What are cemented crowns?
A cemented crown is a crown that is secured to a dental implant using a luting agent similar to crowns cemented onto natural teeth. Some of the benefits are:
Aesthetics. A cemented crown looks just like a natural tooth and is biocompatible with surrounding gingival tissues.
- Aesthetics. A cemented crown looks just like a natural tooth and is biocompatible with surrounding gingival tissues.
- Function. Cemented or fixed crowns work and feel just like natural teeth.
- Fracture Resistance. Cemented crowns are also known for their excellent resistance against breakage. Because of this, cemented crowns are considered to be the first choice for single tooth replacements.
There are two different ways to secure an implant crown, either cemented or screw-retained. Both methods deliver excellent results but cemented crowns are slightly more popular with implant dentists because they are superior in appearance and are faster to deliver to the patient..
The downside of cemented crowns is that they are a little more difficult to remove if any repairs need to be made. Even though they are hard to remove, any repair issues can be easily remedied. Any excess cement retained at the gumline may be prone to harboring bacteria, which can lead to late implant failure. On rare occasions, cement can lead to gum inflammation or even future crestal bone loss. Because of these potential issues, dentists take extra focused care when cementing the final restoration onto dental implants.
What is the process for placing cemented crowns?
After the dental implant is placed and has osseointegrated for three to four months, a crown is fabricated and cemented in place. Your implant dentist will put the cement in the crown or on the tooth—and then push down on the crown making sure it is seated correctly. Then s/he will remove any excess cement. and check to ensure the bite (occlusion) is correct.
You’ll want to be careful not to eat any hard or sticky foods while the cement hardens; you will also want to avoid flossing around the crown immediately. If you feel any soreness or discomfort after the procedure, that is usually readily-controlled with over-the-counter pain medication and saltwater rinses.
How do you determine if you’re a good candidate for cemented crowns?
Cement-retained implant crowns and screw-retained implant crowns have significant design differences, but the end result is much the same. While it is your implant dentist’s responsibility to select the most appropriate method of retention, you should discuss the pros and cons of cemented and screw-retained crowns with your dentist during the treatment planning phase.
Cemented crowns look very much like natural teeth, but can be a challenge to remove. With screw-retained crowns it’s more difficult to achieve a natural look, but they are somewhat easier to remove and replace if the need arises.
Average cost of placing a cemented crown
According to an Implant Evolution survey of implant dentists, the cost of an implant and cemented crown ranges from $2,900 to $4,900. The overall process and associated laboratory cost for a cement-retained crown is very similar to that of a screw-retained implant and crown, but the price of a screw-retained crown may be higher due to the additional lab work required to fabricate the abutment-crown complex. Simply put, more parts=more costs.
Bone density requirements and required scans
There is a minimum amount of bone volume that is required to support dental implants, but beyond the ordinary bone and surgical requirements, there are no other special issues when placing cemented crowns. The overall process is similar to crowns cemented onto natural teeth, a procedure all dentists are very familiar with.
As with any implant procedure, preoperative planning is essential to success. State-of-the-art diagnostic imaging equipment—typically cone beam imaging—allows your implant surgeon to review detailed 3-D images of the surgical area and to develop a surgical plan that will produce the best possible results.
Anesthesia: Can you be put under sedation?
As with most other dental implant procedures, local anesthetic is used to numb the surgical site itself. Local anesthetic may also be required to do the impressions needed to fabricate the abutment and crown. Because the final crown phase is similar to regular dental procedures, sedation is not required to fabricate and cement the final crown and can actually complicate things dramatically.
Preoperative advice and tips
There are no special preoperative preparations needed for cement-retained crowns. Good brushing and flossing habits are always helpful.
Regular preoperative requirements typically include the following do’s and don’ts:
- Do brush your teeth prior to your appointment
- Do wear loose-fitting, comfortable clothing
- Don’t drink alcohol for at least 24 hours prior to the procedure
- Don’t eat or drink anything for at least eight hours prior to surgery if you are scheduled to have general anesthesia
It is extremely important to follow all preoperative instructions precisely because each directive is specifically designed to increase the chances of a successful procedure. If you’re a smoker it’s imperative that you stop smoking, as it leads to more implant failures than any other behavior or activity. In part, that’s because nicotine reduces blood flow, which inhibits the healing process.
Is this a same-day procedure?
No. Like other dental implant procedures, an adequate healing period is necessary for complete osseointegration, which is the process by which bone grows around the implant threads and “locks” the implant into the bone.
There can also be one or two additional appointments needed to facilitate the fabrication of the crown due to the laboratory work required to make the final restoration. But when proper protocols are patiently followed, the long-term success rate for cemented crowns is well over ninety-five percent.
Post-surgery tips and advice for proper healing
Special attention to postoperative care is vital to good healing and the best implant osseointegration possible. Three to four days of post-surgery soreness is normal, but postoperative pain can be controlled by medication. An antibiotic or antimicrobial mouth rinse may also be prescribed in the wake of the procedure.
Besides following postoperative instructions, there are no other special requirements for cemented crowns to heal properly and function well for many years.
Duration of recovery
The recovery time is similar to other dental implant procedures and post-procedure pain is easily controlled. You can expect to go back to work the next day, sometimes even the same day. Again, you should be aware that there can be one or two additional appointments needed to facilitate fabrication of the crown and cement it in place.
Proper upkeep, issues with recovery & rejection, and peri-implantitis
Most implants have long term success rates greater than ninety-five percent but proper postoperative home care is necessary to ensure proper results. Just like natural teeth, cemented crowns also require regular maintenance throughout the life of the implant and crown. Once installed they help prevent peri-implantitis, a condition characterized by inflammation and progressive loss of supporting bone.
Cemented implant crowns are designed to replace missing teeth using a fixed method and have provided millions of patients with replacements that mimic nature in function and aesthetics. Many times an implant and crown is done so well that the average person cannot tell it’s a false tooth! There are other alternative treatment options for replacing missing teeth, including fixed bridges or removable partials, but these options can lead to other complications and typically don’t deliver the same results as do crowns cemented onto dental implants.