Screwmentation, screwmentable and lateral access screws

before and after dental implant

Screwmentation, screwmentable and lateral access screws

Screwmentation is a technique in which a large implant supported prosthesis is attached via a combination of screw retention and temporary cementation.  You cement anterior crowns typically due to angle an screw retain posterior ones.  Nice explanation by Uwe Mohr on DT

Screwmentation or screwmentable?

For screwmentation it is best to have the teeth that will have screw retention be on non-engaging abutments. The other teeth that utilize cement retention should utilize engaging abutments.

Both screwmentation or screwmentable can mean two things to me. One definition of a screwmentable case is the same as the screwmentation definition found above, however there is another definition that is very different.

Screwmentable is also a term we use for delivering a single dental implant crown. This method is where the lab delivers a crown with an access hole and an abutment. The dentist tries in both separately to confirm fit in the mouth. Once we adjust and confirm a proper fit we cement the crown on the abutment on the model or in mouth. I personally prefer to cement it into the mouth, because I have had a case not fit after cementing it on the model. However, the crown/abutment are still easily removable because the crown has an access chamber in it. Therefore we remove it once the cement sets and we clean any residual cement from around the crown abutment interface. Once we remove all remnants of cement we place the prosthesis into the dental implant in the patient and torque to the proper level. Sarafidou JPD 2023 finds this method to provide the advantages of both other methods.

The one issue with this technique is if the implant/abutment angle varies from the abutment/crown angle significantly then you may not be able to retrieve the crown/abutment piece from the implant. DT link

Lateral access screws

Bredent makes one called Security Lock for implant supported PFM.  Not sure how different from their Friction splint FS1

Really sick case using Friction splint from JPD 2016 Pelekanos.  In the article it states the lateral was higher and had to be cement retained as not enough room for the lateral screw.  Also states that today would just use angled abutments, so maybe this is something of the past.

lateral screw implant

Article showing many examples Fujiki 2014 using some sort of tapping system.

lateral screw acessscrewmentation