Dr. Richard Elliott illustrates a screw-retained esthetic restoration
The esthetic restoration of implant-supported maxillary single central incisors remains one of the most challenging treatments in modern dentistry. Achieving the correct soft tissue contour and ceramic esthetics to mirror the natural adjacent central incisor is the key to success.
In my experience, implant dentists are requesting screw-retained options wherever possible due to the ability to easily retrieve the restoration without compromising the framework or the ceramics. The launch of the NobelProcera® Angulated Screw Channel (ASC) abutment by Nobel Biocare® has made screw retaining these cases much easier by allowing the technician to “bend” the screw access channel into a more favorable position (up to 25 degrees). Where the screw access channel of a restoration on an implant incisor cannot be corrected using the ASC software (greater than 25 degrees) and a cementable restoration is indicated, the Straight ASC abutment gives much greater strength due to its titanium interface, which secures it into the implant head, reducing the chances of a fracture in this area.
Case 1: ASC Screw Retained
This case demonstrates an UL1 ASC screw-retained zirconia abutment (Nobel Biocare® “Light” shaded zirconia and IPS e.max® Ceram® [Ivoclar Vivadent]). Ceramic is layered directly onto the abutment for a one-piece screw-retained crown. 
Case 2: ASC Straight
This case presents an UL1 IPS e.max® crown cemented onto a “white” shaded zirconia abutment with a cementable e.max coping pressed in an MO1 ingot and layered with e.max Ceram.
For more information, visit www.nobelbiocare.com
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