Screw Retained Rules

[RileyS]

Since starting up my lab I haven't pushed for screw retained full contour and have a case that a doc wants #2 with zirc abutment and fcz. It's a legacy 4. I was about to ship it off to have ti milled till I saw he wanted the zr abutment. I'm wanting to do screw retained. access hole will be dead center of occlusion.
These cases always make wonder about rules for where access hole can be on crown, obviously not on facial or incisal edge. Any other main rules to consider?

 

[user name]

No reason for a Zr abutment, esp. with a FCZ. You can always angle the access hole some if needed.

Main rule...Dr needs to be able to get the driver in the hole.

 

[CoolHandLuke]

ti base and make it full. no need to complicate it with multiple pieces.

 

[CatamountRob]

There aren't any rules, it's a matter of driver accessiblity and how tolerable the patch job will be to the Dr. and/or patient.

 

[Affinity]

The only rule is follow the rx. Give the dr what they want, even if the access hole is in a bad position. FCZ with a glued TI base is the easiest money I can make.. Id do them all day and plan on it soon.

 

[RileyS]

Textbook material, Fellas! Thanks

 

[Drizzt]

Agree with all the above . Screw retained FCZ have saved my life .

 

[KentPWalton]

Well...the hole also needs to be large enough for the screw to go through as well

as the driver.

 

[rkm rdt]

Hold on a minute!

The angle position of the implant should be the same as the path of insertion.
The contacts can be affected by a poor angle resulting at times in a heavy or open contact and open embrassures.This will sometimes become apparent only after the final tourqe of the screw.

I recommend the dr dust the contacts to be parallel with the implant angle/new path of insertion. They can use the scan body or impression coping to visualize the implant insertion angle.

Thank you and have a great day.

 

[Andrew Priddy]

An angled back screw channel and path of insertion are 2 different things, which I'm sure you know.
I can typically angle one back far enough to get it out of the incised edge.. you may need to core out where the top of the screw hits on the inside facial.. the driver should follow fine as it.s a little thinner... but definitely no need to hollow out the whole access hole up to the incisal. edge

also, there are a few design flaws out there.. if designing under Nobel 3shape library, you can not run an angled screw channel, the software doesn't allow for it. (which I find ironic since they are pretty proud of the Omni)
argen lets you run up to 15 degrees I believe, which is a little problematic going back that far

 

[lcmlabforum]

They probably limit your option to make your own ASC/Omni, so you can pay them the big bucks to make the Procera version of the Omni . . . just wondering out loud.
LCM

 

[Andrew Priddy]

DESS makes an Omni, i'm looking forward to using it at some point on a full arch

 

[Brett Hansen CDT]

I have fabricated a few hundred monolithic e.Max or FCZ screw-retained crowns on Ti abutments in the last couple of years. Making nice broad contacts with the adjacent teeth can be an issue with this style of restoration if the implant orientation isn't parallel with the contacts of the neighboring teeth. This is the first thing I look for after the model has been poured up. If the contacts will be an issue, I give the doc a call to let them know and see if they want to modify the contacts or go to a cement retained crown. The other issue I have run into is when the abutment screw channel is too lingualized. This can weaken the crown because their isn't enough material around the screw hole.

Screw-retained hyrbrid monolithic implant restorations are now the standard for almost all of my doctors. They love them.

 

[GG - J]

Have done a few ASC with noble
are a little $ but have worked out well
can you post a link for omni

 

[Andrew Priddy]

http://www.dess-usa.com/
you need their driver though,,, your nobel Omni won't work