Screw-Retained vs. Cemented Crowns: Which Is Better for Your Implant?

When dental implant treatment is planned, one of the clinical decisions that needs to be made is how the final crown will be attached to the implant. The two most common methods are screw retention and cement retention. Both are widely used in implant dentistry and both have a strong clinical track record.

Patients sometimes ask which option is "better," but the honest answer is that neither is universally superior. The most suitable approach depends on a number of clinical factors, including implant position, bite forces, aesthetic requirements, and the overall treatment plan. This guide explains how each method works and what patients should understand when discussing crown options with their dentist.

What Is an Implant Crown?

An implant crown is the visible part of a dental implant — the tooth-shaped restoration that sits above the gum line. It is custom-made to match the size, shape, and shade of the surrounding teeth and is designed to restore both function and appearance.

The crown connects to the implant body (the titanium post embedded in the jawbone) via a component called an abutment. How the crown is secured to the abutment is where the distinction between screw-retained and cemented crowns comes in.

At our clinic, implant crowns are fabricated from zirconia, a ceramic material valued for its durability and natural appearance. Regardless of how the crown is attached, the material and craftsmanship of the restoration play an important role in the overall result. For patients exploring implant options, our single tooth implant page provides a broader overview of the treatment process.

What Is a Screw-Retained Implant Crown?

A screw-retained crown is attached to the implant abutment using a small screw that passes through the crown and into the implant. The screw access hole — a tiny channel on the biting surface or the back of the crown — is then sealed with a tooth-coloured filling material.

Key characteristics of screw-retained crowns include:

• The crown can be removed and refitted by the dentist without damaging it, which can be helpful for maintenance or repair
• No dental cement is used, which eliminates the possibility of excess cement around the implant site
• A small access hole is present on the crown surface, which is filled but may be visible in certain positions
• Screw retention requires precise alignment between the implant and the planned crown position

Screw-retained crowns are commonly used in situations where retrievability is considered important — for example, in areas where future maintenance access may be beneficial or where the implant angle allows for ideal screw placement.

What Is a Cemented Implant Crown?

A cemented crown is attached to the implant abutment using dental cement, in a similar way to how a traditional crown is fixed onto a prepared natural tooth. The abutment is first connected to the implant, and then the crown is cemented onto the abutment.

Key characteristics of cemented crowns include:

• No screw access hole on the crown surface, which can provide a smoother, more natural appearance
• The cementation process can compensate for minor angulation differences between the implant and the ideal crown position
• Removal typically requires cutting the crown off, which means a new crown may be needed if access is required
• Careful management of excess cement is necessary to reduce the risk of irritation to surrounding gum tissue

Cemented crowns are often considered when aesthetics are a high priority — particularly in the front of the mouth — or when the implant angle makes screw retention less practical.

Key Differences Between Screw-Retained and Cemented Crowns

Understanding the practical differences between the two approaches can help patients engage in informed discussions with their dentist during treatment planning.

Retrievability and Maintenance

Screw-retained crowns can generally be removed and refitted without being damaged. This can be useful if the crown needs adjustment, professional cleaning around the implant, or if a component requires attention. Cemented crowns, by contrast, are more difficult to remove non-destructively and may need to be remade if access to the underlying implant is required.

Aesthetic Considerations

Because cemented crowns do not have a screw access hole, they can offer a marginally smoother surface, which may be preferred in highly visible areas. However, modern techniques for filling screw access holes mean that the difference is often minimal, and both types can achieve excellent aesthetic results.

Bite and Load Management

The position of the implant in the jaw and the direction of biting forces may influence which attachment method is more appropriate. In some cases, the implant angle makes screw retention straightforward; in others, cement retention may provide better alignment of the crown with the opposing teeth.

How Does Crown Choice Affect Long-Term Maintenance?

Both screw-retained and cemented crowns require ongoing care and regular professional review. However, the way maintenance is carried out can differ between the two.

• Screw-retained crowns can be unscrewed for professional cleaning and inspection of the implant and surrounding tissues. This can simplify routine maintenance appointments.
• Cemented crowns cannot typically be removed for cleaning without being damaged. Maintenance focuses on thorough cleaning around the crown margins while it remains in place.
• Both types require good daily oral hygiene, including interdental cleaning around the implant site
• Regular review appointments are important regardless of crown type, to monitor gum health, bone levels, and the condition of the restoration

It is worth noting that neither attachment method guarantees a specific maintenance outcome. Long-term implant health depends on a combination of clinical factors, patient hygiene, and regular professional oversight.

