Screw Retained Or Cemented Dental Implant Abutments….Which Is Better?
Screw Retained Or Cemented Dental Implant Abutments….Which Is Better?
This is actually a really old topic that has become renewed again in the last few years. Do you hold your implant crown or bridge in with a screw abutment connection or do you hold it in with cement? Each technique has their merits.
In this video I will describe many of the reasons why one should be chosen over the other. There seems to be a very large educational gap in dentists that are heavily involved with implants and those that just dabble in dental implant restorations. Some people take an all or none approach with regards to screw retained crowns or cement retained crowns but did not really seem to understand the biomechanical principles in relationship to bone physiology. The same educational gap holds true for connecting implants together or leaving them as individuals. I hope this helps you make a good decision on how to determine what is best for your unique situation. I have utilized both methods for almost two decades now.
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
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Monica D.
December 29, 2020.
There aren't enough words (and I have a lot of words) to tell you how grateful I am to have found Dr. Ramsey Amin and his wonderful staff. I had an enormous amount of bone loss and I was hopeless after being treated by a different doctor for two years. I had multiple procedures such as gum graft, extractions, and a sinus lift. After all of that, the doctor released me and told me he could not help me any longer. He sent me to a large teaching hospital - who also had no idea how to help me. I was terrified and embarrassed. I had been missing teeth due to those procedures since 2017. That sent me out on a journey of meeting with no less than five different dentist/oral surgeons. Most of them shamed me for the bone loss and wondered what I had done to cause this. In reality, I had done nothing. The bone loss is my body's immune system fighting me, as well as hereditary traits. In fact not only was I having difficulty being able to have implants, I also had so much bone loss that I was also not a candidate for dentures. I researched "what to do when you have bone loss and can't get implants" and I found Dr. Amin's website. Then I researched him, read his reviews, watched every one of his You Tube videos. I called and got an appointment, and kept going to consultations with other providers. I had long since stopped smiling and being social. Missing teeth and the shaming was affecting my life so adversely. When I met with Dr. Amin for my consultation he was ready. He had all of my records and had already reviewed my scans. But more than that, he genuinely wanted to get to know about my life. He was/is authentic, kind and extremely professional with so much success and experience in difficult cases like mine. He worked up a treatment plan & I came back two weeks later to discuss my options...and the journey began. I have had three procedures under IV sedation, no pain, no narcotics needed for aftercare. Dr. Amin is a consumate, experienced oral surgeon who cares about your health & understands your fears. He communicates every step of the way and will provide you with all the information you need to make a decision to improve your health. I am still working toward my end goal, and we had to zig from traditional implants and zag to zygomatic implants instead...which is the reason I chose him in the first place. If there was nothing else that could be done to get me healthy & smiling again, I knew he would have that option to help me. And of course 2020, the year of CV-19. Don't worry, Dr. Amin & his staff follow all health & safety protocols. This review is long, because it is important you know my journey, so you might understand how fortunate I feel to be healing. I'm torn, because this place is like a great restaurant, I want to shout from the rooftops how great it is, how great he is. And at the same time, I want to keep this all to myself. I come 75 miles each way to see him. I know people travel from all over the world for his expertise. Do yourself a favor, have a consultation. You won't regret it. Dr. Amin is amazing and so is his staff.
Jennifer B.
December 18, 2020.
I cannot speak highly enough of Dr. Amin and his professional staff. I have to start off and say that I am absolutely TERRIFIED of the dentist due to several past experiences. I found myself putting this off for YEARS until I was referred over to Dr. Amin. I was petrified on my first visit... but he along with his WONDERFUL staff made me feel so calm and at ease. I had quite a bit of work that needed to be done, but we found the perfect plan that worked out for me, and I couldn't be happier. Words cannot express my gratitude to each and every staff member that made me feel safe and comfortable. Dr. Amin was always so attentive in asking if I was ever in pain... and I never was. These are truly remarkable individuals, and I'm so lucky to have a dentist that I can trust. I ABSOLUTELY LOVE each and every one of you!
Thank you,
D M.
December 17, 2020.
I cannot say enough positive things about Dr. Amin and his staff. I originally found them on Yelp about two years ago. I needed an implant, front tooth of all places, and was extremely nervous not only about surgery but about how it would turn out.
Let me just say I just adore the staff. Everyone is crazy friendly and the whole office has a very positive vibe. The staff is adorable and always has me smiling by the time I leave. They are all thorough and on-point about what they do, and I truly appreciate it. They are quick to respond to my emails no matter the question, and their appointment reminders are great too.
