BACKGROUND: Several studies have assessed the accuracy of the indirect snap-on impression technique. However, some impression techniques that utilize plastic snap-on impression copings have not yet been investigated. OBJECTIVES: This study aimed to assess the three-dimensional (3D) accuracy of innovative implant-level impression techniques with plastic impression copings and the splinted open-tray technique with metal impression copings. MATERIAL AND METHODS: This in vitro study used a reference model of the mandible with 4 parallel dental implants. Forty impressions were made with polyether impression material, using the splinted opentray technique with metal impression copings (SOM group), the non-splinted closed-tray technique with snap-on impression copings (NCS group), the non-splinted open-tray technique with snap-on impression copings (NOS group), or the splinted open-tray technique with snap-on impression copings (SOS group); n = 10 per group. Linear discrepancies in the inter-implant distances on the obtained casts were determined in the X, Y and Z axes with the use of a coordinate measuring machine. Subsequently, the 3D accuracy of each impression technique was calculated. Data was analyzed by means of the one-way analysis of variance (ANOVA) followed by Tukey's post-hoc tests. RESULTS: Among different impression techniques, the amount of linear discrepancy was significant only for the Z axis. The SOM, NOS and SOS groups showed less discrepancy in this axis as compared to the NCS group (p < 0.001). A significant difference was also noted in 3D discrepancy (p = 0.022), with the SOM group showing a significantly higher discrepancy as compared to the SOS group (p = 0.016). CONCLUSIONS: The 3D accuracy of the implant-level splinted open-tray impression technique with plastic snap-on impression copings was significantly higher than that of the splinted open-tray technique with metal impression copings.
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