasson and Ottorp17

3i Biomet

EXT

Ferreira et al33

Neodent

EXT

LD, AD
STRAIN
LCR

linear and AD
AD
LD

No more than 15 degrees

AAR

LD
LD
LD, AD
AD

AAR, AS, PE

LD, AD
LD

AAR

GAP

AAR

LD
LD

AAR

GAP

AAR

GAP

Parallel

LA, AD
AAR, IP, AS

LD

GAP
LD, AD

Parallel

AAR

LD
(continued on next page)

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189

Table 1. Selected articles in this review (continued)

Authors

Implant

Implant/Abutment
Connection

No. of
implants

Holst et al19

Nobel Replace

INT

Mpikos et al51

Dr IHDE Dental

EXT, INT

Ongul et al52

Straumann

INT

Rashidan et al53

Replace Select, Dentium

INT

Stimmelmayr et al17

Camlog

INT

de Avila et al14

Conexao

Fernandez et al65

ReplaceSelect, Straumann

Akalin et al7

AstraTech

Implant Alignment

Splint

5
4 EXT
4 INT

Assessment
LD

90, 75, 65 degrees to

horizontal plane

LD, AD
AAR, LCR

LD

AAR

LD

EXT

AAR

GAP

INT

INT

3*

Parallel

LD, AD

GAP
Parallel, 10 degrees buccal

CS, AS, PE

LD, AD

EXT, external type implant/abutment connection; INT, internal type implant/abutment connection; AAR, autopolymerizing acrylic resin; LCR, light-polymerizing composite resin; CS, condensation
type silicone; AS, addition type silicone; IP, impression plaster; PE, polyether; LD, linear distortion; AD, angular distortion; GAP, gap distance between master framework and replicas in experimental models; STRAIN, amount of strain introduced in master framework.
*Six implants were placed in master model but divided into 2 groups (n=3).

Eight implants were placed in master model but divided into 2 groups (n=4) for comparison.

nonsplinting versus splinting with different splinting

techniques, direct versus indirect techniques, and
impression materials. Less than 20% of studies compared
the accuracy of parallel versus nonparallel implants or
between implant/abutment connection types (external or
internal).
DISCUSSION
The current systematic review analyzed relevant studies
of the accuracy of implant impression techniques. This
review not only summarized the results of the included
studies, but also classied the studies according to the
assessment methods used to understand the benets and
limitations of each study.
The amount of linear distortion was the most
frequently used method of evaluating the accuracy of
implant impressions. The studies included in this systematic review used one of 4 different evaluation
methods to measure the amount of linear distortion: the
amount of 3-dimensional displacement of the centroids
of implant or abutment heads (Dx, Dy, Dz), the change in
linear distance (Dr, Dr2 = Dx2 + Dy2 + Dz2) between the
centroids of implant or abutment heads, the distance
between 2 reference points (the outer surfaces between
the implant heads), and the closest distance between the
long axes of implants.
Displacement of the implant or abutment head position is the most important factor for evaluating the
accuracy of an implant impression, thus evaluating the
amount of displacement of each implant or abutment
centroid in X, Y, and Z axes appears to be the most logical
assessment method to measure the amount of linear
distortion. However, this method has an inherent limitation. When an impression technique results in greater
displacement in the X-axis direction (Dx) but less
displacement in another axis (Dy or Dz) than the other
impression technique used in the same investigation or
Kim et al

vice versa, determining which impression technique is

more accurate is difcult. Therefore, many studies have
also assessed the total amount of 3-dimensional
displacement (Dr) to determine which impression technique is more accurate. The second method determines
the degree of accuracy by measuring the linear distance
(in a single plane) between 2 centroids of implant or
abutment heads. Even though this method cannot detect
the translational rotation of the implant body or long
axis, it is still considered a simple and intuitive means of
assessing the accuracy of different impression techniques.
The third method is a modied version of the second and
is a very simple method of determining the interimplant
distance; practically, however, it is difcult to locate calipers at the same positions of implants. This method has
not been reported since the previous systematic review.16
The fourth method was used by only 1 research group,50
who measured the closest distance between implant long
axes to compare impression techniques. This method
cannot detect translational or axial rotation of implants,
and the implant position (especially the head position)
can be displaced without changing the closest distance
between the interimplant long axes. Therefore, the researchers also measured changes in the angles between
the implant axes and combined the results with the
closest distance between them.
Angular distortion can be classied into 2 categories:
rotation of the implant head around the implant long axis
and translational rotation of the implant long axis to a
specic reference axis or plane. The XY, YZ, and ZX
planes were frequently chosen as the reference plane,
with the amount of angular change described as dqXY,
dqYZ, and dqZX, respectively. When a specic implant or
replica was chosen as a reference axis, the angles between the reference axis and the long axes of the implants were measured, and the difference in value
between the measurements made before and after the
impression procedure was regarded as the angular
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Volume 114 Issue 2

