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900 NW 13th St #301
Boca Raton, FL 33486
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Why do dental implant screws loosen and fracture after a prosthesis is placed?

May 3, 2013

 I feel that foreign matter plays a role in contamination of not only the implant fixture threads, but also the implant screw threads. This foreign matter is comprised of blood (body), calculus (body), wax (lab), porcelain powder (lab), metal filings(lab), and stone slurry (lab).  I also feel that the screw head may not seat properly in the screw access hole of the screw abutment, crown, and/or bridge prosthesis due to the same contaminants.

Screw loosening/fracture occurs:
1. When dentists and labs don’t recognize this debris as a contaminant.
2. The dentists and labs don’t use a new/unused screw for the final screw.
3. The proximal contacts of the crown and bridgework are too tight, putting excessive lateral pressure on the screw threads.
4. Calculus formation in the threads of loose screws will inhibit the dentist’s ability to remove the screw without fracture.
5. Screw metal surface quality may play an important role. You need to check with the implant manufacturers.

Presoaking the screw access hole with tarter/stain removing solution is my best advice for existing cases. Lab quality control starts with using advanced magnification such as a quality dental microscope.  GC

Reaching out to dental students across the nation via YouTube

May 2, 2013

Thank you very much for you fit check videos – I think if every dental student watched them and applied the level of detail that you do then the worldwide quality of dentistry would improve drastically!
Thanks for all of your videos – I think they are some of the most informative dental videos on YouTube.

All-on-Four Fixed Implant Denture – "A cost effective alternative to wearing a complete set of removable dentures"

August 12, 2012

   End stage dentistry does not have to end with a complete set of removable dentures.  Now there is a unique treatment concept that will return a patient’s vitality for chewing food and help them avoid embarrassing  moments associated with wearing dentures.  It’s known as the “All-on-Four” technique with same day loading.  Same day loading or “Immediate Loading” allows the patient to never be without teeth.  Patients walk into the dental office with removable dentures and two to three hours later walk out with fixed implant non-removable dentures that they can call their own.  Please click on the following link to watch one of our many videos on the “All – on – Four” method.  GC

 http://www.youtube.com/watch?v=yyqMxvV9SCw&list=UUZFBuQ_o3n2JTDSR2hj3TTg&index=1&feature=plcp 

http://www.youtube.com/watch?v=oyegukONiZA&list=UUZFBuQ_o3n2JTDSR2hj3TTg&index=9&feature=plcp   

Dental Lab Work – do dentists or labs perform the final "fit checking" of your case?

March 18, 2012

I published the following information for dentists to review on YouTube, along with a short video.  Ultimately it is the dentist’s responsibilty to perform the final “fit checking” of your lab work prior to placing it permanently in your mouth. 

“Everyone knows that dentistry is not an “exact science.”  That being said, where do you draw the line regarding the fit of your lab work.  Do you simply trust that your lab is operating at 100% quality control?  Whose level of quality control?  I highly recommend that you at least purchase a stereo zoom microscope that can be mounted to a countertop in your office.  “Fit checking” all of your cases under a microcope after they come back from your lab, will give you the opportunity to send the case back for further adjustments.  You could be faced with making these adjustments directly in the mouth wasting your time, your money, as well as the patient’s time.  For years I’ve struggled with inconsistencies related to lab work during seating appointments.  I had to finally “grab the bull by the horns” and you can too.  Simply purchase a microscope and watch my video on fit checking.  I will be happy to give you the microscope information that you will need to make the right purchase.”  GC

The quality of my dental work  reached an un-imaginable high level of care once I stopped using dental loupes and switched to using a dental microscope.  I send all of my patients’ lab work to dental labs that also use microscopes.  Finally, I perform the final “fit checking” procedure and then place the lab work permanently in my patient’s mouth.  GC

Choosing the right dentist by asking the dental lab?

March 3, 2012

For years, I have accepted many dentists as patients for restorative treatment.   These dentists are seeking out the very best of quality dental care.  Here is a list of some common key points that they shared prior to selecting me as their dentist:

  1. The dentist must have many years experience in cosmetic and restorative dentistry

  2. The dentist must be meticulous in tooth preparation design

  3. The dentist must have persistent attention to detail

  4. The dentist must use a dental microscope

  5. The dentist’s lab must use a dental microscope

  6. The dentist must use a high quality (non-commercial) dental laboratory

Each dentist consulted a high quality dental laboratory and ask the lab owner for a referral as to who they thought presented them with the best dental work.  These dentists were also allowed to review my cases in the laboratory to help them make their final decision.  GC

900 NW 13th Street, Suite 301, Boca Raton, FL 33486 USA
Dr. Gerard Cuomo Gerard Cuomo Microscope Enhanced Dentistry is passionate about dental service through their advanced technology to give their patients perfect smiles. (561) 391-6290 (561) 391-6299 dr@gcuomodds.com