Hi Mohammed. I use the closed tray technique in the following clinical situations:

1. Single implants. 2. two non splinted implants (eg lower overdenture). 3.Limited mouth opening or implants located at the back of the mouth where long screws will not fit. 4. relatively parallel implants (no more than 2 though) and implants with their long axis parallel to the path of removal of the custom tray.

I use the open tray technique in the following clinical situations:

1. two or more splinted implants.2. implants with 15 degrees of divergence or more. 3.  immediate loading protocol.

Hope i answered your question sufficiently.Best regards.

Hi Mohammed,

our established rationale is:

open tray if only implants are involved

closed tray if natural teeth and implants are treated

Best regards,

Jochen

I would prefer an open tray technique when ever possible.  Usually I use a closed tray technique for the posterior quadrants.  Whatever technique I use, I will then join gold cylinders on the cast and then prove them intra-orally.  When there are errors on the cast I will correct the cast so that it matches the positions in the mouth.

I use open tray mostly because I was trained by Drs. Kenneth Kurtz and Mitchell Pines.

P.S. Hello Ira,  So interesting to see your post.  I miss Mitchell alot.

Sincerely,

JulieK

I fully agree with George Michelinakis. I always use closed tray for single implants and multiple single bounded spaces. 

Since open trays "triple trays"have been shown more exacting and accurate in impressions I use a metal framed "rigid" open tray, "triple tray" from Clinician's Choice for all my crown and bridge.  Just because there is a metal interface of the implant and an organic interface of the tooth, with or without a polymer/metal interface, depending on whether or not you use amalgam or polymer for a build-up, the impression materials used in most practice situations do not react differently to the surface when the surface is clean and "dry".  They will also react the same whether the implant is at 30 degrees or the tooth is at 30 degrees.

I feel open tray technique is better. Reorienting the transfer copings onto the impression is difficult and may not be precise. Especially for multiple implants with different angulation. 

Generally, I prefer open tray as applicable because it allow splinting for impression coping which mean more precise recording. Also the closed tray technique require transferring for the impression coping from patient mouth to impression which may lead to unavoidable movement.

THANKS DR.MOHAMED 

I totally agree with George Michelinakis. i also use closed tray Technic for single implant.

Thank you all for your valuable answers... :)

I use an open tray technique. I believe it is more reliable and allow me to have more control over the impression situation and small details. However,  for a single implant a close technique is also a good choice. In addition, there are systems in the market that are only design to use close tray technique  such as bicon dental implants. At the end, it is a matter of personal choice.

It really doesn't matter what technique you use as long as you get a good impression at the fixture level for the lab to get you a good abutment and crown.

Open tray techniques facilitate the impression if the implants lack parallel placement and the draw of the impression copings are not parallel. If after placement of the impression copings, you feel and assess that the copings are parallel enough to not impede draw, then you can use either technique. It's your choice and inventory in your office that will determine the requirement.

I also do completely agree with Dr.George Michelinakis who provided great pointers for the choice.

Also, at the end of the day, how you load the implants and design occlusion will result in the success.

Hope that helps.

I think it does matter which technique you use. Closed if you can, or open if the implants do not have draw.

I can't agree more with Dr. George .... but ofcours

open tray is better. less chances of distortion 

Closed tray technique is good for single unit implants.  Do not use triple trays, but separate trays for each arch.  A medium or small size full arch mandibular plastic tray is good.  It is advisable to use microscope level magnification of 6-8x or more when making the implant impression.  Microscopes allow you to ensure that the impression coping is maximally seated.  Also, that the impression coping does not move in response to light forces put on it using the tine of an explorer.  You can also use microscopes to ensure that the tray edges do not contact the impression coping. 

In general, a dentist should never restore an implant without using microscope-level magnification.  Too many clinically relevant microscopic details must be observed to have complete control over the implant restoration process, and only microscopes can be used to observe these details.

Agree with john. Rightly said. But these microscopes are costly and not easily available. 

It is possible to obtain 6-8x dental surgical loupes telescopes made-in-china for about $200 USD.  Not too expensive.  The cost will quickly re-pay itself.  3 years experience doing all dental work using microscopes is equivalent to 20 years experience doing dental work using unaided vision and overhead operatory light.  Complication rates of 30-50% for unaided vision dentists plummet to 2-3% for microscope-using dentists.  The massive increase in competence will result in increased revenue from the increase in the dentist's reputation and resulting patient referrals.  Re-make rates from crown and bridge procedures, which obviously require microscope-level precision to fit a hard piece of porcelain precisely over a tooth abutment, will plummet, which alone will save thousands of dollars.

Implant & impression coping seating is primarily important in impression making. The technique is dependant on skills of the Dr. To rule out a gap in the interface of implant & impression an IOPA is made before impression making, As far as you are able to re orient impression coping & implant analog perfectly after impression making any technique is ok

For single implant situation closed tray is fine, but for multiple implant situation open tray is advisable to avoid discrepancies

Open tray impressions are preferred as they provide more accuracy than closed tray techniques. For a single tooth implant site or for a full arch impression the open tray technique provides the best possible accuracy and security of the impression coping(s) when a segment of denture strengthening bar is attached to the impression coping or coolings using a low expansion pattern resin such as GC pattern resin. Doing so fortifies the stability of the impression coping within the impression. An open tray is modified to avoid contact with the open tray impression coping(s) and the attached denture strengthening bar. PVS impression material such as Flextime is molded over the impression copings and loaded in the tray. The tray is then passively seated avoiding contact with the copings and the attached bar.. The impression coping(s) are then uncovered. After the material has set, the impression coping(s) are  unscrewed allowing the impression tray to be pulled without any resistance. Next the stability of the impression copings is manually verified. Implant analogue(s) are then attached and a master cast is susequently fabricated with a soft tissue model for single units. The literature supports the use of the above described technique especially for full arch impressions taken for full arch immediate function procedures such as the All-on-4 treatment concept.