Cross-pinning: the philosophy of retrievability applied practically to fixed, implant-supported prostheses.

Biologic and technical complications are widely reported in the dental literature and often compromise the functional and/or aesthetic features of fixed, implant-supported prostheses. Managing complications without damaging or destroying a restoration is an obvious advantage of implant-based dentistry where the option of prosthetic retrievability is almost always available. The technique of cross-pinning uses a transverse screw to secure a prosthesis to a milled implant abutment, allowing prosthetic retrievability irrespective of dental implant alignment. This study presents guidelines for cross-pinning implant-supported prostheses based on resistance form, screw mechanics and natural tooth contours. The technical aspects of cross-pinning are also discussed using examples from four implant systems.

[1]  George A Zarb,et al.  Long-term treatment outcomes in edentulous patients with implant-fixed prostheses: the Toronto study. , 2004, The International journal of prosthodontics.

[2]  M. Zwahlen,et al.  A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. II. Combined tooth--implant-supported FPDs. , 2004, Clinical oral implants research.

[3]  T.M.G.J. van Eijden,et al.  Biomechanics of the Mandible , 2000 .

[4]  W. Chee,et al.  Cemented versus screw-retained implant prostheses: which is better? , 1999, The International journal of oral & maxillofacial implants.

[5]  T Jemt,et al.  Loads and designs of screw joints for single crowns supported by osseointegrated implants. , 1992, The International journal of oral & maxillofacial implants.

[6]  P. Vigolo,et al.  Cemented versus screw-retained implant-supported single-tooth crowns: a 4-year prospective clinical study. , 2004, The International journal of oral & maxillofacial implants.

[7]  P P Binon,et al.  The effect of implant/abutment hexagonal misfit on screw joint stability. , 1996, The International journal of prosthodontics.

[8]  G. Liu,et al.  Application of finite element analysis in implant dentistry: a review of the literature. , 2001, The Journal of prosthetic dentistry.

[9]  T D Taylor,et al.  Prosthetic management of the partially dentate patient with fixed implant restorations. , 2000, Clinical oral implants research.

[10]  Sayed A. Nassar,et al.  Handbook of bolts and bolted joints , 1998 .

[11]  M. Özcan.  Fracture reasons in ceramic-fused-to-metal restorations (Review) , 2003 .

[12]  Hiroshi Hirayama,et al.  Cement-retained versus screw-retained implant restorations: a critical review. , 2003, The International journal of oral & maxillofacial implants.

[13]  Thomas D Taylor,et al.  Early wound healing around endosseous implants: a review of the literature. , 2005, The International journal of oral & maxillofacial implants.

[14]  Sinan Müftü,et al.  Mechanics of the taper integrated screwed-in (TIS) abutments used in dental implants. , 2005, Journal of biomechanics.

[15]  C J Goodacre,et al.  Clinical complications of osseointegrated implants. , 1999, The Journal of prosthetic dentistry.

[16]  W. Chee,et al.  Retrievable cemented implant restorations. , 1998, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[17]  John H. Bickford.  Behavior of a Bolted Joint During Assembly , 1998 .

[18]  H T Shillingburg,et al.  Retention and resistance of preparations for cast restorations. , 1980, The Journal of prosthetic dentistry.

[19]  J B Brunski,et al.  Biomaterials and biomechanics of oral and maxillofacial implants: current status and future developments. , 2000, The International journal of oral & maxillofacial implants.

[20]  P P Binon,et al.  The effect of eliminating implant/abutment rotational misfit on screw joint stability. , 1996, The International journal of prosthodontics.

[21]  C. Goodacre,et al.  Clinical complications with implants and implant prostheses. , 2003, The Journal of prosthetic dentistry.

[22]  S M Morgano,et al.  New abutment for a screw-retained, implant-supported crown. , 2001, The Journal of prosthetic dentistry.

[23]  T W Korioth,et al.  Modeling the mechanical behavior of the jaws and their related structures by finite element (FE) analysis. , 1997, Critical reviews in oral biology and medicine : an official publication of the American Association of Oral Biologists.

[24]  J. Holloway,et al.  Short-term retention properties of cements for retrievable implant-supported prostheses. , 2004, The European journal of prosthodontics and restorative dentistry.

[25]  J I Nicholls,et al.  The relationship between abutment taper and resistance of cemented crowns to dynamic loading. , 1996, The International journal of prosthodontics.

[26]  Marc Quirynen,et al.  Infectious risks for oral implants: a review of the literature. , 2002, Clinical oral implants research.

