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One of the most challenging undertakings in dentistry for both the clinician and the laboratory is a full mouth reconstruction. For patients who present with excessive wear of their dentition, a full mouth reconstruction is critical in re-establishing functional harmony, pulpal health, esthetics, and protecting the dentition from further damage.
Complex dental cases require proper treatment planning to ensure a successful outcome. These cases must consider the patient’s concerns and desired result as a starting point and then create a
One of the most common options for treating an All-On-4® case is a hybrid prosthesis. But all “hybrids” are not created equal. We are a long way from the days of the only option being a cast metal substructure with traditional acrylic and denture teeth.
Teeth play an important role in daily life. They are not just for chewing, but they also help with speaking clearly, give faces shape, and correct support. Teeth can also
Implant Retention Methods: Critical Decisions for Success
Written by Andrew Sedler
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Millions of people experience tooth loss. The American Association of Oral and Maxillofacial Surgeons states that tooth loss affects about 69% of adults aged 35-44 years old. The implant market in the U.S. was valued at 1.1 billion in 2018 and is slated to grow by a 5.1% compound annual growth rate over the next few years, according to information from iData Research. There is no question that the exceptional advantage that implant therapy has over other treatment options is fueling this growth.
Implant rehabilitation can dramatically improve a patient’s quality of life. One of the main advantages is that an implant will provide normal oral processes like proper mastication. They can last a patient a lifetime, and due to their ability to take the place of a natural tooth, they help to prevent bone loss by providing stimulation in the jaw. Implants also play a significant role in keeping surrounding dentition stable and provide support in keeping patients free from gum disease.
It is no wonder then that implants have become a preferred method in restoring missing teeth. After deciding on this treatment option and setting the proper foundation for implant placement, one of the biggest questions is whether or not these implant restorations should be screw-retained or cement-retained. There is then a clinical decision that must be made that involves what type of restoration would work best as related to retention.
This decision of implant crown retention is dependent upon three key factors: the strength of the restoration, peri-implantitis risks, and aesthetics.
Cement-retained Implant Restoration
Cement-retained implant restorations are used in dentistry often, and the process of placing these types of restorations is a familiar one to most clinicians. One of the main benefits of these types of restorations is esthetics, as there is no screw access hole. The lack of a screw access hole can also help with providing ideal occlusal anatomy and occlusal load.
These restorations can be cemented over a custom abutment when there is challenging implant angulation. The margins can be placed right at or slightly below the tissue surface to help with cement removal. Another benefit is that since they are made from custom-designed abutments that mimic an ideal preparation, this can help to provide a natural emergence profile, a passive seat, excellent retention, and improvement with the load forces.
Advantages of cement-retained restorations:
Issues with abutment screws loosening are significantly reduced in cement-retained restorations.
Crowns are less likely to come off and be lost.
Porcelain failure is reportedly not common in cement-retained crowns.
When implants are angled too far to the facial and the access hole is exiting through the facial, cement-retained restorations can provide an excellent solution to this issue.
Some patients can find a screw access hole objectionable. Overall, cement-retained restorations can be a more esthetic option.
Along with the many benefits, these restorations also have some disadvantages, and these must be considered when evaluating the optimum treatment options.
Disadvantages of cement-retained restorations:
Residual cement that is left behind at the implant site is a crucial factor leading to peri-implantitis. (See the above image.)
Cement-retained restorations are more challenging to retrieve should the need arise.
These restorations are not indicated in cases where interocclusal space is limited, as they will have poor retention.
Screw-Retained Implant Restorations
Screw-retained restorations are another option that should be considered when cases are indicated for these restorations. These restorations are best suited when the implant is placed ideally. Because they are retained with a screw, there is no danger of residual cement being left behind, which can cause damage to the patient’s tissue and bone.
These restorations can be easily removed to check the implant site. The margin of these restorations can be placed well below the tissue reducing the chance of the titanium showing through the gums.
