SPECILIATIES OF CEMENTATION AND SCREW-RETAINED TECHNIC FOR IMPLANT CROWNS

There are two common types of bonding the implant crowns: screw-retained and cement-fixed methods. We will mention about speciliaties of these two technic here.

ADVANTAGES AND DISADVANTAGES OF CEMENTATION

Gluing technique called cementation is the most widely used method in dental implant applications. Some of advantages of cementation technique are:

• No hole for screwing,
• Tolerance of inclined implants,
• Easy placement due to the formable cement layer.

One of the disadvantages of cementation is that the excess cement remaining between the crown and gingival tissue may cause peri-implant problems in the future. According to the research and experiences shows that the leakage of cement material into the subgingival spaces with pressure exerted during the placement of the crown results in gingival problems in later periods and this excess amount needs to be carefully removed.

Due to the data obtained on the above-mentioned peri-implant problems related to the cementation technique, in some recent publications, the use of this method is recommended in certain cases. As a result of this, it is highly recommended that cementation technique should be applied carefully by an expert.

WHAT IS SCREW-RETAINED AND HOW TO APPLY?

The screw-retained method has the advantage of being easy to adjust for some changes that may need to be made later. For example, it is easier to remove for later maintenance or when surgical intervention is required. The fact that the angle of attachment can be variable also increases its usability. With the innovations made in the screw-retained technique, serious ease of use has been provided. Nobel Biocare's recently introduced the ASC (Angulated Screw Channel) abutment allows angles of up to 25 ° for screw entry.

In addition, screw retention requires fewer components, which makes it more compact. Because of this tehnique doesn’t contain cement there will be no irritation of gingival tissue by excess adhesive material. However we can say that occlusal hole may be counted as a disadvantage, albeit aesthetically small.

WHICH METHOD -SCREW-RETAINED OR CEMENT-FIXED- SHOULD CHOSEN?

As mentioned, both techniques have pros and cons. Academic publications on the subject and some experience have shown that which of the two methods is to be used should be evaluated according to the case by a specialist dentist. Before deciding the procedure, the risks of peri-implant should be taken into consideration according to the area where the crown will be located (anterior, posterior, upper or lower) as well as aesthetic factors. Retrievability is also an important factor to consider.

While single tooth treatment is performed, there may be technical problems with screw-retained method and cement technique may cause biological problems. Dynamic abutments and ASCs provide ease of use, especially in the front aesthetic area. In addition, screw retention should be particularly preferred in arc implant treatments.