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Implants
4-unit, 2-implant cement-retained bridge... Engaging or non-engaging abutments?
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<blockquote data-quote="ddsTech" data-source="post: 295701" data-attributes="member: 1467"><p>I appreciate everyone's input on this. All good responses. Thanks very much! </p><p></p><p>The concept of non-engaging abutments reducing the load on the screws, as Sda36 mentioned, is what keeps me coming back to this idea of cutting off the engaging element. If the bridge is cemented though, doesn't this already minimize that strain on the implants and screws as long as the bridge fits passively? I'm thinking that the screw strain issue is a much bigger factor for screw-retained restorations. If everything isn't perfect with a screw-retained bridge, something has to break, remodel or orthodontically move to relieve that strain. Not so with a cemented bridge that fits passively, correct?</p><p></p><p>KTR - valid point about trouble aligning the abutments properly without the engaging elements. If I did remove them, DrG's suggestion of using the FPD as the seating jig should be accurate enough to align them correctly, I would think?</p><p></p><p>Keith Goldstein, I love the concept of the Angled screw channel ti bases non engaging you mentioned. It would solve many issues I'm seeing in cases. Question.... is the bond strength of the bridge to the Ti base great enough to support tall restorations? If a bridge or crown is 10mm in height, is the cement bond enough to hold the restoration in place?</p><p></p><p>DrG, that's exactly how I'm doing the case. The Atlantis abutments are done, with draw like a traditional FPD case. Unfortunately, we've had some screw loosening issues in the past, so the Dr. wants access to the screws. </p><p></p><p>As Contraluz mentioned in his post, regarding larger cases, Dr. Carl Misch talks a lot about using "soft access" cements that make these cemented bridges "removable" without cutting screw access channels in the restoration. Bosworth Super EBA zinc oxide eugenol cement is an example of a "soft access" cement he uses. Another one is a polycarboxylate cement, Duralon. He gives different indications for each. I'd love to know how difficult it is to remove an implant-supported FPD cemented with these cements. If I read Dr. Misch correctly, this is his preferred was to go over screw-retained restorations.</p></blockquote><p></p>
[QUOTE="ddsTech, post: 295701, member: 1467"] I appreciate everyone's input on this. All good responses. Thanks very much! The concept of non-engaging abutments reducing the load on the screws, as Sda36 mentioned, is what keeps me coming back to this idea of cutting off the engaging element. If the bridge is cemented though, doesn't this already minimize that strain on the implants and screws as long as the bridge fits passively? I'm thinking that the screw strain issue is a much bigger factor for screw-retained restorations. If everything isn't perfect with a screw-retained bridge, something has to break, remodel or orthodontically move to relieve that strain. Not so with a cemented bridge that fits passively, correct? KTR - valid point about trouble aligning the abutments properly without the engaging elements. If I did remove them, DrG's suggestion of using the FPD as the seating jig should be accurate enough to align them correctly, I would think? Keith Goldstein, I love the concept of the Angled screw channel ti bases non engaging you mentioned. It would solve many issues I'm seeing in cases. Question.... is the bond strength of the bridge to the Ti base great enough to support tall restorations? If a bridge or crown is 10mm in height, is the cement bond enough to hold the restoration in place? DrG, that's exactly how I'm doing the case. The Atlantis abutments are done, with draw like a traditional FPD case. Unfortunately, we've had some screw loosening issues in the past, so the Dr. wants access to the screws. As Contraluz mentioned in his post, regarding larger cases, Dr. Carl Misch talks a lot about using "soft access" cements that make these cemented bridges "removable" without cutting screw access channels in the restoration. Bosworth Super EBA zinc oxide eugenol cement is an example of a "soft access" cement he uses. Another one is a polycarboxylate cement, Duralon. He gives different indications for each. I'd love to know how difficult it is to remove an implant-supported FPD cemented with these cements. If I read Dr. Misch correctly, this is his preferred was to go over screw-retained restorations. [/QUOTE]
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4-unit, 2-implant cement-retained bridge... Engaging or non-engaging abutments?
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