Is One Option "Better" Than the Other?

This is one of the most frequently asked questions, and the answer is nuanced. Neither screw-retained nor cemented crowns are inherently better in all situations. Each has characteristics that may make it more suitable in certain clinical scenarios.

Factors that influence the decision include:

• The position of the implant in the jaw and its angulation
• Whether the crown is in a highly visible area where aesthetics are a priority
• The biting forces that the crown will need to withstand
• The patient's long-term maintenance needs and preferences
• The overall treatment plan, particularly for cases involving multiple implants

The "better" option is the one that best fits the individual clinical situation. This is determined through careful treatment planning, not through a general rule or patient preference alone.

How Dentists Decide Which Crown Type to Use

The decision between screw retention and cement retention is made by the treating dentist as part of the overall treatment plan. This decision takes into account several clinical variables:

• Implant placement and angle — the position and angulation of the implant in the jawbone directly influences whether a screw access hole can be placed in an acceptable position on the crown
• Bite analysis — the relationship between the implant crown and the opposing teeth affects load distribution and may favour one method over the other
• Aesthetic zone — in areas where appearance is critical, the dentist will consider which method provides the best visual result
• Long-term planning — if future access to the implant or crown is anticipated, retrievability may be factored into the decision

In many cases, the dentist will explain their reasoning during the treatment planning stage. Patients are encouraged to ask questions about why a particular approach has been recommended for their case.

When Should Crown Type Be Discussed?

Crown attachment method is typically discussed during the treatment planning phase, after the implant position has been determined and before the final restoration is fabricated. This is the best time to:

• Ask your dentist to explain the planned attachment method and why it has been chosen
• Understand the potential advantages and limitations of each option in your specific case
• Discuss any preferences you may have, while recognising that clinical factors may take priority
• Clarify how the choice may affect future maintenance appointments

Informed patients are better equipped to participate in treatment decisions. However, it is also important to trust the clinical judgement of the treating dentist, who will consider factors that may not be immediately apparent to the patient.

Dental Implant Crown Planning in London

At our London clinic, crown type is one of many details considered during the treatment planning process. We take the time to explain the reasoning behind each recommendation, including how the crown will be attached and what this means for long-term care.

Our approach is patient-led and transparent. If you have questions about screw-retained versus cemented crowns — or any other aspect of implant treatment — we welcome the conversation. Every treatment plan is tailored to individual clinical needs, and we believe patients should understand each element of their care.

Discussing crown options during a consultation can help clarify which approach is most suitable for your implant and long-term care. If you would like to explore your options, you can book a consultation or contact our team with any questions.

Frequently Asked Questions

What is the difference between screw-retained and cemented implant crowns?

Screw-retained crowns are fixed to the implant abutment with a small screw, while cemented crowns are bonded using dental cement. Both methods are clinically established, and the choice depends on individual factors such as implant position, aesthetics, and maintenance considerations.

Are screw-retained crowns easier to maintain?

Screw-retained crowns can be removed by the dentist for professional cleaning and inspection, which may simplify certain maintenance procedures. However, both crown types require good daily oral hygiene and regular professional reviews.

Can cemented crowns cause problems with implants?

If excess cement is not properly managed during placement, it can potentially irritate the surrounding gum tissue and contribute to inflammation. However, when placed carefully by a trained clinician, cemented crowns are a well-established and widely used option.

Does crown type affect how long an implant lasts?

The attachment method alone is not a primary determinant of implant longevity. Factors such as oral hygiene, regular maintenance, bone health, and overall treatment planning have a greater influence on long-term outcomes.

Can crown type be changed later?

In some cases it may be possible to change from one crown type to another, but this depends on the implant position, the abutment design, and other clinical factors. It is not always straightforward and would need to be assessed individually.

How do I know which option is right for me?

The most suitable crown type is determined during treatment planning, based on your specific clinical situation. Your dentist will explain the reasoning behind their recommendation and answer any questions you may have.

Does the crown material differ between screw-retained and cemented options?

Not necessarily. At our clinic, zirconia is used as the crown material for both screw-retained and cemented restorations. The attachment method and the crown material are separate considerations in treatment planning.

If you have questions about implant crown options or would like to understand how your treatment would be planned, a consultation provides the opportunity to discuss every aspect of your care in a supportive, no-pressure environment.