Screw-Retained vs Cement-Retained Implant Crowns: How to Choose

Every implant crown or bridge is held on in one of two ways. A screw-retained restoration is fixed with a screw through an access hole in the crown. A cement-retained restoration is cemented onto an abutment, like a crown on a natural tooth. Both work well in the right case. The choice affects how easily you can retrieve the restoration, the risk of leftover cement, the aesthetics, and which abutment you order.

Screw-retained restorations

The crown or bridge is joined to its base (a Ti-base, a multi-unit abutment or a cast abutment) and screwed directly to the implant or abutment. The screw access hole is sealed with a filling material.

Advantages

• Retrievable. Remove the screw and the restoration comes off for repair, hygiene or a screw check. No cutting, no damage.
• No cement under the gum. Excess cement around implants is a known cause of peri-implant inflammation. Screw retention removes that risk.
• Works with limited height. Retention doesn’t depend on abutment height, so it suits short interarch spaces.

Limitations

• Access hole. The hole has to come out on the occlusal or lingual surface. If the implant is angled toward the facial, the hole can land in a visible spot.
• Precision. A multi-unit bridge must fit passively. A framework that doesn’t fit puts the screws under load.
• Porcelain around the access hole can chip if the hole is large or close to the edge.

Cement-retained restorations

An abutment is screwed to the implant, then a crown is cemented onto it, just as on a prepared tooth.

Advantages

• Familiar workflow. The crown is made and seated the way most clinicians and labs already work.
• Intact occlusal surface. No access hole, which helps aesthetics and occlusion.
• Angle correction. An angled abutment can correct the axis, so the crown seats on a usable path even when the implant is tilted.
• Passive fit is easier. The cement layer takes up small discrepancies.

Limitations

• Excess cement. Cement pushed below a deep margin is hard to see and remove. Keep margins shallow, use a minimal amount of cement and clean carefully.
• Harder to retrieve. Removing a cemented crown often means cutting it off.
• Needs height. A short abutment gives poor retention.

Side by side

	Screw-retained	Cement-retained
Retrievability	Easy: unscrew it	Difficult: often cut off
Excess cement risk	None	Present, depends on margin depth
Occlusal surface	Has an access hole	Intact
Implant angulation	Access hole may be visible	Angled abutment can correct it
Passive fit	Critical	More forgiving
Minimum height	Low	Needs enough abutment height
Typical parts	Ti-base, multi-unit abutment, cast abutment	Stock or custom abutment, cemented crown

Which abutment for which option?

Screw-retained single crowns are usually made on a Ti-base: the lab designs the crown in CAD/CAM software, mills it and bonds it to the Ti-base, and the whole unit screws into the implant. See Ti-bases for internal hex and Ti-bases for conical connection.

Screw-retained bridges and full arches usually sit on multi-unit abutments. These move the screw connection up to a common level and correct angulation, so a framework can be seated passively over several implants. See multi-unit abutments and the All-on-4 guide.

Cement-retained crowns use a stock or custom abutment. Choose the collar height so the margin sits just below the gum, not deep, to make cement clean-up easier. See cemented abutments for internal hex and conical connection.

Custom cast abutments can be made from castable abutments when a stock shape won’t fit.

Can you combine them?

Yes. A screw-cement (hybrid) design bonds the crown to a Ti-base in the lab, so the cement is cured and cleaned outside the mouth, then the unit is screwed in. It keeps the retrievability of a screw-retained crown and avoids cement in the mouth. This is now a common choice for single CAD/CAM crowns.

Tips for either option

• Tighten every abutment and prosthetic screw to the torque in the instructions for use with a torque wrench. For why screws loosen and how to fix them, see abutment screws: why they loosen.
• Check the occlusion. Heavy lateral contacts load the screw joint in both designs.
• Record which system, platform and abutment you used, so parts can be reordered.

Frequently asked questions

Is screw-retained or cement-retained better?

Neither is better in every case. Screw-retained is easier to retrieve and avoids cement under the gum. Cement-retained gives an intact occlusal surface and corrects angulation more easily.

What is a screw-retained abutment?

A base, such as a Ti-base or a multi-unit abutment, that the crown or bridge is joined to and screwed onto the implant with. The restoration comes off by removing the screw.

What is a cemented abutment?

An abutment screwed to the implant that acts like a prepared tooth. The crown is cemented onto it.

Why is excess cement a problem with implants?

Cement left below the gum around an implant is hard to detect and can cause inflammation of the surrounding tissue. Shallow margins and careful clean-up reduce the risk.

Can a screw-retained crown be used on an angled implant?

Sometimes. If the access hole would come out on a visible surface, an angled abutment with a cemented crown, or a multi-unit abutment for bridges, is usually the better solution.

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