Abstract
Implant prostheses were classified into screw-retained prosthesis and cement-retained prosthesis by their method of retaining, and there is screw and cement retained implant prosthesis (SCRP) which has been made reflecting the strengths of these two. The advantages of the SCRP technique are easy retrievability and passive fit of implant prostheses. However, the occlusal screw holes of implant prostheses can be thought as a disadvantage with respect to esthetics and occlusion. Inappropriately positioned implants also limited the use of the SCRP technique. The present study is reporting about the case where nine implants (US II, OSSTEM, Seoul, Korea) were placed in maxilla and eight in mandible respectively in fully edentulous patients. Then, the cement-retained prosthesis was applied for the part in which the screw hole positioned improperly, and screw-retained prosthesis for properly positioned implants so that the combined screw-cement prosthesis has been produced where the satisfying result has shown in both function and esthetics. Three-year follow-up has been done for the patient.
Figures and Tables
Fig. 1
Pre-operative intraoral view (A, B and C) and panoramic radiograph (D) after 3-month extraction.
A: Occlusal view of maxilla, B: Occlusal view of mandible, C: Anterior view and D: Pre-operative panoramic radiograph.
![jkap-50-318-g001](/upload/SynapseData/ArticleImage/0084jkap/jkap-50-318-g001.jpg)
Fig. 3
Impression taking and master model fabrication.
A, B: Pick-up impression coping of maxilla and mandible connected with Duralay resin, C, D: Impression of maxilla and mandible, E, F: Master cast of maxilla and mandible.
![jkap-50-318-g003](/upload/SynapseData/ArticleImage/0084jkap/jkap-50-318-g003.jpg)
Fig. 4
Abutment positioned onto implant replica, Duralay resin modification and abutment milling used to correct implant angulation.
A: Plastic sleeve of UCLA abutments of maxilla modified with Duralay resin and milling, B: Plastic sleeve of UCLA abutments and ER abutments (arrow) of mandible modified with Duralay resin and milling, C: Customized abutments of maxilla fabricated with UCLA abutment, D: Customized abutments of mandible fabricated with UCLA and ER abutments (arrow).
![jkap-50-318-g004](/upload/SynapseData/ArticleImage/0084jkap/jkap-50-318-g004.jpg)
Fig. 5
Metal framework fabrication.
A, B: Metal-ceramic waxing of coping on prepared abutment and wax cut-back, C, D: Casted metal framework with access channel of occlusal screw.
![jkap-50-318-g005](/upload/SynapseData/ArticleImage/0084jkap/jkap-50-318-g005.jpg)
Fig. 6
Abutments positioned in the mouth and following check of metal framework.
A: Right buccal view, B: Frontal view, C: Left buccal view, D: Upper occlusal view and E: Lower occlusal view.
![jkap-50-318-g006](/upload/SynapseData/ArticleImage/0084jkap/jkap-50-318-g006.jpg)
References
1. Misch CE. Screw-retained versus cement-retained implant-supported prostheses. Pract Periodontics Aesthet Dent. 1995. 7(9):15–18.
2. Chee W, Felton DA, Johnson PF, Sullivan DY. Cemented versus screw-retained implant prostheses: which is better? Int J Oral Maxillofac Implants. 1999. 14:137–141.
3. Misch CE. Contemporary implant dentistry. 1999. 2nd ed. St. Louis: Mosby Inc.;549–593.
4. Hebel KS, Gajjar RC. Cement-retained versus screw-retained implant restorations: achieving optimal occlusion and esthetics in implant dentistry. J Prosthet Dent. 1997. 77:28–35.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
5. Michalakis KX, Hirayama H, Garefis PD. Cement retained versus screw-retained implant restorations: a critical review. Int J Oral Maxillofac Implants. 2003. 18:719–728.
6. Taylor TD. Prosthodontic problems and limitations associated with osseointegration. J Prosthet Dent. 1998. 79:74–78.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
7. Zarb GA, Schmitt A. The longitudinal clinical effectiveness of osseointegrated dental implants: the Toronto study. Part III: Problems and complications encountered. J Prosthet Dent. 1990. 64:185–194.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
8. Breeding LC, Dixon DL, Bogacki MT, Tietge JD. Use of luting agents with an implant system: Part I. J Prosthet Dent. 1992. 68:737–741.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
9. Goodacre CJ, Kan JY, Rungcharassaeng K. Clinical complications of osseointegrated implants. J Prosthet Dent. 1999. 81:537–552.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
10. Pauletto N, Lahiffe BJ, Walton JN. Complications associated with excess cement around crowns on osseointegrated implants: a clinical report. Int J Oral Maxillofac Implants. 1999. 14:865–868.
11. Aparicio C. A new method for achieving passive fit of an interim restoration supported by Brånemark implants: a technical note. Int J Oral Maxillofac Implants. 1995. 10:614–618.
12. Preiskel HW, Tsolka P. The DIA anatomic abutment system and telescopic prostheses: A clinical report. Int J Oral Maxillofac Implants. 1997. 12:628–633.
13. Voitik AJ. The Kulzer abutment luting; Kal technique. A direct assembly framework method for osseointegrated implant prostheses. Implant Soc. 1991. 2:11–14.
14. Rangert B, Jemt T, Jörneus L. Forces and moments on Branemark implants. Int J Oral Maxillofac Implants. 1989. 4:241–247.
15. Kan JY, Rungcharassaeng K, Bohsali K, Goodacre CJ, Lang BR. Clinical methods for evaluating implant framework fit. J Prosthet Dent. 1999. 81:7–13.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
16. Kallus T, Bessing C. Loose gold screws frequently occur in full-arch fixed prostheses supported by osseointegrated implants after 5 years. Int J Oral Maxillofac Implants. 1994. 9:169–178.
17. Kim SG, Park JU, Jeong JH, Bae C, Bae TS, Chee W. In vitro evaluation of reverse torque value of abutment screw and marginal opening in a screw- and cement-retained implant fixed partial denture design. Int J Oral Maxillofac Implants. 2009. 24:1061–1067.
18. Lindström H, Preiskel H. The implant-supported telescopic prosthesis: a biomechanical analysis. Int J Oral Maxillofac Implants. 2001. 16:34–42.