Peri-implantitis is not as common in screw-retained restorations due to the elimination of cementation.
It is easy to remove the restoration because of the screw access hole.
Screw-retained restorations work well when there is limited interocclusal space.
Along with the benefits and indications, there are also some disadvantages of using screw-retained restorations.
Disadvantages of screw-retained restorations:
The access hole may compromise the strength of the restorative material, thereby increasing the chances of restoration failure.
Screws can become loose over time, leading the restoration to fall out and get lost.
These restorations are dependent on the angulation of the implant in terms of where to place the access hole. This can lead to the access hole being placed in an undesirable area.
Some patients have esthetic concerns regarding the access hole.
It is important to note that many advances are being made with both cement-retained and screw-retained restorations to help mitigate the disadvantages associated with each of these restorations. For example, in the case of screw-retained restorations, setting the proper foundation, planning, and ultimately placing these restorations can open up more opportunities to use this modality and take advantage of being able to retrieve them when necessary. Also, with the introduction of angulated screw channels, the ability to use screw-retained restorations has expanded.
The most significant problem with cement-retained restorations is the difficulty in removing all of the residual cement from the implant site. Custom abutments can be designed with supragingival margins to create an easier cement removal process to help with this problem.
As in almost all restorative procedures, the importance of proper planning plays a big part in the overall success of the case. Understanding the advantages and limitations of each restorative option can help in determining the best way to proceed.
In implant cases, understanding the differences between screw-retained and cement-retained restorations plays a big part in ensuring a successful outcome.
Most importantly, staying on top of new developments, techniques, and materials is essential in providing patients with the very best options available. The Burbank Dental Lab implant team is available to offer support and help in planning these cases and recommending the best retention method for a specific case.
BiteSoft® splints prevent teeth from grinding and clenching during the night. This innovative, successful solution to bruxism offers patients the opportunity to sleep peacefully throughout the night, without damage to their teeth or restorations.
Zir-MAX.M, and Zir-MAX.Me are high strength monolithic zirconias that exceed your expectations for zirconia restorations, ideal for use in full and single crowns and bridges.
Burbank Dental Lab's Smiles By Design diagnostic wax-ups are the blueprint to your final restorations. Your Smiles By Design team custom designs each case to meet your specifications, and always has the goal to create a functionally sound and esthetically pleasing design.
DuraTemps are laboratory fabricated provisional restorations that are much more durable and esthetic than traditional chair-side fabricated provisionals, even rivaling the finished restorations.
SMART 1® abutments are custom engineered to best meet each patient’s case needs. Burbank Dental Lab uses the most advanced design and milling technologies to deliver the most precise fits available.
Burbank Dental Lab offers three distinct options within the screw retained category of implant restorations: Smart1 porcelain fuse to milled Co/Cr, Smart1 Screw Retained Zirconia, and the traditional Porcelain Fused to Cast UCLA abutments.
Burbank Dental Lab's Smart1 Implant Bars & overdentures are designed using our decades of experience and fabricated with the world's most advanced technology, resulting in ease of delivery, and the most durable, comfortable denture available.
Burbank Dental Lab can fabricate “guided surgery appliances” from your CBCT based scans, using state of the art digital printers and titanium guide cylinders that correspond to your surgical system.
Vitallium has been the first name of partial dentures for over 60 years. The physical properties provide extraordinary strength and unprecedented fracture resistance while allowing for smaller, lighter, more delicate partial frameworks.
Burbank Dental Lab has three new state-of-the-art Carbon M2 printers. We are very excited about the options that these cutting-edge printers will allow us to offer our dental clients. Here are some of the advantages that these printers will begin to deliver to you and your dental practice.
Our New State-Of-The-Art 3d Printers
Carbon offers a highly dependable 3D manufacturing solution for many dental applications with its breakthrough Digital Light Synthesis™ technology, enabled by a wide range of dental materials.
