What are screw-retained crowns?
A screw-retained implant crown is a single-tooth fixed restoration that is secured to a dental implant by means of a screw.
Some of the benefits of screw-retained crowns are:
– The ability to precisely place the crown(s)
– Good bone retention around the implant(s)
– Screw-retained crowns are easy to remove when maintenance, repairs, or surgical intervention is necessary
There are two different ways to secure a single implant crown, either screw-retained or cemented. Both methods deliver excellent results but screw-retained crowns have long been popular with implant dentists due to the proven long-term success they deliver.
What is the process for placing screw-retained crowns?
After the regular root form dental implant is placed and has osseointegrated for three to four months, the abutment (post) and crown are ready to be fabricated and secured onto the implant. Special impressions called lab transfers are taken so that the laboratory can utilize precise implant parts and fabricate a one-piece crown and abutment.
Essentially, the final abutment and crown are fabricated together and the entire structure is screwed onto the dental implant. By securing the entire structure with a precisely torqued screw, the implant-crown complex has amazing strength and is able to withstand extreme chewing forces.
How do you determine if you’re a good candidate for screw-retained crowns?
Screw-retained implant crowns and cement-retained implant crowns have significant design differences, but the end result is similar. While it is the implant dentist’s responsibility to select the most appropriate method of retention in each individual case, the pros and cons of screw-retained and cemented crowns should be discussed during the treatment planning phase.
Average cost of placing a screw-retained crown
According to an Implant Evolution survey of implant dentists, the cost of a screw-retained implant and crown ranges from $2,900 to $4,900. The overall process and associated laboratory cost for a screw-retained implant and crown is very similar to that of a cement-retained crown, but the price of a screw-retained crown may be slightly higher due to the additional lab work required to fabricate the abutment-crown complex.
Bone density requirements and required scans
There is a minimum amount of bone volume that is required to support dental implants, but beyond the regular bone and surgical requirements, there are no other special issues when placing screw-retained implant crowns.
As with any implant procedure, preoperative planning is essential to success. State-of-the-art diagnostic imaging equipment—typically cone beam or CBCT imaging—allows your implant surgeon to review detailed 3-D images of the surgical area and to produce 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 transfer impressions needed to fabricate the final abutment and crown. Additional sedation options—including general anesthesia—are available but are usually not needed for single implant procedures.
Preoperative advice and tips
There are no special preoperative preparations needed for screw-retained crowns.
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 successful surgery.
Smoking cessation is imperative because smoking 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 screw-retained 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 screw-retained 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 surgery. But besides following postoperative instructions, there are no other special requirements for screw-retained implant crowns to heal properly and function well for many years.
Duration of recovery
The recovery time associated with screw-retained crowns is similar to other dental implant procedures and postoperative pain is easily controlled. Generally, patients can go back to work the next day, or sometimes the same day. You should be aware, however, that there can be one or two additional appointments needed to facilitate fabrication of the crown.
Proper upkeep, issues with recovery & rejection, and peri-implantitis
Most implants have success rates greater than ninety-five percent but proper postoperative home care is necessary to ensure proper healing. Screw-retained crowns also require regular maintenance throughout the life of the implant and crown. But one of the benefits of screw-retained crowns is that they help prevent peri-implantitis, a condition characterized by inflammation and progressive loss of supporting bone.
Alternative treatments
Screw-retained 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. And there are few alternative treatment options, namely, fixed bridges supported by natural teeth or removable partials.