An esthetic solution to the screw-retained implant restoration: introduction to the implant crown adhesive plug: clinical report.

UNLABELLED Screw-retained implant crowns may be clinically demanding, especially managing the esthetic and occlusal challenges of screw access channel closure. Many clinicians have moved away from using screw retention as a means of fixing a crown to an implant in favor of cementation to an underlying abutment. A link has been established between peri-implant disease and excess cement extrusion in cement-retained implant restorations. This article describes a novel technique of bonding a pressed porcelain plug into the screw access channel of an implant restoration that allows for control of occlusion, matches the esthetics of a cement-retained crown, and eliminates the issues of excess cement. CLINICAL SIGNIFICANCE Overcoming the restorative challenges (esthetic, occlusal) of the screw access channel in a screw-retained implant restoration is difficult. By fabricating a pressed ceramic over metal crown and esthetic plug these challenges can be dealt with in a predictable manner.