To Screw or to Cement?
Posted on 09/15/2014
To Screw or to Cement?
With the continuing growth of implant dentistry, the restorative dentist often finds her or himself faced with the choice of screw versus cement retained. We’ve been asked the question - which is better?
As with most decisions in dentistry, the answer is that it depends. Neither is better or worse. In general, screw retained offers easier options for retrieval, but typically inferior esthetics. Cement retained offers the lab more flexibility, but can be more complicated to remove. Here is an overview:
Screw Retained:
Commonly used in the posterior. Limited by implant position. If implant is off the ridge on the buccal or lingual, the screw hole often will not have path of insertion.
Cement Retained:
Commonly used anywhere in the mouth. Allows technician to correct angulation issues. Does not require composite to cover access hole. But creates difficulty for retrieval. If screw loosens, doctor may compromise the abutment when attempting to access the screw.
Hybrid Screw Retained:
A new hybrid approach where the lab makes a custom abutment, but then fabricates a crown with a screw access hole and cements the two together, in the lab, has become more popular. While a bit more expensive on lab labor, the parts are cheaper as a stock abutment can be used.
With the continuing growth of implant dentistry, the restorative dentist often finds her or himself faced with the choice of screw versus cement retained. We’ve been asked the question - which is better?
As with most decisions in dentistry, the answer is that it depends. Neither is better or worse. In general, screw retained offers easier options for retrieval, but typically inferior esthetics. Cement retained offers the lab more flexibility, but can be more complicated to remove. Here is an overview:
Screw Retained:
Commonly used in the posterior. Limited by implant position. If implant is off the ridge on the buccal or lingual, the screw hole often will not have path of insertion.
Cement Retained:
Commonly used anywhere in the mouth. Allows technician to correct angulation issues. Does not require composite to cover access hole. But creates difficulty for retrieval. If screw loosens, doctor may compromise the abutment when attempting to access the screw.
Hybrid Screw Retained:
A new hybrid approach where the lab makes a custom abutment, but then fabricates a crown with a screw access hole and cements the two together, in the lab, has become more popular. While a bit more expensive on lab labor, the parts are cheaper as a stock abutment can be used.