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Screw Retained Or Cemented Dental Implant Abutments….Which Is Better?

This is actually a really old topic that has become renewed again in the last few years. Do you hold your implant crown or bridge in with a screw abutment connection or do you hold it in with cement? Each technique has their merits.

In this video I will describe many of the reasons why one should be chosen over the other. There seems to be a very large educational gap in dentists that are heavily involved with implants and those that just dabble in dental implant restorations. Some people take an all or none approach with regards to screw retained crowns or cement retained crowns but did not really seem to understand the biomechanical principles in relationship to bone physiology.  The same educational gap holds true for connecting implants together or leaving them as individuals. I hope this helps you make a good decision on how to determine what is best for your unique situation. I have utilized both methods for almost two decades now.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry

17 thoughts on “Screw Retained Or Cemented Dental Implant Abutments….Which Is Better?

  1. Hello there Doctor Amin,

    Is a cement retained dental implant more prone to infection than a screw-retained dental implant? Or are they equally prone to having infection? Thanks!

  2. I had a implant crown chip and dentist removed crown ( had a cement abutment) then replaced with a new crown but screwed into my implant. It came loose after 6 months. He just unsealed… and rescrewed it in. Says if this happens again and comes loose… I will have to have the implant in my upper jaw completely removed and replaced… EXTREMELY COSTLY AND SURGICAL!!! Does this sound right?

    1. For him to say that, there must be something wrong with the implant….like maybe it fractured?? Find out why!

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  3. Hello I’ve lost two lower jaw teeth due to big fillings and no crown it cracked and shattered had to extract it. My dentist sent me to oral surgeon to take it out when I took it out the surgeon suggested bone graft tht was the first time I found out abt bone graft after bone craft I delayed the implants waiting caz of financial situation n lack of knowledge like 4-5 yrs went back to get implants to same doctor she suggested to get bone graft osseous/bul graft and guided tissue reg nonresorb again caz the previous graft has dissolved before getting endosteal implant placement. She gave me the price I left and scheduled an appointment with my general dentist he also does implants but he’s not oral surgeon or periodontist but some dentist do implants as well after examination he said I don’t need bone graft I left and made an appointment with a periodontist he also said I dnt need bone graft as well. I need to make a decision soon I’m confused what to do caz my upper teeth are coming down it already has I didn’t know abt tht I just found out abt tht recently by looking to my recent X-ray can u let me know if I need to get the graft n guided tissue reg or not need to please need to make a decision soon and I need your suggestions I found your site online and I learned so much by reading all the info abt implants I learned about full porcelain implants from your site please suggest me if I need to just go for implants or get the graft and guided tissue reg before implants thank u

    1. Thank you for your kind words. Without a detailed examination and 3-dimensional scan there is no way for me to help you with this particular situation. Standard panoramic image is not enough to diagnosis and treatment plan dentistry of this magnitude. Find a dentist that is experienced and that you trust to perform the procedures for you.

  4. Hello Dr. Amin. I have written one comment an hour ago but it is not posted yet.
    plz Doctor my situation is, 10 years before I got a two small screws ceramic front teeth (in Morocco), 2 years earlier I broke the crowns and got two new glued crowns ( in China). Last week the right front tooth broken and fell with one screw (the screw got brownish dark color); FYI I re-glued the this same tooth 6 weeks earlier. When I presented to my Doctor in China still, she suggested the implants and the flipping bridge.
    My question is: Can I do the same first option the ceramic + screw? As the implant is very expensive and the long terms effect of flipping bridge are esthetically dis-encouraging for the front teeth.
    I appreciate your soon advice.

    1. It is a little bit hard to fully understand your question. I don’t know what a flipping bridge is… I’m thinking this is a typo? Perhaps you can re-post your question with a little bit more clarity?

      Without seeing you it would be impossible to answer these details. It sounds like you need to see an expert in dental Implantology rather than just a “regular dentist.” They should be able to help you develop a long-term stable and predictable solution. Your teeth should not be falling out!

  5. Hello Dr. Amin. I would like to hear your advice on my situation please.
    I got two front teeth old school two small screws ceramic root (in Morocco 10 years ago) of which the crown replaced by glued one two years ago (in China). Now the right tooth, one of the screws loosen and led to the fell of the crown. Now my Doctor gave me two choices the detachable bridge or the implants. Can I just process as the first time, because here dental care is very expensive? waiting for your kind reply.
    By the way I m located in Shanghai province in where the life standards are high and all specialties are available.

  6. Hi I have had 6 implants n my upper jaw and then a fixed denture but I have a gap between the gum and the denture where food gets in the dentist said that it’s do you can clean properly is this true.

    1. On the upper jaw there is not supposed to be a gap between a Prettau style implant bridge and the gums. On the lower jaw it is okay to have this open. If the space is present on the upper jaw it will prevent you from speaking clearly. The design of the bridge has to be made to be butted up against the gum. If it is screw retained, a could be removed and porcelain added to the underside to close in that space. You will likely have to have the dentist take a pickup impression.

  7. hello dr amin iam young man who went to the dentist and have exam and xray he said I have gum disease and bone lost but my top teeth looks very healthy and strong still he suggest to remove all my top and bottom teeth and replace them what my next step should be should I get second opinion or what you advice thank you

    1. Second opinion for sure! This shouldn’t be a surprise to you. Even though they look good, the bone and gum may be damaged.

  8. Hello Dr Amin. Two years ago I lost two implants which caused my overdenture to become unstable. The surgeon added three additional bicon implants. My dentist couldn’t use screws and cemented a full upper arch bridge. I am constantly searching for my bite and have terrible jaw and neck pain. I saw a diplomate of implantology and was told it has to be removed to begin the process again as she can see the rivet part of the screws and I need something that can be removed yearly for cleaning.

    1. Ugh. Sounds like you need an expert. Implant dentistry is not as easy as the commercials make it seem. It is a highly complex field.
      I am not a huge fan of Bicon especially when missing all teeth.

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About Ramsey Amin, DDS

Dr. Ramsey Amin has extensive experience in surgical and restorative implant dentistry. As one of only less than 400 Diplomates of the American Board of Oral Implantology/ Implant Dentistry (ABOI/ID) he is considered an expert, and board-certified in dental implants. He is a former instructor at the UCLA School of Dentistry.