01 Dec Cemented crown or screwed crown on implant in single tooth rehabilitation?
I can confidently say that screwed crown is a better option – when feasible – for several reasons:
- it is faster
- it is cleaner
- it is cheaper
- you can shape soft tissues in the way you like (soft tissues can impede the correct seating of a cemented crown but they cannot impede the seating of a screwed crown)
- easily retrievable
- it is the only solution when the interocclusal space is scarce (a cemented crown needs at least an interocclusal space of 5mm). A screwed crown can be done even with an inter-occlusal space of 3mm.
- you can use all-ceramic crowns (with the cemented prosthesis you can use just metal-ceramic crowns with a metal collar because you need to have the possibility to hammer the crown in case the abutment screw becomes loose)
The very question should be “when Not using a screwed crown?”
There are few clinical situations that can limit the applicability of screwed crowns and impose the use of cemented crowns.
- The absolute contra-indication to the screwed crowns is when the axis of implant (and the hexagon) – in the mesio-distal direction – is not parallel to the contact areas of the adjacent teeth.
- The relative contra-indication to screwed crowns is when the axis of the implant makes the screwing hole falling on the buccal side (aesthetic issue) or too much lingually or palatally (volume issue). In this case, we have today the possibility – at some extent – to use special screws (and special screwdrivers) for angulating the hole. That’s why this situation is nowadays a relative contraindication
By Dr Pasquale Venuti