Covering Occlusal holes in screw retained crowns?
I prefer implant screw retained crowns and bridges wherever possible and explain the merits to patients. Fortunately, most patients understand the rationale behind this. However, on the odd occasion I have had a couple of patients who did not like the greyish appearance the occlusal composite takes when obscuring the occlusal access hole. My question is what is the best way to disguise this so that it blends in more seamlessly with the crown and so that we lose the grayish tinge ( (let’s assume the patient does not want to pay the extra for a zirconia abutment). What materials and techniques are you using to cover over the occlusal access holes?
11 Comments on Covering Occlusal holes in screw retained crowns?
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Leal
7/27/2015
Use Renamel Creative Color Opaquer Pink in the metal areas. The 2,5gram flowable syringe lasts forever. Use very thin amounts at a time. I have never tried an opaquer as aggressive as the Renamel one. Then it's all about basic dentistry (dentin, body, enamel, translucid, etc.).
Ibrahem Soubt
7/27/2015
Cover the metal surface with a thin layer of Flowable Empress Direct Opaquer, light cure it then add a layer of the desired shade of universal composite like Tetric Evo Ceram or Tetric N Ceram..that's it
Nathan Vassiliades
7/28/2015
If you have a Cerec you can mill an emax inlay to fill the hole.
peter jorgenson
7/28/2015
have your ceramist supply the ceramic/zirconia core plug. seat with flowable composite. to retrieve (why) use slimline tared fissure bur to score composite around plug and pop out core plug.
Robin Rother
7/28/2015
In addition to previous answers my routine is to treat the porcelain margins of the hole with HF gel for a minute. Then apply silane and a bond. Opaque as mentioned above and seal with composite. Simple, rapid and inexpensive. This gets round the later problem of stain infiltration too.
mwjohnson dds, ms
7/28/2015
to eliminate the show through make your crown out of monolithic emax or zirconium. Have a screw hole already pressed or milled into the crown. The abutment can be any material but I like titanium or gold anodized titanium posteriorly. After you seat the abutment and try in the crown then cement the crown to the abutment with permanent cement. This takes the two pieces and makes them one screw retained prosthesis. The composite plug blends seamlessly with the all ceramic restoration.
Adam
7/28/2015
I agree using monolithic zirconia helps I also use plumbers tape white and then Premise XL1 and Premise XL2 they are highly opaque but still a nice colour and this seems to cover the grey really well.
Dan Stragier
7/28/2015
Place plumber's tape in the screw hole (usually 3\4 of an inch will do) packed tight to 3mm below the occlusal surface. (this is really easy to pick out if you ever need to access the screw). Keep it DRY. Place a thin layer of masking agent to cover all metal and tape, but not the porcelain. Cure the masking agent. (I use 3M white masking agent paste). Porcelain etch the masking agent and porcelain, then use your silane primer. Finally place the matching composite. Hope that helps.
Katona Tamás Dr.
7/29/2015
I prefer to use ADC ceramic repair kit. It contains most of above mentioned materials, and has great opaquer. Average people won't know where those holes are. Regards, and thank You for sharing all stuff.
Tony Collins AM
7/29/2015
Have your ceramist make the access hole slightly wider and fire porcelain down the tube for 2 - 3mm. Then use your matching composite.
Dean tanaka
8/6/2015
Try this:) Teflon, then Fuji IX. Blocks the grey very nicely. And it's soo easy.