[27]  D van Steenberghe,et al.  Survival of the Brånemark implant in partially edentulous jaws: a 10-year prospective multicenter study. , 1999, The International journal of oral & maxillofacial implants.

[28]  H. Lindström,et al.  The implant-supported telescopic prosthesis: a biomechanical analysis. , 2001, The International journal of oral & maxillofacial implants.

[29]  John H. Bickford.  Introduction to Assembly , 2007 .

[30]  U. Lekholm,et al.  Prevalence of subjects with progressive bone loss at implants. , 2005, Clinical oral implants research.

[31]  Mark J Gervais,et al.  A rationale for retrievability of fixed, implant-supported prostheses: a complication-based analysis. , 2007, The International journal of prosthodontics.

[32]  M. Ryder,et al.  Risk assessment in clinical practice. , 2004, Periodontology 2000.

[33]  N. Lang,et al.  Association between periodontal and peri-implant conditions: a 10-year prospective study. , 2004, Clinical oral implants research.

[34]  Ameen Khraisat,et al.  Fatigue resistance of two implant/abutment joint designs. , 2002, The Journal of prosthetic dentistry.

[35]  T. Jemt.  Failures and complications in 391 consecutively inserted fixed prostheses supported by Brånemark implants in edentulous jaws: a study of treatment from the time of prosthesis placement to the first annual checkup. , 1992, The International journal of oral & maxillofacial implants.

[36]  Maxwell Aw,et al.  Effect of crown preparation height on the retention and resistance of gold castings. , 1990 .

[37]  F P Valbao,et al.  Alternative method for retention and removal of cement-retained implant prostheses. , 2001, The Journal of prosthetic dentistry.

[38]  H. T. Shillingburg,et al.  Influence of preparation features on retention and resistance. Part II: three-quarter crowns. , 1983, The Journal of prosthetic dentistry.

[39]  C. Goodacre,et al.  The effectiveness of auxiliary features on a tooth preparation with inadequate resistance form. , 2004, The Journal of prosthetic dentistry.

[40]  E. Lautenschlager,et al.  Changes in prosthetic screw stability because of misfit of implant-supported prostheses. , 2002, The International journal of prosthodontics.

[41]  J. Hobkirk,et al.  Preload loss in gold prosthesis-retaining screws as a function of time. , 2004, The International journal of oral & maxillofacial implants.

[42]  R. Fournelle,et al.  The effect of repeated torque and salivary contamination on the preload of slotted gold implant prosthetic screws. , 2002, The Journal of prosthetic dentistry.

[43]  J. Davies,et al.  Mechanisms of endosseous integration. , 1998, The International journal of prosthodontics.

[44]  S A Aquilino,et al.  Tooth preparations for complete crowns: an art form based on scientific principles. , 2001, The Journal of prosthetic dentistry.

[45]  U C Belser,et al.  Compressive and tensile zones in the cement interface of full crowns: a technical note on the concept of resistance. , 1999, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[46]  Bjarni E Pjetursson,et al.  A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. , 2004, Clinical oral implants research.

[47]  A. Vissink,et al.  Microbiota around root-form endosseous implants: a review of the literature. , 2002, The International journal of oral & maxillofacial implants.

[48]  Gary C Armitage,et al.  Periodontal diagnoses and classification of periodontal diseases. , 2004, Periodontology 2000.

[49]  F. M. Gardner,et al.  Quantitative determination of taper adequate to provide resistance form: concept of limiting taper. , 1988, The Journal of prosthetic dentistry.

[50]  B Rangert,et al.  Forces and moments on Branemark implants. , 1989, The International journal of oral & maxillofacial implants.

[51]  C. Kreulen,et al.  A systematic review of single-tooth restorations supported by implants. , 2000, Journal of dentistry.

[52]  J. H. Koolstra.  Dynamics of the human masticatory system. , 2002, Critical reviews in oral biology and medicine : an official publication of the American Association of Oral Biologists.

[53]  J I Nicholls,et al.  The effect of tooth preparation height and diameter on the resistance of complete crowns to fatigue loading. , 1997, The International journal of prosthodontics.

[54]  J. Wennström,et al.  Outcome of implant therapy in relation to experienced loss of periodontal bone support: a retrospective 5- year study. , 2002, Clinical oral implants research.

[55]  Björn Klinge,et al.  A systematic review of the incidence of biological and technical complications in implant dentistry reported in prospective longitudinal studies of at least 5 years. , 2002, Journal of clinical periodontology.

[56]  S. Müftü,et al.  Mechanics of the tapered interference fit in dental implants. , 2003, Journal of biomechanics.