Table 2. Articles that were not included in the study after full text
reading
Reason for Exclusion

Year

Less than 3 implants

Carr et al

1992

Inturregui et al

1993

Bartlett et al

2002

Burns et al

2003

Bambini et al

2005

Cabral et al

2007

Assuncao et al

2008

Assuncao et al

2008

Assuncao et al

2008

Lee et al*

2008

Wostmann et al

2008

Filho et al

2009

Lee et al

2009

Assuncao et al

2010

Alikhasi et al

2011

Jang et al

2011

Rutkunas et al

2012

Tarib et al

2012

Howell et al

2013

Not a laboratory study

Jemt et al

1999

Papaspyridakos et al

2012

Lack of information
Schmitt et al

1994

Not a comparison of impression techniques

Lechner et al

1992

Vigolo et al

1993

Wee et al

1998

Cranin et al

1998

May et al

1999

Wee et al

2002

Castilho et al

2007

Review article
Lee et al

2008

Not a comparison between impression techniques

Del Corso et al

2009

Stimmelmayr et al

2012

Ono et al

2012

*Five implants were placed in the master model but only 2 implants were used for each
comparison.

distortion. The majority of the angular distortion studies

used a coordinate measuring machine or similar equipment to measure the rotations.
Before the previous systematic review, only 1 study
had compared impression accuracy by measuring the gap
between the master framework and the implant (replica)
head.24 Since then, 9 studies included in the present review have measured the gap distance between the master
framework and the implant head,14,59-66 a measuring
technique apparently popular among investigators.
However, 4 of the 9 studies were published by the same
research group.59,60,64,66 This assessment method has 1
major disadvantage. Because investigators tightened each
THE JOURNAL OF PROSTHETIC DENTISTRY

distal prosthetic screw of the master framework, a slight

angular displacement of a distal implant or abutment head
can produce an exaggerated opposite side gap. Furthermore, identifying which specic implant or abutment
replica was displaced the most was difcult.
Implant/abutment connection types are simply classied as external or internal connections. Of the 20 investigations published since the previous review,16 14
studies6,7,13,19,26,30,32,33,40,42,49,50,52,53 used internal connection implants, reecting the popularity of internal
connections in contemporary implant dentistry. Sorrentino et al32 evaluated the effect of implant alignments
(parallel versus nonparallel) and coping engagement
lengths (1 mm versus 2 mm) in internal connection implants. They reported that more accurate casts were
produced when the implants were parallel rather than
nonparallel alignments and that short engagement
length produced more accurate results when the implants were not parallel. Mpikos et al51 reported that
neither impression technique nor implant parallelism
inuenced the impression accuracy in external connection implants, but the accuracy was signicantly inuenced by the implant parallelism in internal connection
implants. Most internal connection implants have longer
or broader implant/abutment connections than external
connection implants. The longer or broader connection
area can cause displacement of the impression copings
during the removal of the impression tray, exaggerating
the amount of distortion in nonparallel implant alignments. In addition to the longer or broader connection
area, there is a special consideration for internal
connection implants. Greater vertical distortion (Dz)
resulted in a more retentive coping design rather than a
coping design with less retentive form.53
However, the study ignored an important difference
other than the retentive designs of impression copings.
Internal connection is further divided into internal
hexagon and internal conical connections,69 and a
certain amount of axial displacement is inevitable in
internal conical connection implants during tightening
procedures.70,71 The less retentive copings were used
for internal hexagon connections, whereas the more
retentive copings were used for internal conical
connection implants. Even if clinicians try to use the
same amount of tightening force during impression
procedures, internal conical connections have a greater
chance of vertical displacement than internal hexagon
or external hexagon connections. Unlike for external
hexagon implants, the results of splinting copings in
internal connection implants were inconsistent. Vigolo
et al72 reported that more accurate results were obtained with splinted rather than nonsplinted pick-up
techniques, but Ongul et al52 reported no signicant difference between nonsplinted and splinted
pick-up techniques for 6 implants with buccal
Kim et al

