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Treatment guidelines

Screw-retained vs. cement-retained

Key points

  • The restorative dentist determines the retention mechanism (This may or may not be with patient input).
  • Screw retention provide retrievability but may compromise esthetics and strength.
  • Cementing implant retained full crowns is consistent with routine fixed dental prosthesis fabrication.
  • Cements for natural teeth may not be ideal for dental implants.
  • Excess cement retention may lead to late implant failure.

Additional resources

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Videos

Chandur Wadhwani: The impact of cement, its techniques and protocols for long term outcomes

Residual cement is considered a main causal risk factor for peri-implant disease. Cement remnants causing microbial activity, immune reaction, allergic response, activation of titanium surface may be the route by which bone is lost around implants. Dr Wadhwani discusses the...
Peri-implantitis
Implant prosthetics
Fixed prosthetics
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Videos

Eric Rompen: Long-term tissue health and stability - how to achieve

Stable and healthy soft tissue conditions are important for the longevity of implant restorations and crucial for their esthetic success, especially in the esthetic region. Dr Rompen is reviewing aspects of the biological width and gingival biotypes and is discussing important...

CAD/CAM
Implant designs
Immediate implant placement

Digital Textbooks

eBook: Single Implants and their Restoration
Single implants and their restoration
When any restoration, provisional or definitive, is cemented over an abutment, the force of the expressed cement can displace the peri-implant mucosa and cement can be forced apical to the crown margin. Therefore, complete removal of all the excess cement is essential to prevent adverse peri-implant responses from the soft tissue or bone. Problems associated with residual cement left behind from incomplete cement removal were first reported in 1999. The potential post-cementation problems that can arise include bleeding, soreness, acute swelling, the presence of purulent exudate, and over time even radiographic evidence of actual bone loss.
eBook: Single Implants and their Restoration
Single implants and their restoration
With single implant supported crowns adverse outcomes have been categorized as biological, mechanical, or esthetic complications. The authors of a systematic review indicated lower rates occurred with biologic, mechanical, and esthetic complications in the more recent studies but they still judged these incidence rates to be high.

Questions

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