Metal-ceramic crowns on screwed implants:the challenge of the final esthetic outcome!

In metal-ceramic crowns on implants, the hole to access the healing screw can be an esthetic problem for the patient, both for the composite camouflage to be used and for the opacification of the underlying metal structure.
Teflon is placed to protect the screw head and therefore leaving the metal surface covered. The ideal condition is leaving approx. 2 mm of margin in pure ceramics exposed on the metal structure to achieve a good adhesion and at the same time a camouflage of the composite and of the ceramic.
the exposed ceramic surface is etched with fluoridric acid (HF 9.6%) for 60 seconds to obtain the area’s microroughness. After etching the area, it is cleaned and dried, and then Tokuyama Universal Bond is applied, following the manufacturer’s prescriptions.
The layering is carried out with a first thin layer of Omnichroma Blocker, as if it were a dentin mass, and then supercolors Tokuyama Estelite Color (Dark Brown) are applied to characterize cavities and fissures. The restoration is completed using Omnichroma (used as an enamel mass), to achieve an optimal final result.