DENTAL IMPLANT CROWNS: are they the same?

Dental implant has dramatically improved over the last 10 years. It became popular in the 1990s, and today they are considered the gold standard for replacing missing or failing teeth. For many people, a single dental implant and crown is the right combination.

Not all implant crowns are alike, and they have varied application for use.

Types of Material

Similar to conventional crown, implant crown can be fabricated out of different materials, including ceramic-metal crown and all-ceramic crown. 

  • Metal-ceramic crown: the metal substructure is beneath the porcelain layers. Esthetic appearance, however sometimes the metal can show through. Metal appearance may be a complication in esthetic zone like anterior region.
  • All-ceramic crown: strong, no metal component. Ideal for esthetic zone. Single anterior crowns can be shade matched using these materials.

All-ceramic crown versus Metal-ceramic crown 

Types of Attachment

With the same basic architecture, there are two options for how the permanent crown attaches to the implant: screwed or cemented.

  • Screw-in crown: a screw attachment can securely fasten a crown to an implant without the need for cement; it also allows for easy removal for repair or replacement should the crown become worn. On the other hand, it could pose a cosmetic problem – even though the access hole for the screw may be covered with a tooth-colored filling, it could still be distinguishable from the rest of the crown. 
  • Cemented crown won’t have this cosmetic issue with an access hole, and will look just like a natural tooth. But the cement may also cause gum inflammation and potential bone loss in sensitive patients. Moreover, removing a cemented crown can be more difficult.

Screw-in crown with access hole. No risk of gum inflammation caused by residue cement

Cemented crown. Ceramic crown will be cemented on metal abutment

The condition of your mouth, the type of implant will all factor into determining which method is best for you. For posterior region, the screw method may be more advantageous. Esthetically speaking, though, a cemented crown may be a better option in terms of final smile appearance.

References

  1. Misch, Carl E. Contemporary Implant Dentistry. St. Louis, MO: Mosby Elsevier, 2008.
  2. Hamed MT, Abdullah Mously H, Khalid Alamoudi S, Hossam Hashem AB, Hussein Naguib G. A Systematic Review of Screw versus Cement-Retained Fixed Implant Supported Reconstructions. Clin Cosmet Investig Dent. 2020;12:9‐16.
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