Dr. P.I. Branemark (an orthopaedic surgeon in Sweden) presented his 30 year research on dental implants at the Toronto Conference of 1984. The term osseointegration was introduced by Dr. Branemark at this conference. This was the first presentation of long term scientific data that proved dental implants can have long term success IF performed following his protocol. If the Branemark principles were followed, his studies demonstrated a long term success rate of 98%.
Dr. Branemark developed strict surgical, prosthetic and laboratory protocols that had to be meticulously followed in order to obtain his high success rate. One of the prosthetic principles required that all implant supported or implant retained restorations be screw retained. This arrangement created a pyramid for the implant restoration. At the base of the pyramid is the root form implant itself that is integrated with the bone at approximately 50 N/cm. The next level is the abutment which is retained to the implant via an abutment screw at 20 N/cm (single tooth restorations could be higher). And finally, the restoration is connected to the abutment with a prosthetic screw engineered to withstand 10 N/cm of force. This was a brilliant set up because the first warning sign of a problem (typically an occlusal overload) was reflected by loosening of the weakest screw, the highly visible prosthetic screw. This early warning sign allowed the clinician to take corrective measures before more serious damage occurred at the deeper levels. The other advantage of this setup is the quick and easy full retrievability of the restoration and abutment without causing any damage to the implant or surrounding bone.
Over time, Dr. Branemark’s principles of osseointegration were changed by outside vendors and clinicians in order to reduce the number of steps and time required to complete an implant restoration. These changes resulted in a commensurate reduction in success rate. Shifting from screw retained to cement retained restorations was one of the major prosthetic changes. There are benefits to cement on restorations but the advantages of early warning and easy retrievability are lost. Another consideration with cement on restorations is the possibility of retained deep subgingival cement which can result in peri implantitis, bone loss and possible loss of the implant and associated restoration. The disadvantage of a screw retained restoration is the unsightly appearance of the screw access hole. DIS offers the exclusive Esthetibond Restorative System which provides esthetic and functional restoration of the implant screw access hole
DIS does not suggest which type of implant retention system a clinician should use. That is completely up to the clinician and the particular considerations associated with each patient. DIS is simply offering our Esthetibond System to those clinicians who choose to use a screw retained restoration and would like to esthetically and functionally restore the screw access hole. . If you would like to see a demo video of the DIS Esthetibond System click here.