The Screw versus Cement Debate: Will that be Peri-implant Disease by Misfits and Poor Access to Care or Bad Margins and Subgingival Cement?

The Screw versus Cement Debate: Will that be Peri-implant Disease by Misfits and Poor Access to Care or Bad Margins and Subgingival Cement?

Will that be Peri-implant Disease by Misfits and Poor Access to Care or Bad Margins and Subgingival Cement?

Abstract: Patients that have their prostheses installed by current screw-in and cement-in installation systems are exposed to a multitude of risk factors for complications. What appears to be lacking in the dental industry is a basic understanding of the root causes of these installation-specific complications. Without this knowledge and related terminology, it is difficult to discuss and develop new systems of installation that can make treatment better. We know that peri-implant disease is largely a consequence of infection of the peri-implant tissues by oral pathogens. The question is, can dentists reduce the microbial challenge around teeth and the peri-implant environment? Can dentists reduce the uncleanable spaces that foster the growth of oral pathogens between misfit implant parts, under prosthesis cantilevers, under overhanging and in open margins, and on residual subgingival cement? The root causes of the risk factors for mechanical complications and related biological complications are “Prosthesis Dimensional Error and the Tissue Effects”. Two of the Tissue Effects have been identified as the Resistance to Displacement Effects and the Gingival Effects. This article reveals how to reduce complications by exploiting CAD/CAM technology to create prosthesis designs and installation protocols that are sensitive to the root causes of treatment complications and can thus mitigate their negative effects. 

Citation: Svoboda ELA. Screw versus Cement Debate: Will that be Peri-implant Disease by Misfits and Poor Access to Care or Bad Margins and Subgingival Cement? 2021 Spectrum Implants V12 N4:38-47. Or at www.ReverseMargin.com

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Correspondence: [email protected]. Dr Svoboda is in private practice placing and restoring dental implants. He invented the Reverse Margin System and holds patents on the design aspects of both the crown and abutment. Related publications are available at www.ReverseMargin.com

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