Screw or cement retained implant crown: how your new tooth is held

When you have a single implant, most of the talk is about the implant itself: the brand, the bone, the healing time. But the tooth you actually see and chew with is the crown on top, and there is a quieter question that matters for years afterwards. Should it be a screw or cement retained implant crown? In other words, is the crown screwed onto the implant, or glued onto it? Both methods are used every day by good dentists. They behave differently when something needs attention, and they differ in one specific risk to the gum. This article explains both in plain terms so you know what to ask.

The three parts of an implant tooth

A single implant tooth has three parts:

• The implant. A titanium post placed in the jawbone. It acts as the root.
• The abutment. A connector that sits on top of the implant and comes up through the gum.
• The crown. The visible tooth, usually zirconia at our clinic.

The abutment is always screwed into the implant. The question is how the crown is held to the abutment and implant.

Screw-retained crowns

In a screw-retained design, the crown and abutment are joined together in the laboratory, and the whole unit is fastened into the implant with a small screw. The screw passes through a narrow channel in the crown. Once the screw is tightened to the right force, the dentist seals the channel with a small plug and a tooth-coloured filling.

For a back tooth, the access hole sits in the middle of the biting surface. For a front tooth, it is on the tongue side, as long as the implant is angled correctly. You do not see it when you smile.

Why many dentists like screw retention

• It can be removed. If the porcelain chips, the screw loosens, or the gum needs treatment, the dentist can open the hole, take the crown off, fix the problem and put it back. Nothing has to be cut off.
• No cement under the gum. There is no glue to squeeze out below the gum line, which removes one known cause of inflammation around implants.
• Useful where space is short. When there is little height between the gum and the opposite tooth, a screw can hold a crown that cement might not.

The limits

• The implant must be placed so that the screw channel comes out in a good place. If the angle would put the hole through the front of a tooth, screw retention may not work without special angled parts.
• The access hole interrupts the biting surface slightly, and its filling may need redoing over the years.
• Screws can loosen, particularly in people who grind their teeth.

Cement-retained crowns

In a cement-retained design, the abutment is screwed into the implant first, a bit like a small prepared tooth. The crown is then cemented onto the abutment, much as a crown is cemented onto a natural tooth.

Why it is used

• The crown surface is unbroken. No access hole, which some dentists prefer for appearance and for the bite.
• More forgiving of implant angle. A custom abutment can correct the angle, so the crown can sit straight even when the implant could not be placed in the ideal direction because of the bone.
• Familiar technique. It works like conventional crown cementing.

The main concern: leftover cement

When a crown is cemented, a little cement squeezes out at the edge. On a natural tooth that edge is usually easy to clean. On an implant, the edge of the crown often sits below the gum, and any cement left there is hard to see and hard to remove.

A study in the Journal of Periodontology examined implants with signs of peri-implant disease (inflammation of the gum and bone around an implant) using a dental endoscope. Excess cement was found at 81% of the diseased implants and at none of the healthy controls. After the cement was removed, signs of inflammation had gone from 74% of those implants a month later. That does not mean cement always causes problems. It does show why careful cement technique matters, and why many dentists choose screw retention when they can.

What the research says overall

A systematic review in the International Journal of Oral and Maxillofacial Implants pooled 73 studies and found five-year survival of about 96% for cement-retained and about 96% for screw-retained reconstructions, with no significant difference between them. The same review found that screw-retained restorations had fewer technical and biological complications overall. Each method still has its typical weak point: cemented crowns can lose retention and come unstuck, while screw-retained ones can have a screw work loose.

A separate review of single implant crowns in Clinical Oral Implants Research found five-year survival rates above 97% for both zirconia and metal-ceramic crowns, with zirconia giving fewer aesthetic problems. So the crown material and the fixing method both work well when the case is planned properly.

Why it matters more if you live abroad

If you have your implant in Antalya and live in the UK, retrievability is worth thinking about. If a screw-retained crown needs attention, a dentist anywhere can usually remove and refit it without damaging it, as long as they know the implant system. That is one reason every implant patient at our clinic receives an implant passport, which records the implant brand, size and position, and copies of the X-rays and scans. Any dentist who sees you later can then identify the parts quickly.

Our implants are MegaGen, Neodent or Straumann, all at the same price of £300 per implant. These are widely used systems, which helps if you ever need parts at home. Our prices page lists what each part of treatment costs.

How the decision is made at our clinic

The fixing method is decided by the dentist, not by a menu. On the first day in Antalya, a 3D CBCT scan shows the bone and lets the dentist plan the implant position. That plan already takes the crown into account. On the second trip, when the implant has healed (about 3 months in the lower jaw, 4 to 6 months in the upper), the implant is scanned and the crown designed. If the angle allows a screw-retained crown, that is often the dentist's first choice. If it does not, a well-designed cemented crown is a sound alternative.

Implants with abutment are covered by our written lifetime guarantee, and a failed implant is replaced once free of charge. The full terms are on our guarantee page.

Questions worth asking any implant dentist

1. How will my crown be fixed? Screw or cement, and why for your tooth.
2. Can it be removed if needed? And what would that involve?
3. If cemented, how is excess cement controlled? A good answer mentions abutment design, the position of the crown edge and an X-ray check.
4. Which implant system is it? Ask for it in writing.
5. What should my UK dentist know? You should leave with records they can use.

Looking after it

Whichever method is used, the care is the same. Brush twice a day, clean around the implant with floss or an interdental brush, and keep up regular check-ups at home. Tell your dentist if the crown ever feels slightly loose, clicks or if the gum around it bleeds or swells. Caught early, a loose screw or trapped food is a quick fix. If you grind your teeth, a night guard protects both the screw and the crown.

If you are thinking about a single implant and would like to know how your crown would be planned, send us a recent X-ray through our contact page or on WhatsApp. One of our dentists will review it and send a written plan with an itemised price. You can read more about the treatment itself on our dental implants page.

Common questions

Can I see the screw hole in a screw-retained crown?

The access hole is on the biting surface of a back tooth or the inner surface of a front tooth. It is sealed with a tooth-coloured filling material, so in normal life it is very hard to spot.

Can a screw-retained crown come loose?

Occasionally the screw can loosen, usually because of heavy biting or grinding. A dentist opens the access hole, retightens or replaces the screw and seals it again. It is a short appointment and the crown is not damaged.

Is cement-retained worse?

Not in itself. Both types show similar long-term survival in reviews. The main concern with cement is leftover cement under the gum, which careful technique and the right abutment design reduce.

Which type will I get at your clinic?

Your dentist decides after the 3D scan, based on the implant position and angle, and tells you in your written plan. If you want to know, ask: we are happy to explain.

Does the fixing method change the price?

No. A single implant with a zirconia crown is £450 at our clinic, whichever way the crown is fixed. See our prices page.

Sources

1. Wittneben, Millen and Brägger (2014), International Journal of Oral and Maxillofacial Implants: Clinical performance of screw- versus cement-retained fixed implant-supported reconstructions, a systematic review
2. Wilson (2009), Journal of Periodontology: The positive relationship between excess cement and peri-implant disease
3. Pjetursson et al. (2018), Clinical Oral Implants Research: Survival and complication rates of zirconia-ceramic and metal-ceramic implant-supported single crowns
4. Oral Health Foundation: Dental implants

Checked October 2026. Where we give our own view as a clinic, we say so.