August 2015

angulations. The former study used internal hexagon

connections implants, whereas the latter study used
internal conical connection implants. The inherent
axial displacement in internal conical connection can
produce greater vertical errors than in internal
hexagon implants. As a result, greater distortion may
have hindered the detection of statistical differences
between nonsplinted and splinted techniques in the
latter study. Further investigations are needed of the
effect of splinting copings in internal connection
implant impressions.
Recent investigations have preferred the splinting
over nonsplinting technique and direct over indirect
impressions. However, Phillips et al46 reported more
accurate results with a nonsplinted pick-up impression
compared with a resin splinted pick-up impression
technique for an experimental model with 5 implants.
However, the researchers did not measure the position
of the implants (replicas) in the denitive casts; they
only measured the positional change of impression
copings from the master model to the impression tray.
Kim et al27 reported that a splinting technique resulted
in greater displacement of copings during the impression procedure, but produced signicantly less
displacement of replicas during cast fabrication. Therefore, the impression phase in which the measurements
were performed should also be considered to compare
the results of studies.
CONCLUSION
Based on the analyses of the studies included in the present systematic review, the conclusions were as follows:
1. Measurement of linear distortion at specic reference points was the most frequently chosen method
for assessing the accuracy of the implant impression
techniques.
2. Most studies included in this review compared
splinting and nonsplinting impression techniques
and the effects of different splinting materials.
3. Recently published studies preferred direct to indirect impressions and splinted over nonsplinted
techniques.
4. In contrast to reports of external connection implants,
results reported for internal connection implants
were inconsistent, even though the number of
studies of internal connection implants is increasing.
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33. Ferreira VF, Barboza EP, Gouvea CV, Bianchini GM, Mussallem F,
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56. Lorenzoni M, Pertl C, Penkner K, Polansky R, Sedaj B, Wegscheider WA.

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Corresponding author:
Dr Sunjai Kim
Gangnam Severance Dental Hospital
Eonju-ro 211, Gangnam-gu
Seoul 135-270
KOREA
Email: sunjai@yuhs.ac
Copyright 2015 by the Editorial Council for The Journal of Prosthetic Dentistry.

