So many of us are getting away from screws coming through the occlusal surface for our dental implant supported cronws because of esthetics. But even torqued down screws have became loose under cemented implant crowns. I have checked the occlusion and even placed cement in the screw holes.
Any thoughts?
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use an implant system with an internal attachment instead of an external hex. loose screws will be very rare.
If you keep using screw retained prostheses,
ask your technician to bevel the occlusal surface of your ceramic and use opaque composite like Kolor+ from Kerr company to hide the access hole; you’ll get excellent esthetic results and easy access to implant if necessary; internal hex is safer but there is no safety in terms of absorbing occlusal overloadings if any. loosing screws are better than implant fracture or periimplantitis…
The implant load certainly will cause the loosening of the screw. Great idea about the Kolor or opaque composite.
I agree about internal attachment but it the older implants that were external hex
If you send the abutment to the lab, don’t send the screw. Make them buy “lab screws” for use on cases in the lab. The screw you are using to place the restoration MUST be in virgin condition. Many labs will use that screw while making the restoration….something you don’t want. We try to be careful but not all things work as we plan. Also, you might consider using Ceka Bond on the screw.
Wow…..I never knew this about the screws and the Ceka Bond that does work well but a suggestion that many do not know about.
If you srew the abutment to your implant wait 5 min. After 5 min. there will be some relaxation in the screw and the torque has deminished. Torque it once again and the screw hold longer. When the screw comes loose and you did use permanent cement you can drill a whole to the screw and now you have a direct screw abutment-crown to your implant and you can treat it as a screw type crown. Good luck