An Introduction to the Implant Crown with an Esthetic Adhesive Margin (ICEAM)

Abstract

The transition margin from an implant abutment to a crown is challenging to manage especially esthetically. Placing the abutment margin in a subgingival position helps hide the unesthetic transition, however, this reduces the ability to clean excess cement, increases the risk of peri-implant disease and the inability to control gingival sulcular fluids may affect the cement bond. The implant crown with an esthetic adhesive margin provides for supragingival bonded margins that can aid in complete removal of excess cement at the same time providing an esthetically pleasing result.

A Current Perspective on Screw‐Retained Single‐Implant Restorations: A Review of Pertinent Literature

“…Techniques have been developed to assist clinicians in approximating the right amount of cement that avoid the use of retraction cord . Another method to carry ceramic to the implant level, and to avoid excess cement with a cemented crown, is to bond a ceramic crown or veneer to a ceramic abutment that is made with a finish line just subgingival to the gingival margin …”

“…49 Another method to carry ceramic to the implant level, and to avoid excess cement with a cemented crown, is to bond a ceramic crown or veneer to a ceramic abutment that is made with a finish line just subgingival to the gingival margin. 50,51 The selection of screw-retention avoids the above problems. Margin depth of a cemented implant crown is limited by the clinician's ability to clean the cement, whereas a ceramic margin on a screw-retained crown can extend gingivally as far as the implant/abutment interface.…”

The Team Approach to Replacing the Congenitally Missing Lateral Incisor: Restorative and Periodontal Considerations

“…The restorative team member must determine whether the definitive restoration will be cement or screw retained. There is currently significant discussion about cement‐retained restorations contributing to the causes of peri‐implantitis 17,20 . For this reason, some clinicians have abandoned cement‐retained implant restorations.…”

“…1) All‐ceramic abutments (zirconia) provided the advantage over metal abutments of less gray/darkness displaying through the facial tissue and allowed prosthetic margins to be designed more shallow. Although zirconia abutments are currently manufactured primarily white, the shade can be modified with pressed ceramics 17 or layered porcelain techniques. Marchack and Yamashita 18 reported in 1997 a modified custom abutment with a 360° porcelain collar as another alternative to all‐ceramic abutments.…”

Commentary

“…Clinicians utilizing this technique are encouraged to expand this protocol to include a predictable technique for transferring the meticulously developed emergence profile. The literature is replete with numerous articles that provide technique for development of custom impression copings . These custom impression copings will provide the communication necessary for laboratory procedures that result in esthetically superior restorations of the implant.…”