An implant crown: screw-retained or cemented

There are two ways to fix a crown on an implant — with a screw or with cement. Each has its strengths, and the choice is made in advance, at the planning stage.

A screw-retained crown is fixed through an opening in the chewing surface, which is then closed with filling material. A cemented crown is placed onto an abutment and glued, like an ordinary crown on a tooth.

What makes screw retention good

• it can be removed at any time — for inspection, cleaning or remaking
• there is no cement, so no risk of excess left under the gum
• easier to service if inflammation develops around the implant
• nothing has to be drilled out if the crown breaks

Cement remnants under the gum are not a trifle. They are a known cause of inflammation around an implant, which develops quietly and is found late. Screw retention removes that risk entirely.

What makes cementing good

• the chewing surface is solid, without an opening — sometimes that matters aesthetically
• it compensates for an awkward implant angle through the shape of the abutment
• a tight contact with neighbouring teeth is easier to achieve

How the option is chosen

The main factor is where the implant points. If its axis exits through the chewing surface, the screw opening can be hidden invisibly and we choose a screw-retained construction. If the axis runs forward, towards the lip, the opening would land on the visible surface of a front tooth — then we work with cement or with a custom angled abutment.

So the decision is not made in the chair on the day the crown goes in, but earlier — when the position of the implant itself is planned. That is worth discussing with the dentist before surgery, not after.