Screw-Retained Crowns Explained: A Guide to Dental Implant Crowns and How They Work

Screw-Retained Crowns Explained: A Guide to Dental Implant Crowns and How They Work

Post by : Dr Keiron Thompson BDS GDC No. 228585 | 17 September 2025

What Is a Screw-Retained Crown?

When it comes to replacing a missing tooth with a dental implant, patients often ask, “What type of crown will I get, and does it matter how it’s attached?” One common option is the screw retained crown, a reliable and widely used solution in implant dentistry.

Dental implant treatment typically involves two main phases. First is the surgical placement of a titanium dental implant screw, which acts as the new tooth root. This screw is inserted into the jawbone and left to heal for approximately 3–6 months, a process known as osseointegration, where the implant fuses with the bone to create a strong foundation.

During this dental implant healing phase, your dentist will cover the implant with either a cover screw or a healing abutment, depending on whether the implant is buried under the gum or slightly exposed. This ensures the area remains undisturbed and bacteria-free while healing.

Once the implant is fully integrated, the restorative phase begins. This is where the dental implant crown, the visible tooth-like part, is attached to the implant. The crown can be connected in one of two ways: using dental cement or a small internal screw. When a screw retained implant crown is used, the restoration is secured directly to the implant with a tiny screw, allowing for easy access and long-term maintenance.

Several factors influence the choice between a screw retained crown and a cement-retained crown, including implant position, available spacing, aesthetics, and clinical preference. In this blog, we’ll explore the differences between screw and cement retained crowns, how the implant crown procedure works, and the advantages of screw retained crowns for long-term dental health and ease of replacement.

Dental Implant Treatment: How Screw Retained Crowns Are Placed

At Surbiton Dental, we often recommend screw retained crowns when restoring dental implants due to their long-term reliability and clinical advantages. The dental implant treatment process typically involves precise planning and a staged approach tailored to the health of your jawbone and surrounding tissues.

In most cases, we carry out implant procedures using a one-stage approach. This means that the dental implant with a screw is surgically placed into the jaw, and a healing abutment is attached at the same time. The benefit of this method is that the gum tissue heals naturally around the healing abutment, helping to form a natural tissue collar for the future dental implant crown. It also simplifies the final dental implant impression appointment, often eliminating the need for additional anaesthesia.

However, in cases where the bone is softer or requires extra time to integrate with the implant (as seen in some upper jaw placements or patients with low bone density), a two-stage procedure may be necessary. In this case, the implant is fully covered by gum tissue during healing. After 3–6 months, a minor second procedure is done to expose the implant and attach the healing abutment.

Once the healing phase is complete and the implant has successfully integrated with the bone, we move on to taking impressions. The visible part of the implant, called the implant platform, is typically around 4.5mm in diameter and features an internal hexagon. This design helps prevent unwanted micro-movement between the crown and implant during chewing, enhancing the stability and durability of the restoration.

With a screw retained implant crown, an access hole leads directly to the crown abutment screw. This provides two key advantages:

1. Retrievability: The screw access means we can remove the crown easily if repairs, adjustments, or a dental crown replacement are ever needed.
2. Cleaner Gum Line: Unlike cement-retained crowns, there’s no risk of excess dental cement becoming trapped under the gums, which can cause inflammation, infection, or even implant failure.

This retrievable and hygienic design is one of the major advantages of screw retained crowns, especially when placed in patients with a history of gum sensitivity or implant complications.

Advantages of Screw Retained Crowns

While both cemented and screw-retained crowns are widely used in dental implant procedures, screw-retained options offer several key advantages that make them a preferred choice for both patients and clinicians.

1. Retrievability and Maintenance:

One of the greatest advantages of screw retained crowns is that they can be easily removed if needed, without damaging the crown or the implant. This means if you need adjustments, repairs, or a full dental crown replacement in the future, it’s a far simpler procedure.

2. No Cement Complications:

Cement-retained crowns carry the risk of excess dental cement becoming trapped beneath the gum line. This can lead to inflammation, infection, or implant failure. With a screw retained implant crown, this risk is eliminated. The crown is secured using a precision screw, with the access point discreetly covered, preserving the health of your gums and implant.

3. Better Gum Health and Hygiene:

Thanks to crown abutment access, your dentist can more easily monitor and clean the implant site, helping to prevent peri-implantitis and promoting long-term success.

4. Predictability in Complex Cases:

For full arch restorations or implants placed at an angle, screw-retained designs offer more flexibility. They can be fine-tuned to improve fit and bite alignment during the implant crown procedure.

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