Retrievable Cement And Screw-Retained Implant-Supported prostheses : The Combination Prosthesis
Authors: Dr Nazlı Hilal GÜVENER & Dr Ozlem KARA
Faculty of Dentistry, Department of Prosthodontics, Bezmialem Vakif University, Turkey
Aim : This presentation describes a method to fabricate a retrievable cement and screw-retained implant- supported prosthesis that combines the advantages of both systems.
Cement-retained implant-supported restorations have advantages over screw-retained restorations, such as the passive fit of castings, reduced complexity of clinical and lab procedures, enhanced esthetics, and reduced cost factors. However, a disadvantage of cementing implant- supported restorations is the possibility of residual subgingival cement and the potential difficulty in retrieving the restoration. Should an abutment loosen or any repair of the restoration become necessary, the restoration may be destroyed during the removal procedure if the cement seal cannot be easily broken. Furthermore the retained cement might initiate an inflammatory process, ultimately leading to periimplant bone loss that can compromise success. Excess cement removal with scalers might lead to scratching of the implant/abutment surfaces, which favors plaque adherence and subsequent periimplant disease and possible failure.
Methods/Results: This paper describes a simple, practical, and effective technique for fabricating a retrievable cemented implant restoration. The technique facilitated predictable prosthesis retrieval and allowed for removal of excess cement. Another advantage of the described design is intentional removal of the prosthesis to remove excess cement. This may prevent complications with residual excess cement.
The purpose of this paper is to describe a workflow for the fabrication of cemented posterior metal ceramic restorations. with a metal screw access hole for patients with partial edentulism.
Conclusion: It has been proved that preparing cemented implant supported prosthesis with a screw access hole in the metal framework improved prosthesis survival rates and lowered the cost of maintenance without increasing the risk for porcelain fracture or screw loosening.