Fabrication of the future is here!
Burbank Dental Lab has three new state-of-the-art Carbon M2 printers. We are very excited about the options that these cutting-edge printers will allow us to offer our dental clients. Here are some of the advantages that these printers will begin to deliver to you and your dental practice.
Our New State-Of-The-Art 3d Printers
Carbon offers a highly dependable 3D manufacturing solution for many dental applications with its breakthrough Digital Light Synthesis™ technology, enabled by a wide range of dental materials.
What Our Clients Say
“I have been working with Burbank Dental Lab for many years. They always get back to me in a timely manner whenever I have questions regarding a case. Mr. Wyoming...
“I appreciate the quality and efficiency of this lab. I especially like the turn around times for their crowns (about 5 days). Thank you for your work and I highly...
“Burbank Dental Lab’s Smile Design Group helped to transform my patient’s smile with their exceptional attention to detail and overall quality of the emax crowns. The case was a success,...
“Burbank is a terrific dental lab, I always get top-notch work and prompt, courteous customer service.Whether it’s fixed, removable, implants, veneers or anything else, I know I can rely on...
“Burbank is amazing. I am blown away by their craftsmanship. Crowns are absolutely beautiful. Patients love them. Wyoming and Jason have been great with communication. I will continue to send...
“I have been using Burbank Dental Lab for a few years now. I have been very happy with the results. The best part is that the team communicates well regarding...
“Very good service, recommended and attentive I am very grateful to the dental doctor who treated my dental problems very successfully and helped me regain my beautiful smile.”
“I have been using Burbank Dental Lab for several years now and am continually impressed with the quality of their work and their customer service! Everyone that works there is...
“I am very impressed with the attention to detail and easy communication. I use Burbank Dental Lab even though I’m on the east coast because the results are always predictably...
“I have been a client of Burbank Dental for over 20 years. Everyone from the phone operators to the techs to management is wonderful and friendly. I have done a...
“I have been using Burbank Lab for over 30 years and recommend them highly. The owner Tony is a stand-up guy with a ton of integrity and a mensch. The...
“When I want something done right, I send it to Burbank. After experiencing inconsistent quality from my previous lab partners, Burbank was highly recommended by a colleague so I gave...
“After experiencing a decline in quality and communication from our previous lab we decided to give Burbank a try based on the recommendation of several business associates. The service from...
“I am a Heartland dentist in Texas and I have been looking for a comprehensive lab that I could use for implants, removable, and fixed. I discovered Burbank a few...
“Delivery time was excellent! The fit of the screw retained implant crown including emergence profile, contacts, seating, and occlusion were perfect. Didn’t do anything but seat it and torque the...
“Absolutely gorgeous and high-quality maxillary zirconia hybrid on Ti-bases. Their lab followed my prescription exactly. Their technicians have amazing talent. Thank you, Burbank!”
“We were looking for a lab that could accept our digital scans and produce high-quality centric-relation nightguards for patients. Burbank Dental Lab was recommended by a dental school classmate. We...
Burbank Dental Lab has far exceeded all of my expectations, and has fully delivered top tier prosthodontic work. What sets this lab apart from others is the constant communication. When...
“This lab provides restorative dentists with excellent technical support and high-quality lab work at reasonable fees. Their restorations are consistently excellent both from a functional and esthetic standpoint.”
“High quality dental lab with years of experience. Very professional service and results are second to none. Whether its cosmetic work, implant work, or digital, Burbank has their act together....
“In 25 years practicing dentistry I have not delivered a better full mouth rehabilitation crowns and bridge case like the one I did today. Aesthetics, fitting, contact, and occlusion was...
“I have been using Burbank for a while now. They are the only lab I’ve worked with who delivers consistently superior results. Their esthetic and implant work is second to...
“Full Arch fixed prosthetic cases go extremely smoothly with Burbank Dental Lab and their imetric photogrammetry in-office workflow. Highly recommend this workflow for anyone doing full Arch cases. Working with...
