Screw implant, screw fixation of crowns on implants: which system is more expensive and better, price

If it is necessary to replace a missing tooth, a screw can be used. implantation, the feature of which is the use of a special prosthesis - a screw implant. This technique allows you to simulate the presence of not only the crown of the tooth, but also its root. The result is an even distribution of the load on the bone during chewing.

Basal implantation it is distinguished by ease of use, reliable fixation and tightness of tissue bonding due to a special coating, which also prevents the screw from rejecting. After the reconstruction of the lost tooth, the patient can appreciate the functionality and appearance of his smile, which does not bring the slightest discomfort.

Screw implant: features and accessories

Screw constructions are the most common products used in orthodontic practice. They can have various types of threads, be collapsible and cast, have a smooth or rough surface, have a bioactive coating, differ in one- or two-stage installation. To improve the strength of the bond, special recesses are used, which do not give the implant the ability to rotate around its axis or move.

To achieve increased stability of the screws in the bone tissue, special “self-tapping” structures can be used.

The components of the screw structure are:

• body;
• cover screw;
• gingiva former;
• abutment.

An integral part of the entire structure are anti-rotation locks, represented by anchors, indentations, platforms and longitudinal grooves in the apex of the intraosseous structure.

Implants are fixed by implanting a metal screw into the jawbone. The mounted part of the structure can differ in the type of thread, smooth or rough surface and the presence of a bioactive coating. The latter promotes better healing of the metal screw in the bone tissue and prevents its rejection. After the end of the healing process, the crown is attached.

In the photo, implants with screws:

Advantages and disadvantages

The advantages of using screw implants include:

• at fracture abutment, diseases periodontium and the need to replace orthopedic elements, screw-retained prostheses can be removed;
• use of screw pins makes it possible to reduce the height of the crown while maintaining its retention in parallel;
• individual selection of fit and optimally selected sizes of all elements;
• preservation of the integrity of the prostheses and the screw in case of breakage of the connection;
• low risk of developing inflammation and lack of irritation mucous membrane, since with cement fixation, the remnants of the material can contribute to the development of peri-implantitis.

The disadvantages include:

• aesthetic component (the duration of implantation of screw implants takes from 2 to 6 months, at this time the holes from them look unaesthetic; although they can be masked with composite materials on molars and premolars, gray spots are still visible);
• limitation in the possibility of changing the angle of inclination of the pin;
• the difficulty of replacing the screw in case of its mechanical breakdown;
• the likelihood of damage or loosening of the screw due to the load on the masticatory muscles (in case of excessive straining pressure can be transmitted to the bone that surrounds the screw, which can lead to fracture rod).

Types of products

The following types of screw implants are used in orthodontic practice:

1. Intraosseous root-shaped implants. They are currently the most used. This view is a cylinder with a screw thread. Can only be used with normal bone thickness.
2. Plate-shaped intraosseous screws. They penetrate deeply into the bone tissue and occupy a large volume, therefore they have the greatest stability. Most often used for thinning bone tissue.
3. Combined type of intraosseous implant. It is a collaboration of the two types described above. As a rule, these structures take up a large volume and have a complex shape.
4. Subperiosteal implants. This type is implanted not into the bone itself, but into the space between it and the periosteum. This species is less dense and more extended.
5. Constructions implanted into the mucosa. This is the least traumatic species with great mobility. Such structures are often used to anchor prostheses that have been previously installed.

Don't forget about mini screw implants. In the practice of orthodontists, mini-implants are used as a support structure on which a force acts. This screw is connected to the tooth in need of correction using a special traction. Thanks to the use of this technique, the tooth is "pulled" to the right place.

Mini screws cannot be used for self-treatment in orthodontic practice. They, as a rule, play the role of additional elements in trainers, braces and plates. Mini products can be used simultaneously with these constructions, to start or complete the required course of treatment.

