Evaluation of the soft tissue manegement around the implant-suppotted crown using integrated abutment crown at the posterior region

Purpose:There are two ways in the prosthodontics of fixed partial implant treatment: screw-retained crown and cement-retained crown.When coming with stress distribution,aesthetic and passive fit of the crown,cement-retained crown establish superiority over screw-retained crown.While it happens to a damaged crown which need to repair or a wrong implant site,screw-retained crown is better than cement-retained crown to be the first choice and it avoid gingivitis which induced by remanet cement.Conventional screw-retained crown procedure is that fit abutment on implant first,and then tight abutment screw with the crown.It would loosening in function,resulting in gingiva recess and horizontal food impaction.Integrated abutment crown(IAC) is the whole body of abutment and crown which fixed on implant with screw on occlusal surface.The aim of the present study was to evaluate the soft tissue management around the implant-supported crown using IAC restoration at the posterior region.Materials and Methods: IAC was restored by two ways:one is the abutment was casted with the crown simultaneity and then screw-retained;the other is abutment and crown were casted respectively,cement them,remove remanet cement and finally retained by screw.And also there is two ways to manage soft tissue:one is using temporary crown to shape soft tissue progressively,and then take the customed impression to fabricate the final crown;the other is try- in the IAC and was retained by screw with managing the soft tissue contemporary.Porcelain or polymer ceramic was fused to the metal of crown.29 patients underwent implant surgery and 48 implants were inserted and restored.19 implants of 14 patients use the ITI system,while 29 implants of 15 patients use the OSSTEM GS system.When managing the soft tissue,only 2 restorations of ITI and 3 restorations of GS use the former program.Prosthodontic procedures contain the radiograthic confirmation of abutment placement uniformly.Follow-up time after operation was 6 months to 1 year to evaluate losseness of IAC and shape and health of soft tissue.Results: All the patients with those two prosthetic plans come to the same destination-all of them with IAC have not looseness on function and use IAC directly could manage ideal gingiva margin and papulla height.It avoid gingivitis induced by remanet cement and horizontal food impaction.One patient who has the wrong implant site was restored by IAC successfully.The screw hole of occlusal surface is filled with polymer ceramic which come up to aesthetic prosthodontics.Conclusion: 1) At the posterior region,IAC restoration could manage the soft tissue to reduce the horizontal food impaction which last for a long time in implant treatment.2) IAC could has the satisfied results while at a wrong implant site or low occlusion.3) IAC allows for shorter post-treatment waiting time,provideing less additional consultment,avoiding more cost and inconvenience of patients.4)IAC is better for the health of soft tissue and repair of crown,so it is that can be a better choice in regions where have advanced requirement for health and function.