Сучасні медичні технології (Jun 2022)
COMPARISON OF CEMENT AND SCREW FIXATION OF ORTHOPEDIC STRUCTURES
Abstract
In dental prosthetics, every detail is important, because at this stage, not the aesthetic component is put in the first place, but the issue of engraftment of the implant. This will affect the further quality of life and the condition of the patient’s oral cavity. Therefore, in professional circles there are still discussions about which method of fixing the prosthesis is better - cementing or screw fixation, especially since both of them are widely used in dental surgery. This article will discuss the disadvantages and advantages of these methods. The connection of the implant, abutment and crown can be performed in two ways: fixation on cement - an abutment is fixed on the installed implant with a screw, on which the crown and dental cement are fixed. Screw fixation - the crown is connected to the abutment in advance, in the laboratory, then the finished structure is attached to the implant. For connection, a screw is used, which is inserted into a vertical hole penetrating the crown and abutment. After installing and fixing the crown, a hole remains on the chewing surface (the so-called screw shaft) - it is covered with a composite material. Of course, the screw design is mainly preferable due to the absence of excess cement. Excess cement is a good basis for biofilm formation. The larger the area of the cement joint, the more bacteria appear. But the doctor is not able to use screw fixation in such situations: inconvenient entry into the implant shaft and there is no straight-line entry of the structure. Screw fixation has other advantages and disadvantages. The following advantages are distinguished: the crown can be easily removed; construction details fit exactly; there is no danger of cement getting into soft tissues; less work in the clinic and laboratory. So, when installing a denture, the orthopedist has two options for connecting the main parts of the structure (implant, abutment and crown) - cementing and screw fixation. In the first case, an abutment is fixed on the implant, and a cement-fixed crown is placed on top. During fixation, the screw crown is connected to the abutment in advance, and then the finished structure is attached to the implant itself. The method gets its name from a screw that is inserted into the crown and abutment and leaves a small hole in the crown. This "screw shaft" used to be a serious aesthetic problem, but now it is easily masked by the composite material.
Keywords