PubMed · 4258050
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H A Gerbert. [Telescope prosthesis].. https://pubmed.ncbi.nlm.nih.gov/4258050/
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OBJECTIVE: The aim of the present clinical longitudinal study was to observe, over 10 years, the prognosis of abutment teeth restored with fixed prostheses retained by glass ionomer luting cements and one conventional zinc phosphate cement. METHODS: Three dentists prepared 135 abutment teeth in 61 patients to retain 81 fixed prostheses. The prostheses were retained by two glass ionomer luting cements (Ketac-Cem, Fuji Ionomer), or a conventional zinc phosphate cement (De Trey Zinc Zement Improved). The patients were examined yearly for 10 years. RESULTS: Post-operative hypersensitivity occurred in five teeth restored with glass ionomer luting cement. The prevailing reason for abutment tooth failure was secondary caries (n = 21) and pulp necrosis (n = 5). Non-parametric survival estimates indicated that 80-85% of the abutment teeth remained intact after 5 years and 71-81% after 10 years. CONCLUSIONS: The 10-year results indicate that the prognosis of abutment teeth restored with fixed prostheses is good, regardless of whether a glass ionomer or a zinc phosphate luting cement is used.
Posts were recommended more than 100 years ago to retain artificial crowns. Recent studies suggest that posts can weaken teeth; therefore restorative procedures that help preserve pulpal vitality and eliminate the need for posts are desirable. If endodontic therapy is unavoidable, conservation of remaining tooth structure is most important. When a post is required to retain a core for an artificial crown, a custom cast post is the most effective means of conserving tooth structure. The length of the post should not be compromised, although 4 to 5 mm of apical gutta-percha must be maintained. The restorative prognosis is improved if the width of the post does not exceed one half the width of the root, and the cemented artificial crown should extend apical to the core to provide a 1.5 to 2 mm ferrule. Complex procedures have allowed the dentist to restore extensively damaged teeth. However, extraction and replacement with implant-supported prosthodontics may be more prudent with severely compromised teeth.
A custom-milled abutment may be positioned in six different orientations on a hexed implant. When more than one implant abutment is to be placed, the number of possible orientations increases and makes this step time consuming. It is imperative that the abutment be held in a fixed position while the abutment screw is tightened. Occasionally the master working cast is not accurate and a procedure to correct the cast without making a new impression is required. This article describes a procedure for making and using a positioning jig to alleviate these problems.