RESUMO
BACKGROUND: Implant restorations are considered an ideal treatment option for replacement of missing teeth in partially edentulous patients. Abutment screw loosening is one of the frequently observed technical complications of implant-supported prosthesis. This study aimed to determine the prevalence and factors associated with the abutment screw loosening in cement-retained single-implant crowns. METHODS: Enrolment criteria included partially edentulous patients who have been rehabilitated with one or more cement-retained single-implant crowns with minimum postcementation period of 1 year. They were recalled and evaluated for the presence or absence of screw loosening both clinically and radiographically. They were further evaluated for the presence or absence of factors associated with screw loosening such as parafunctional habits, wider occlusal table, steep cuspal inclines, non-axial loading and cantilevering of the pontic. RESULTS: Twenty-six cement-retained single-implant crowns out of 280 showed screw loosening, making the overall prevalence rate of 10.77%. Among the factors evaluated, parafunctional habits were associated with three cases, wider occlusal table in four, steep cuspal inclines in three, non-axial loading in nine and cantilevering of the pontic in three cases. Exact reasons could not be ascertained in four cases. CONCLUSION: Abutment screw loosening seems to be a significant prosthetic complication of cement-retained single-implant crowns. Factors evaluated significantly affect the functional durability of the prosthesis. These factors should be considered while restoring to enhance the longevity of such restorations.
RESUMO
BACKGROUND: The restoration of an endodontically treated fractured tooth has been a challenge for restorative dentists for decades. The performance of fiber posts when used in conjunction with direct composite resin restorations have been largely unreported. This study was conducted with the aim of evaluating the survival rate of endodontically treated teeth restored with adhesive bonded fiber reinforced resin posts and direct composite core with additional crown coverage. METHODS: Sixty patients who required endodontic treatment with post core crown were selected from outpatient department of Air Force Institute of Dental Sciences, Bangalore. Sixty-four teeth were endodontically treated and restored with fiber post and direct resin composite core restoration. Patients were evaluated immediately after restoration and reevaluated at the end of first, second and third months. After 3 months of clinical evaluation, if teeth were asymptomatic they were restored with complete coverage porcelain fused to metal restorations and evaluated immediately, and again reevaluated at the end of first, third, and sixth months. RESULTS: After 3 months of clinical evaluation, only two teeth exhibited periapical lesion with clinical symptoms and three teeth without any clinical symptoms. Five teeth exhibited slight marginal staining, three teeth showed partial loss of restoration, and two teeth exhibited complete loss of restoration with the fracture of the post. At the end of sixth month after restoration with full coverage crown, two teeth had dislodged restoration due to fracture of post and two teeth exhibited displacement of the post. CONCLUSION: Fiber posts are the best alternative for restoration of fractured endodontically treated teeth. Fiber posts and direct composite resin core materials are strongly recommended for restoration of endodontically treated mutilated teeth among the dental establishments of Armed Forces.