Types of abutments

The following types of abutments are commonly used for screw implants:

1. Spherical: is a rounded element used for removable prosthetics. They are very popular due to their ease of installation and high reliability.
2. Standard: The most common type of abutment. Thanks to a wide variety of required sizes, shapes and lengths, it allows for inexpensive but high-quality prosthetics.
3. Angular or multi-unit: it is used when it is necessary to install the implant not at a right angle to correctly ensure the transition between the screw and the dental crown.

All abutments can be made of ceramic, plastic, metal or combine these materials. The choice of the latter concludes in the quality and financial capabilities of the patient.

Varieties of crowns

Screw fixation on implants is performed with different types of crowns:

1. Metal-free: ceramic, from zirconium dioxide. This type of crown has high performance capabilities due to its lightness, aesthetics, high strength and hypoallergenicity of the material itself.
2. Sintered metal.

The use of the CEREC system, which currently manufactures cemented crowns, is also gaining significant popularity. However, progressive manufacturers are developing zirconia crowns that will be used for screw retaining.

Metal-free crowns can only be placed on ceramic abutments. This imitates the matt transparency inherent in a living tooth. When using metal-ceramic crowns, the abutment will shine through their surface, thereby disrupting the aesthetic characteristics of the dentition.

Indications and contraindications

The use of screw-retained implants is recommended for:

• included defects in the dentition due to tooth loss;
• the need to create a distal support for bridge prosthesis with end defects;
• the creation of an intermediate support in patients with included defects of a large extent;
• complete absence of teeth in the patient.

Contraindications include:

• periodontal disease;
• generalized periodontitis;
• Availability abnormal bite;
• parafunction of the chewing muscles.

Screw fixation steps

The whole procedure of implantation of an orthodontic construction consists of several stages:

1. Preparing the future bed and screwing in the finished screw. After this stage, the patient needs several months for the implant to heal. Healing times are not the same: for the upper jaw from 4 months, for the lower jaw - from 2 months. Implantation is carried out during a one-stage operation, during which the doctororthodontist removes a decayed tooth, forms a bed and implants a screw into it.
2. Installation healing abutment. This part of the structure contributes to the restoration of the gingival contour, which was damaged during the previous stage. In some situations, this step can be performed simultaneously with the first.
3. Placement of the abutment, which acts as a link between the metal screw and the prosthesis.
4. The final orthodontic stage, which includes fixing the crown on the implanted structure. Installation on cement is used in most situations due to its ease of implementation, less often screw fixation is used.

Prices, which is more expensive and better

Implant system / part of the structure	Nobel biocare	OSSTEM IMPLANT	Straumann	MIS
Implant	RUB 50,000	RUB 29,000	RUB 53,000	RUB 22,000
Healing abutment	3,500 RUB	2400 RUB	3,500 RUB	2400 RUB
Abutment	13 000	5 300	13 000	5 300
Crown	8 000	8 000	8 000	8 000

The cost of installing one screw implant from the South Korean corporation Dentium is 16,500 rubles.

Which screw implant system is more expensive and better will help to understand the division of all structures depending on their pricing policy:

1. Expensive: Swiss manufacturers Straumann, companies in which the USA and Switzerland cooperate - Astra tech, Nobel biocare.
2. Average value: companies in which the United States and Germany cooperate - Xive, Ankylos, South Korea - Osstem.
3. Budget: Israeli companies Alpha bio and MIS, a South Korean company Dentium.

A few more important points:

Manufacturing time

The production time is individual and depends both on the amount of work to be done and on the workload of the chosen dentistry. The fabrication of the implant usually takes several weeks. After its implantation, it should take from 3 to 6 months, only after that crowns can be installed on the titanium rods. Within six months, the rod grows together with the bone tissue.

Implant Screw Extraction Kit

The set for extracting screws from the structure consists of:

• trepanning cutters;
• implant extractor;
• forceps for removing implants;
• manual adapter;
• drivers.

the effect

When choosing a basal screw, the patient agrees with the operative installation of the chosen design. Upon completion of the implantation, the patient can immediately use new teeth, gradually get used to chewing new food and do not worry about an aesthetic defect, since screw implants completely restore the usual appearance smiles. This low-traumatic procedure does not require complex bone augmentation and can be used by patients in the most difficult cases.

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