Cement-Retained Implants Crowns and Bridges: Best designs to help repairs?
I switched to cement retained implant crowns and bridges for three reasons. First of all, it is more like conventional crown and bridge on natural teeth. Second, it is a lot easier than screw retention. Third, my patients would not accept the diminished aesthetics of a screw hole filled with composite. But, now what I have been finding is that when I need to repair the crowns and bridges, I need to drill through the occlusal or lingual and find the abutment screw channel which can be difficult. I have seen now three new design techniques for making this easier.
One is to design the implant crown so that the screw hole is not covered with metal. In other words when the crown metal framework is cast there is an open channel in the metal framework leading to the abutment screw. The second technique is to use a CBVT scan to record the position of the abutment screw channel. The third is to have the technician make a pin hole through the occlusal or lingual and fill the coronal portion with composite that blends in with the porcelain but fill the cervical portion with a brightly colored composite to make it easier to follow the pin hole channel to the abutment screw.
Are any of you using these technqiues and what has been you experience? Do you have other techniques to recommend?