Newsletter

The clinical performance of dental implant restorations may be influenced by many factors, not the least of which is the fit/adaptation between the prosthesis and the supporting implants. In turn, implant prosthesis fit may be influenced by impression and scanning accuracy, prosthesis design, components used, a wide variety of manufacturing elements, clinical placement of the definitive restoration and subsequent prosthesis maintenance. While reams of literature have been published on the topic of implant restoration fit, this issue of the Prosthodontics Newsletter will review select studies of a few critical considerations that will help practitioners improve the delivery of care.

Central to reliable dental implant restoration is the dentist’s capacity to understand and appropriately manage prosthesis retention screws. In this respect, dentists have truly become modern-day oral engineers. Predictable therapeutic success requires an appreciation of screw-joint preload, screw-torque maintenance during function, and screw lubrication and its impact on preload, along with factors influencing the anticipated loss of preload over time and reliable mechanical generation of preload using the appropriate tools. In this issue of Prosthodontics Newsletter, we review some of the current literature detailing the application of prosthesis retention screws in successful implant dentistry.

In the past, labial implant projection in the anterior maxilla might have required prosthetic screw access through facial or incisal restoration surfaces. Introduction of the angled screw channel (ASC) concept permitted prosthetic screw tightening using a hexalobular, sphere-shaped driver that engages the screw at various angles. This allows the screwdriver and the restoration’s screw channel to follow an orientation different than the implant’s long axis to emerge more esthetically through the restoration’s palatal surface. While the ASC design may have solved the esthetic concern, other problems may arise. This issue of Prosthodontics Newsletter looks at recent research on the ASC.

The movement of teeth adjacent to dental implant restorations is a perplexing and complicated phenomenon that may relate to normal alveolar growth, functional occlusal loading or parafunctional occlusal activities, or it may have some multifactorial etiology. Although understanding the factors that may lead to adjacent tooth movement is important, the mere fact that it occurs is an essential consideration in treatment planning, restoration and maintenance protocols.

To provide optimal implant-based clinical care for partially edentulous patients missing 2 to 3 teeth, the practitioners must consider implant location and design of the restoration prior to implant surgery.

The relatively recent development of titanium base abutments for implant-supported fixed prosthodontics, particularly single implant restorations, was intended to solve key laboratory and clinical problems.

While over the past several decades implant therapy has been remarkably successful in addressing challenging patient needs, the wise practitioner remains informed about potential surgical, treatment and posttreatment complications.