The most frequent complications over the 5-year observation period were fractures of the veneering material (13.5%), loss of access hole restoration (5.4%), abutment or screw loosening (5.3%), and loss of retention of the cemented prosthesis (4.7%). conducted a systematic review and reported that the survival rate of metal–ceramic implant supported fixed dental prosthesis was 96.4% after 5 years and 93.9% after 10 years. No statistical differences were detected when comparing survival rates of screw-retained and cemented single crowns there was no statistically significant difference between all-ceramic and metal-ceramic single crowns. Technical complications reached a cumulative incidence of 8.8% for screw-loosening, 4.1% for loss of retention, and 3.5% for fracture of the veneering material after 5 years. They reported that survival of implant-supported single crowns was 96.3% after 5 years and 89.4% after 10 years. studied the survival rate and the incidence of biological, technical, and esthetic complications of single crowns on implants. In a recent long-term systematic review, Jung et al. suggested that re-tightening abutment screws 10 min after initial torque applications should be performed routinely to increase stability and decrease screw loosening. Thus, the overestimation of the hand-driven forces should be avoided. In a study simulating clinical settings, 60 dental students applied their maximum controlled torque to the head of a screw-driven, the mean torque value obtained by hand was 11.5 Ncm. Using a mechanical torque instrument to tighten the screw to a recommended torque level (20-30 Ncm) has greatly diminished this prosthetic complication. The frequency of screw loosening is reported to be between 5% and 65%. Screw-retained restorations are associated with screw loosening complication especially in single crown restoration. Radiographic evaluation of the implant may be prescribed to evaluate the quality of bone surrounding the implant an intra-oral peri-apical X-ray can be used to check for any unwanted signs of a failure of the implant. Various shapes and sizes of healing caps are available for different implant systems. In one-stage as well as two-stage surgical protocols, the surgeon is responsible of placing the healing cap (or gingival former) on the fixture before referring the patient for prosthetic construction. If surgical insertion followed a two-stage protocol, then a healing time of at least 2 weeks should be allowed after surgical exposure. Measure and cut your rails on the ground so you don’t get metal shavings on your roof. Be sure to keep your Racking Report handy during this stepit specifies rail size and spacing for your system. The prosthetic procedures are usually conducted after proper healing time is allowed following the surgical insertion of the implant. With the flashings in place, you’re ready to attach the racking rails. The two main procedures needed for getting a crown restoration are taking an accurate impression and delivering the screw retained single crown. CLINICAL STEPS FOR SCREW-RETAINED CROWN RESTORATION OF A SINGLE IMPLANT
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