Akademik Veri Yönetim Sistemi
The 48. Annual EPA Congress | The 27. Scientific TPID Congress, Nevşehir, Türkiye, 11 - 13 Eylül 2025, ss.1, (Tam Metin Bildiri)
Achieving ideal esthetics in implant-supported restorations in the anterior region can be challenging, especially when the screw access hole is located on a visible surface. Traditional masking techniques such as opaquer or composite fillings often fall short in terms of color stability, translucency, and surface texture. Thus, they may fail to meet esthetic expectations in the anterior maxilla. This case report presents an alternative technique for concealing a screw access hole in the esthetic zone.
A 52-year-old female patient presented with partial edentulism in both anterior and posterior maxillary regions. A fixed implant-supported bridge was planned. During planning, a 30° multi-unit abutment was used to position the screw access hole palatally on the right maxillary central incisor (tooth #11). However, despite the abutment angulation, the access hole appeared on the labial and incisal surfaces, creating a significant esthetic concern.
To solve this issue, a metal-ceramic component resembling a partial laminate veneer was digitally designed using dental design software. This 1.5 mm thick cover piece was fabricated to match the adjacent porcelain in terms of contour, translucency, and texture. Its intaglio surface was sandblasted and bonded with resin-modified glass ionomer cement. At the one-year follow-up, the restoration preserved its esthetic stability, and the patient reported high satisfaction.
Several techniques have been described for managing screw access hole-related esthetic problems, including opaque composites, pink ceramics, prefabricated ceramic caps, and opaquer materials. Recently, angulated screw channel (ASC) systems have been introduced to direct screw access toward less visible areas. However, ASC systems require specific component compatibility and may not suit every clinical case. The technique described here provides a practical and effective solution that maintains esthetic harmony without requiring ASC systems.
Keywords: dental implants, screw-retained implant, dental esthetics, metal-ceramic, screw access hole