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APPENDIX
Supplemental Table 1. Articles that were not included in study after full text reading
Articles
Alikhasi M, Siadat H, Monzavi A, Momen-Heravi F. Three-dimensional accuracy of implant and abutment level impression techniques: effect on marginal discrepancy.
J Oral Implantol 2011;37:649-57.
Assuncao WG, Cardoso A, Gomes EA, Tabata LF, dos Santos PH. Accuracy of impression techniques for implants. Part 1e inuence of transfer copings surface abrasion.
J Prosthodont 2008;17:641-7.
Assuncao WG, Gomes EA, Tabata LF, Gennari-Filho H. A comparison of prolometer and AutoCAD software techniques in evaluation of implant angulation in vitro. Int
J Oral Maxillofac Implants 2008;23:618-22.
Assuncao WG, Tabata LF, Cardoso A, Rocha EP, Gomes EA. Prosthetic transfer impression accuracy evaluation for osseointegrated implants. Implant Dent 2008;17:248-56.
Assuncao WG, Delben JA, dos Santos PH, Tabata LF, Gomes EA, Barao VA. Evaluation of a two-step pouring technique for implant-supported prostheses impression. Acta
Odontol Latinoam 2010;23:8-12.
Bambini F, Ginnetti L, Meme L, Pellecchia M, Selvaggio R. Comparative analysis of direct and indirect implant impression techniques an in vitro study. An in vitro study.
Minerva Stomatol 2005;54:395-402.
Bartlett DW, Greenwood R, Howe L. The suitability of head-of-implant and conventional abutment impression techniques for implant-retained three unit bridges: an
in vitro study. Eur J Prosthodont Restor Dent 2002;10:163-6.
Burns J, Palmer R, Howe L, Wilson R. Accuracy of open tray implant impressions: an in vitro comparison of stock versus custom trays. J Prosthet Dent 2003;89:250-5.
Cabral LM, Guedes CG. Comparative analysis of 4 impression techniques for implants. Implant Dent 2007;16:187-94.
Carr AB. Comparison of impression techniques for a two-implant 15-degree divergent model. Int J Oral Maxillofac Implants 1992;7:468-75.
Castilho AA, Kojima AN, Pereira SM, de Vasconcellos DK, Itinoche MK, Faria R, et al. In vitro evaluation of the precision of working casts for implant-supported restoration
with multiple abutments. J Appl Oral Sci 2007;15:241-6.
Cranin AN, Klein M, Ley JP, Andrews J, DiGregorio R. An in vitro comparison of the computerized tomography/CAD-CAM and direct bone impression techniques for
subperiosteal implant model generation. J Oral Implantol 1998;24:74-9.
Del Corso M, Aba G, Vazquez L, Dargaud J, Dohan Ehrenfest DM. Optical three-dimensional scanning acquisition of the position of osseointegrated implants: an in vitro
study to determine method accuracy and operational feasibility. Clin Implant Dent Relat Res 2009;11:214-21.
Filho HG, Mazaro JV, Vedovatto E, Assuncao WG, dos Santos PH. Accuracy of impression techniques for implants. Part 2 e comparison of splinting techniques.
J Prosthodont 2009;18:172-6.
Howell KJ, McGlumphy EA, Drago C, Knapik G. Comparison of the accuracy of Biomet 3i Encode Robocast Technology and conventional implant impression techniques. Int
J Oral Maxillofac Implants 2013;28:228-40.
Inturregui JA, Aquilino SA, Ryther JS, Lund PS. Evaluation of three impression techniques for osseointegrated oral implants. J Prosthet Dent 1993;69:503-9.
Jang HK, Kim S, Shim JS, Lee KW, Moon HS. Accuracy of impressions for internal-connection implant prostheses with various divergent angles. Int J Oral Maxillofac
Implants 2011;26:1011-5.
Jemt T, Back T, Petersson A. Photogrammetryean alternative to conventional impressions in implant dentistry? A clinical pilot study. Int J Prosthodont 1999;12:363-8.
Lechner S, Duckmanton N, Klineberg I. Prosthodontic procedures for implant reconstruction. 2. Post-surgical procedures. Aust Dent J 1992;37:427-32.
Lee H, Ercoli C, Funkenbusch PD, Feng C. Effect of subgingival depth of implant placement on the dimensional accuracy of the implant impression: an in vitro study.
J Prosthet Dent 2008;99:107-13.
Lee H, So JS, Hochstedler JL, Ercoli C. The accuracy of implant impressions: a systematic review. J Prosthet Dent 2008;100:285-91.
Lee YJ, Heo SJ, Koak JY, Kim SK. Accuracy of different impression techniques for internal-connection implants. Int J Oral Maxillofac Implants 2009;24:823-30.
May KB, Curtis A, Wang RF. Evaluation of the implant master cast by means of the Periotest method. Implant Dent 1999;8:133-40.
Ono S, Yamaguchi S, Kusumoto N, Nakano T, Sohmura T, Yatani H. Optical impression method to measure three-dimensional position and orientation of dental implants
using an optical tracker. Clin Oral Implants Res 2012;24:1117-22.
Papaspyridakos P, Benic GI, Hogsett VL, White GS, Lal K, Gallucci GO. Accuracy of implant casts generated with splinted and non-splinted impression techniques for
edentulous patients: an optical scanning study. Clin Oral Implants Res 2012;23:676-81.
Rutkunas V, Sveikata K, Savickas R. Effects of implant angulation, material selection, and impression technique on impression accuracy: a preliminary laboratory study. Int
J Prosthodont 2012;25:512-5.
Schmitt JK, Adrian ED, Gardner FM, Gaston ML. A comparison of impression techniques for the CeraOne abutment. J Prosthodont 1994;3:145-8.
Stimmelmayr M, Guth JF, Erdelt K, Edelhoff D, Beuer F. Digital evaluation of the reproducibility of implant scanbody tean in vitro study. Clin Oral Invest 2012;16:851-6.
Tarib NA, Seong TW, Chuen KM, Kun MS, Ahmad M, Kamarudin KH. Evaluation of splinting implant impression techniques: two dimensional analyses. Eur J Prosthodont
Restor Dent 2012;20:35-9.
Vigolo P, Millstein PL. Evaluation of master cast techniques for multiple abutment implant prostheses. Int J Oral Maxillofac Implants 1993;8:439-46.
Wee AG, Schneider RL, Aquilino SA, Huff TL, Lindquist TJ, Williamson DL. Evaluation of the accuracy of solid implant casts. J Prosthodont 1998;7:161-9.
Wee AG, Cheng AC, Eskridge RN. Accuracy of 3 conceptually different die systems used for implant casts. J Prosthet Dent 2002;87:23-9.
Wostmann B, Rehmann P, Balkenhol M. Inuence of impression technique and material on the accuracy of multiple implant impressions. Int J Prosthodont
2008;21:299-301.

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