Dental implants are a stem screw inserted directly into your jawbone, replacing your missing tooth root. Once inserted, the bone on which you are operating your implant will fuse with them, holding the implant housing in place. Then, with the crown made on it, you will regain a functional and aesthetic appearance.
With every tooth you lose, a piece of your quality of life comes out. Implants offer your veneers the possibility of permanently with the closest stability and surface grade to natural teeth.
Like anything to permanently limit your life, getting a dental implant is no small decision. In addition to many things that should enlarge the treatment, the important thing is whether the implant will be screwed or screwless, although they usually do not know much about the people who will get it done.
Screw-retained Implants
Screw-retained implants are free from potential complications as they are not used to attach the implant to the abutment and the abutment to the crown.
Although clinical performance is similar to both screw and cement implants in terms of failure rates, a recent study found that, overall, screw-retained restorations have less biological and technical regulation. The adhesive can provide a favorable environment for bacteria that can cause contamination problems and future implant failure.
Extracting a great advantage of screw-protected restorations. If complications arise, the issues can be handled more easily thanks to the protective nature of the crown or abutment. This allows for simplified removal of the implant for materials, cleaning, direct visualization of the implant, or soft tissue examination. The ability to handle organs that have to rebuild, or wear and tear, is a reason for the high popularity of screw-retainedimplants. While the screws can loosen the routine, retightening is a simple solution.
What screw-retained implants offer in terms of value is offset by their lack of aesthetics. As these implants are screwed into the post through the abutment, a visible screw hole remains in the prosthesis. The screw access hole usually looks similar, even when coated with composite. This is a major concern for patients, especially with anterior implants where lengthening is critical.
Cement-retained Implants
Cement-retained implants offer superior aesthetics compared to their screw-retained counterparts. This is because an access hole is required when affixing the prosthesis directly to the implant abutment. The resulting appearance is more like a natural tooth.
Along with advances in cement retainers, new radiolucent cements make it even easier to achieve a natural look. However, the fact that they are almost invisible makes these holes difficult to clean.
This difficult cement removal can have important implications for the success of the restoration. Modern cements are often difficult to see, which means it’s easier to accidentally leave residual cement behind. As we mentioned earlier, this excess cement creates a great environment for bacteria that can compromise osseointegration and increase the risk of cement failure or gingivitis and infection. Poor removal of excess cement has also been associated with an increased risk of peri-implantitis and peri-implant mucositis.
Removability is a challenge with cement dentures. A major disadvantage of cement implants is that there are few options when repairs or adjustments are required. Because the restoration is cemented to a screwed abutment, there is no way to remove the restoration if the screw loosens. Generally, this results in complete destruction of the restoration to gain access to the screw.
Fortunately, cement-retained implants have a higher resistance to porcelain breakage than screw-retained alternatives, so the restoration could, in theory, retain its aesthetics and structure longer. However, if an implant crown with adhesive needs repair, this often means that the entire restoration has to be rebuilt, at extra cost for the patient.
In conclusion;
Clinicians need to evaluate each case and its indications separately and make determinations accordingly. Cement-retained implants are a good choice when aesthetics is at the forefront. Where aesthetics is a lower priority, screw-retained restorations provide greater flexibility and eliminate the risk of infection or implant failure due to excess cement. Regardless of the retention method chosen, with careful planning and execution, practitioners can create a long-lasting restoration that meets the patient’s needs.
