Abutment Screw Access Fill
Access fill, whether screw or endo, always seems to be a topic of restorative discussion. What can we do to prevent the dark shadowing or grey appearance? We spend all of that time on the crown or implant solution then compromise the final esthetics with a poorly masking access fill. This case shows a screw retained implant crown. Teflon tape is first packed into access opening directly over the abutment screw(about 1/4 to 1/2 inch long). Unlike a cotton pellet, teflon tape can be well packed into the access opening to prevent the screw from backing out. Tetric EvoFlow Bulk Fill Shade A (Ivoclar Vivadent) is layered directly over the teflon tape, followed by Tetric EvoCeram (A2). The block is an emax MT (A2).
I love Tetric EvoCeram for these as well. Between it and Monobond Etch & Prime, I never worry about safely, properly, and beautifully restoring an access anymore. Nice photos.
I have found that when there is metal close to the occlusal that placing a first layer of composite over the tape, then a thin layer of a flowable opaquer (I use Flow-It Universal Opaque) followed by the last 1.5 mm of composite prevents any grey show through.
Exactly right Gary. So many options fot this. Layering seems to be the key to avoid any of the metal showing through.
I'm just using enough Teflon to completely mask any metal, burnishing it tightly, then filling with sonicfill. The Teflon does a nice job of blocking the gray.
I have gone to two layers teflon tape to make sure screw does not get blocked, and evoceram flowable and works great
