screw bridge question

[Edy]

I am thinking on switching from regular metal bridge which i am using last few years to screw bridge , can u guys give some info on this system , what are the pros and the negatives about this system , should i switch to this or keep doing the regular with glued bridges , is this system only good when u have perfect implants done by the doctor ?i asked a friend here and he told me some problem about this is the screw , it might brake and remain in the implant without having the possibility to get it out from there , this is the only main problem he explained to me , what u say ?

 

[Smilestyler]

I've had screws break off in the abutment before. Yes they a bit of work to get out but not that big of a deal. If you are asking for yourself, then I would suggest you speak to a dentist that you trust for a treatment plan. A lot of info is required before anyone can suggest one treatment over another.

 

[Jo Chen]

Implant placement is critical for screw retained restorations. Posteriors need to have the screw access hole emerge through the central fossa and anteriors through the cingulum. Because the access is through the cingulum for anteriors you often end up with a ridge lap, making for a unfavorable hygiene situation. The screw hole needs to be obturated, often with composite that does not match the surrounding porcelain unless you have a creative ceramist who can fashion a ceramic plug to be bonded in to the screw access hole.
Screw retained bridges may be fastened directly to the implant with the prevailing implant manufacturers torque value or in to intermediate abutments with a reduced torque value around 10 to 15 Ncm depending on implant manufacturer (BioHorizons torques to 35 Ncm regardless). Utilizing intermediate abutments makes for a chain of multiple components, increasing the risk of failure.
The screw access hole can be of significant diameter. This can lead to the occlusal surface being mostly a hole in the case of premolars. Porcelain tends to be weak around the access hole because of limited support. Overcoming this drawback would require carrying a chimney of metal all the way to the occlusal plane leaving a exposed metal rings.
The recent resurgence of screw retained restorations is largely caused by the concern of periimplantitis resulting from excess cement left in the sulcus at the time of delivery. Various techniques are described in the literature on how to avoid this issue.

 

[Edy]

the question is that if its better with screw over the glued crowns ? because from my newbie view of this is


- dentist never uses glue , if there is some change or fix of porcelain , he just unscrew the crown and send it to me

- my favorite thing for me is that i dont need to go and use the parallel stent surveyor handpiece + i will stop buying the abutments and the 15 / 25 degrees abutments are kinda costly here + i will build my metal bridge how ever i see it good without thinking about any abutment problems.

-faster time until finishing the process untill glaze , less sending to the lab with all the abutment measurements from doc.

The only thing i just dont know about how this works , i assume for this system the doctor should take a very accurate transfer measurement right ? what kind of transfer ur doctors use for the accurate measurement

 

[Jo Chen]

the question is that if its better with screw over the glued crowns ? because from my newbie view of this is


- dentist never uses glue , if there is some change or fix of porcelain , he just unscrew the crown and send it to me

- my favorite thing for me is that i dont need to go and use the parallel stent surveyor handpiece + i will stop buying the abutments and the 15 / 25 degrees abutments are kinda costly here + i will build my metal bridge how ever i see it good without thinking about any abutment problems.

-faster time until finishing the process untill glaze , less sending to the lab with all the abutment measurements from doc.

The only thing i just dont know about how this works , i assume for this system the doctor should take a very accurate transfer measurement right ? what kind of transfer ur doctors use for the accurate measurement

Expound, pictures, drawings?

 

[STJDENT]

I screw over 95 & of all bridges. So do everybody in Sweden. If you need to angle screw holes there are few ways to do it ...
You avoid expensive abutments costs, faster, better service, more profitable

 

[Edy]

I screw over 95 & of all bridges. So do everybody in Sweden. If you need to angle screw holes there are few ways to do it ...
You avoid expensive abutments costs, faster, better service, more profitable

Can u explain the proces in few words ? From the doctor until the case is done , so I understand the big picture for a start,Ty

Oh
And if can link the plastic parts u are using while u waxing the bridge to be a support to the screw itself

 

[STJDENT]

You make the model as usual. There are many companies in Europe that makes both plastic or CoCr / Ti standard abutments. You wax, cast, and finally burn the porcelain. I use metal abutments (better precision),wax and cast only vaxpart which then laser welded to prefabricated abutment. Now it is optimal for porcelain.

 

[Edy]

You make the model as usual. There are many companies in Europe that makes both plastic or CoCr / Ti standard abutments. You wax, cast, and finally burn the porcelain. I use metal abutments (better precision),wax and cast only vaxpart which then laser welded to prefabricated abutment. Now it is optimal for porcelain.

u mean that if am working ( like u said with metal abutments ) i get more precision ? hmmm , can u explain why ? because in my opinion if u wax the metal right with the screw technique its the same thing like u wax on metal abutments , i started to thinking more about this screw technique after i saw wonderful works done on this forum.

 

[nvarras]

Metal abutments are precision machined. Much more accurate than any human hand could be.