“Great Dental Lab for removable and crown and bridge. Amazing customer service. Vince and Dmitri are very accommodating and will ALWAYS work with you. Their product is top notch!” (click...
Hi Tony, hope you’re well. I’ve sent you a before and after case of a #8 old PFM replacement – single tooth next to natural #9. (Click for photo). Also...
“Just wanted to let you all know that I retired a few years ago but I sincerely appreciated both the help and especially the great quality of the work you...
“The implant department at Burbank is amazing! They have delivered casework that has exceeded my expectations and our patients are thrilled! We switched from a local lab to Burbank; our...
“We’ve been using this lab for a few years now and we are very happy. Excellent customer service, very kind billing staff and work is always well done. Every time...
“Burbank Dental Lab has provided us with many years of high-quality work, timely service and friendly staff. Our thanks, from all of us at Westlake Dental Associates.”
“Fantastic case! I just dropped these two implant abutment/crowns in and they were perfect! Thank you!” MARGINS: Excellent CONTACTS: Excellent CONTOUR: Excellent OCCLUSION: Excellent FIT: Excellent SHADE: Excellent ESTHETICS: Excellent...
This case is the case where you sent me the samples of the acrylics for a patient who is very sensitive to different chemicals, etc. She wore each sample disc...
“What an amazing lab to work with. Each person I have encountered has been amazing. From Joel and Kenny to Laura in Accounting to Tony himself. The crowns go in...
“We have used this lab for 18 months. They have proven to be very patient and customer-centric. They produce some really nice work and are easy to work with. Cases...
“Vincent and Karen are the best! I worked with Vincent on a full mouth rehab case. Everything turned out great and the patient is very happy. Working with Vincent made...
“They were great to work with and went out of their way to make sure we received our lab case the very same day. Holly even volunteered to come personally...
“Burbank Dental Lab is our most trusted dental lab for all of our dental work. They are extremely reliable and deliver exceptional products. They are always available for questions and...
“Amazing lab! The work always comes back in a timely manner and is beautiful! Marissa is who we are lucky enough to have help us with our cases and she...
“Very nice case! This patient was very happy. My only adjustment was to reduce the excess in the ovate pontic area that was overdone.” MARGINS: Excellent CONTACTS: Excellent CONTOUR: Excellent...
“I absolutely love this lab, very quick, beautiful work, and very professional. Marissa is so much help, and has answers every single time! Wouldn’t use anyone else!”
“For more than 5 years I have sent my removable lab work to Burbank Dental Laboratory. I delivered a new FUD and new mandibular distal extension RPD with a locator...
“Implant abutment and crown – this case was great! Thank you! The pink porcelain looked great where the gingival margins needed to be leveled.” MARGINS: Excellent CONTACTS: Excellent CONTOUR: Excellent...
“This was the first crown I inserted since we talked about the contacts being tight. This crown was PERFECT!!! Absolutely no adjustments were needed! This was one of those “throw...
“As a new customer to Burbank Dental Lab, I was pleasantly surprised at the interest the staff expressed for the INDIVIDUAL needs of my patients. As an academic, my ideal...
“Burbank is an excellent lab! It is one of the most high-tech operations in the country and I have visited many of them. Tony, Andrew, and the entire team have...
Thank you Joel for an excellent job. What I really love about Joel and Vincent from Burbank Lab is that 1. They listen to the instructions and follow them. 2....
“Thank you Joel for an excellent job. What I really love about Joel and Vincent from Burbank Lab is that: 1. They listen to the instructions and follow them. 2....
“Just completed a maxillary Prettau Zirconium bridge on 5 implants and am very pleased with the service, the attention to detail, and the communication skills of this lab, in particular...
This dental lab is world renowned for high quality of their crown and bridgework. I especially appreciate their expertise in implant castings. I happen to work with a couple of...