Screw Retained Dental Implant Crowns

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Planning for Screw Retained Implant Crowns

In general, the screw access hole should be down the long axis of the implant. This is important in relation to ease of placement, avoiding damaging lateral tension forces when torquing the screw which could lead to screw loosening and avoiding the issue of possibly threading the screw if proper access has not been made. Therefore, prior to placing the dental implant, it is important to plan what type of restoration is to be placed.

However, recent advances in prosthetic design have evolved and Nobel Biocare now have an angulated screw channel. This allows a angulation difference of 25 degrees, which is significant. This can be applied to the posterior and anterior regions. This is possibly a game changer in dental implant prosthetics.

Placing Screw Retained Dental Implant Crowns

The placement is generally quite simple. The crown and abutment is a one piece prosthetic device. The crown is then placed within the dental implant. There is only one path of insertion and therefore a placement jig is not required. Initially, screw down gently until the crown is stable and in it's fully seating position. Check the marginal adaptation, contacts, embrasure space and occlusion. Take a peri-apical radiograph to ensure correct seating. If so, make any necessary adjustments.

Once all of the relevant checks have been made and verified, torque the screw to 20Ncm using a prosthetic torque wrench. The screw should be covered with sterile cotton wool and the access cavity restored with composite.

Tip: for metal based substructures, to avoid a grey shadow use an opaque flowable composite around the periphery and on the base. Voco have an excellent one which I routinely use to block out dark areas whilst placing composites.

Removing Screw Retained Implant Crowns

Simply remove the composite and cotton wool carefully and unscrew the abutment screw. Simple.

Tip: be very careful not to damage the abutment screw! Use an ultrasonic to remove the final layer of composite.

Conclusion

In many cases, screw retained implant crowns are the desired option. With the evolution of the Nobel Biocare angulated screw access, the scope for these restorations has increased hugely. With the huge advantage of no cement, I would suggest considering screw retained restorations for single implant crowns as the first choice option.

An article for dentists by Dr Nissit Patel

Tagged with: Dental implants Screw retained crowns Nobel biocare angulated screw access Screw retained implant crowns

EAO Congress Lisbon 2026

Fantastic Event in Lisbon

Dr Nissit Patel attended the European Association of Osseointegration (EAO) Congress from 24th-26th September in Lisbon, Portugal. This was a wonderful event, with incredible presentations from world renowned speakers, live surgery, a wonderful trade fair and educational events. There is always so much to learn in the world of dental implants and it is great to be able to connect with our European and world wide colleagues at such events.

Congratulations to the EAO for organising such a successful event and we look forward to seeing you next year in Madrid!

Dec 2025

30th

30th of December 2025

Dental implants to replace missing back teeth and improve the bite

Replacing missing back teeth is essential. The molar teeth are designed for mastication i.e chewing . Without molars, it is far harder to break down foods for ease of swallowing. This essentially means that the diet will be one of soft foods only and eating will take much longer. This would not be a great look at a New Years eve dinner party!

Our front teeth are created for incising food i.e cutting. If the teeth in front of the molars are overloaded with excessive force then further problems will result such as cracks, fractures and even teeth splitting in half meaning the loss of more teeth.

The good news is that molar teeth can be replaced using dental implants to restore chewing function, spread the forces and enjoy those harder goods once again.

Our case of the month for December is a classic one where the back teeth were lost due to bruxism which severely impaired function.

May 2025

23rd

23rd of May 2025

Replacing multiple teeth with dental implants

Teeth can be lost for various reasons such as tooth decay, trauma, failed root canal treatments or periodontal (gum) disease. The loss of teeth can have a significant impact on not only everyday function but aesthetics and general confidence when out and about. Replacing missing teeth is vital as this will restore function ( eating is important!) , improve aesthetics and prevent the adjacent and opposing teeth from moving into undesirable positions. The latter is a particular problem if the teeth are not replaced for a few years as this will make any dental implant treatment far more complicated.

Feb 2024

28th

28th of February 2024

Peri Implantitis - What Is It And How Can It Be Treated

Peri implantitis is becoming a major issue for dental implants and it is important to be aware of this when embarking on implant treatment to replace missing teeth. The term relates to a number of factors around implants but the main issues are:

1. Inflammation of the surrounding mucosa ( gum )

2. Increased pocket depths around the dental implant

3. Bleeding on probing

4. Suppuration ( pus oozing from the tissues)

5. Loss of bone around the implant either in a horizontal , vertical or both directions.

This differs from peri implant mucositis where there is bleeding on probing, possible swelling and inflammation and increase in pocket depths BUT there is NO loss of bone around the implants. Peri implant mucositis is reversible but peri implantitis is irreversible. Diagnosis is essential and the earlier the treatment, the better the diagnosis. Often, the disease may go un noticed, very much like gum disease, but once symptoms develop it is often too late to prevent bone loss. It is essential that regular dental and hygiene visits are maintained after dental implant treatments so that any problems can be spotted at an early stage. In general, we would advise twice yearly appointments or quarterly hygiene appointments if there has been past gum disease present.