J Adv Prosthodont.  2016 Apr;8(2):150-157. 10.4047/jap.2016.8.2.150.

Mechanical and biological complication rates of the modified lateral-screw-retained implant prosthesis in the posterior region: an alternative to the conventional Implant prosthetic system

  • 1Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea.
  • 2Department of Periodontology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea. youngtaek77@naver.com
  • 3Department of Prosthodontics, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.


The modified lateral-screw-retained implant prosthesis (LSP) is designed to combine the advantages of screw- and cement-retained implant prostheses. This retrospective study evaluated the mechanical and biological complication rates of implant-supported single crowns (ISSCs) inserted with the modified LSP in the posterior region, and determined how these complication rates are affected by clinical factors.
Mechanical complications (i.e., lateral screw loosening [LSL], abutment screw loosening, lateral screw fracture, and ceramic fracture) and biological complications (i.e., peri-implant mucositis [PM] and peri-implantitis) were identified from the patients' treatment records, clinical photographs, periapical radiographs, panoramic radiographs, and clinical indices. The correlations between complication rates and the following clinical factors were determined: gender, age, position in the jaw, placement location, functional duration, clinical crown-to-implant length ratio, crown height space, and the use of a submerged or nonsubmerged placement procedure.
Mechanical and biological complications were present in 25 of 73 ISSCs with the modified LSP. LSL (n=11) and PM (n=11) were the most common complications. The incidence of mechanical complications was significantly related to gender (P=.018). The other clinical factors were not significantly associated with mechanical and biological complication rates.
Within the limitations of this study, the incidence of mechanical and biological complications in the posterior region was similar for both modified LSP and conventional implant prosthetic systems. In addition, the modified LSP is amenable to maintenance care, which facilitates the prevention and treatment of mechanical and biological complications.


Dental implant; Dental prosthesis design; Peri-implantitis; Prosthesis failure; Single-tooth implant

MeSH Terms

Dental Implants
Dental Implants, Single-Tooth
Dental Prosthesis Design
Prostheses and Implants*
Prosthesis Failure
Retrospective Studies
Dental Implants


  • Fig. 1 Three-dimensional view (A), cross-sectional view and photograph (B) of the modified lateral-screw-retained implant prosthesis (LSP). The modified LSP consists of a lateral screw, an abutment with a lateral hole, an antiloosening abutment screw, and a crown with a negative screw housing (1, lateral [transverse] screw; 2, abutment; 3, abutment screw).

  • Fig. 2 The modified LSP retains the implant prosthesis by the application of a pushing force onto the abutment (arrow). This system has a negative screw housing located within the crown, which provides mechanical locking by pushing against the walls of the abutment. The lateral screw penetrates the abutment to make direct contact with the abutment screw.

  • Fig. 3 (A) The modified LSP does not involve access-hole resin or sealing materials, and so the occurrence of lateral screw loosening (LSL) can be clinically verified by visually checking the lateral screw access hole. The lateral screw can be tightened if necessary using a lateral screwdriver with a contra-angle attachment. The implant abutment/crown is manually tightened to a torque of 5-10 Ncm. (B) Since the lateral screw is designed for use with a lateral screwdriver and a contra-angle attachment, it is easily managed within the oral cavity.

  • Fig. 4 Frequency distribution of implants according to their position in the jaw and the complication rates of the implant-supported single crowns (ISSCs) with the modified LSP in the posterior region. ASL, abutment screw loosening; LSF, lateral screw fracture; CF, ceramic fracture; PM, peri-implant mucositis; PI, peri-implantitis.

  • Fig. 5 Incidence of mechanical and biological complications according to the duration of functional loading.


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