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  • Title: In vitro effect of load cycling on metal-ceramic cement- and screw-retained implant restorations.
    Author: Karl M, Graef F, Taylor TD, Heckmann SM.
    Journal: J Prosthet Dent; 2007 Mar; 97(3):137-40. PubMed ID: 17394911.
    Abstract:
    STATEMENT OF PROBLEM: In implant prosthodontics, restorations can either be cement- or screw-retained. Aside from passivity of fit, esthetics, and retrievability, the occlusal opening of the screw-access hole (SAH) is a major difference between the 2 types of restorations. In veneered fixed partial dentures (FPDs), the SAH forms a discontinuity of the ceramic layer and may be an origin for chipping fractures. PURPOSE: The objective of this study was to investigate whether more chipping fractures occur during dynamic loading on the occlusal surface of screw-retained ceramic-veneered implant FPDs than in cement-retained restorations. MATERIAL AND METHODS: Ten cement-retained and 10 screw-retained ceramic veneered 5-unit FPDs were manufactured for a 3-implant situation. A masticatory simulator was used for loading the occlusal surface of the FPDs to the implant positions for 20,000 cycles with a force of 100 N applied for 1 second followed by 1 second of no loading. For analysis, 3 clinicians evaluated the FPDs using a light microscope and a dental probe. The numbers of chipping fractures found were analyzed by means of a generalized linear model with Poisson response (alpha=.05). RESULTS: The investigators found significantly more chipping fractures in the group of screw-retained FPDs, the rate ratio of screw-retained FPDs versus cement-retained FPDs being greater than 1 with a P value of .0023. CONCLUSION: The SAH of screw-retained implant FPDs forms a weak point of the ceramic layer.
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