Dr. Amin is very thorough and reassuring, and answered any questions my husband or I had. My regular dentist had questions about the procedure and Dr. Amin's office even reached out to them at my request (my dentist said they never received a call, but Dr. Amin's staff had date, time and notes - love the thoroughness!). After surgery the Dr. called to leave me a message about how it went. Very minimal pain during healing, never any pain during any visits. It took a few tries to get everything just right for the permanent crown (color, etc), but the end result is beyond fantastic! At one point during healing I thought I was experiencing some looseness or wiggling but unfortunately couldn't make it to the office. When I was finally able to make it in the Dr. was so relieved, bless his heart. Luckily it was just a false alarm and everything checked out ok.
They're a bit further out from me, but I wanted the best. I sure found it! I wish they were my regular dentist, and I'm looking forward to seeing them again for my check-up which was delayed due to COVID.
Melissa E.
December 9, 2020.
I found Dr. Amin a few years back after I hadn't been to a dentist in a decade. Many traumatic dental experiences in childhood have made me so phobic that even getting a cleaning was a knee-knocking, heart-pounding trial. But finally I couldn't put off some things any longer. During my first anesthesia session, Dr. Amin replaced five old metal fillings, and during the second he did three more plus a crown. I was completely comfortable, and never felt a thing. Because they were extra-long sessions, I did sleep for about 12 hours after, but the next day I felt just fine.
This past week, my back top tooth cracked in half and fell out of my mouth, and a couple days later the crown on the remainder of the tooth fell out too! Despite being nervous about Covid 19, I had to get it taken care of, so I called and quizzed the staff about precautions, which turned out to be even above and beyond what I would have expected. So yesterday I went for the tooth extraction and plug. After they put on the blood pressure cuff and put in the IV, I gradually got a little tired and closed my eyes. I sat there for about 10 minutes and thought Gee, I wonder if they're going to get started any time soon, and a minute later Dr. Amin said "Wake up, you're all done!"
That was a short session, and I didn't have the kind of fatigue I did my first time. I stayed up most of the evening. Today, everything is good! I'm taking my antibiotic and eating soft foods, and there is surprisingly little pain now that the numbness has worn off. The tooth site and my cheek are a little sore, and the corner of my mouth, and I have a very slight headache, but nothing to any great level--I'm not even taking the acetaminophen. I feel good, and wide awake.
Thanks to everyone at the office for a comfortable and professional job! I really REALLY appreciate you for giving me painless dental experiences!
Tanya S.
December 3, 2020.
What can I say about Dr. Amin he is the best! I'm so grateful for him. He has literally changed my life and given me the confidence to smile more. I had major restorative dental work done and everything went smoothly. Dr. Amin is very compassionate and he really cares about his patients he made me feel comfortable and cared for. He is very knowledgeable and has a great sense of humor. His office is very clean and they take the patients health and safety very serious. His staff is also amazing they made me feel very welcomed and important. I'm so happy I did my research and found Dr. Amin. Thank you Dr. Amin and team.
Sheila S.
November 6, 2020.
Two implants done! Finished all procedures and I couldn't be happier. It's the first time in years I looked forward to going to the dentist. Even during Covid life the staff and Dr. Amin took care of me. There is a possibility I may move to Long Beach but I would still travel to keep Dr. Amin as my dentist.
Allison S.
November 4, 2020.
I could not ask for a more caring, exceptionally knowledgeable dental care provider. He's not just a dentist, but someone who looks after your immediate dental needs and helps you plan and prepare for the future.
Julia R.
October 8, 2020.
I've been going to Dr. Amin since I turned 16 and have been going since. Before going to Dr. Amin's dental office, I had 4 crowns that I was not happy with and dealt with it until finally I asked Dr. Amin and because I feel comfortable and because I trust him with his work I recently had my crowns fixed and worked on by Dr. Amin and have never loved my smile the way I do now, I can actually enjoy my pictures, I can enjoy my smile from either angle and that really mattered to me. Thank you so much Dr. Amin still and will be in love with MY smile
Aaron D.
October 6, 2020.
I've been coming to Dr. Ramsey for about five years and I have to say, he is by far the best dentist I've had - ever. The staff is professional and kind, the office is exceptionally well maintained, and Dr. Ramsey is careful and extremely knowledgeable about current developments and research in dentistry.
I recently had a dental implant which was a long process but well worth it. I required a sinus lift as well as a bone graft. The surgery went off without a hitch, I was comfortable and the healing process was quick and without complication.
Highly recommend!!
Flo O.
September 21, 2020.
This is my 1st review of Dr. Amin, and in my over 17 years of being with him, my experiences with Dr. Amin and his staff have always been positive. I don't recall a bad experience with the several implant procedures i have had. They run an efficient office. I like that they are proactive and reach out to their patients to remind us of routine care needed. Dr. Amin's bedside care is impeccable. They are also technologically up to date in terms of sending out texts as reminders, ability to incorporate any appointment into your mobile phone. That is certainly a plus. Keep up the great care!!!
17 Comments
Fred
Hello there Doctor Amin,
Is a cement retained dental implant more prone to infection than a screw-retained dental implant? Or are they equally prone to having infection? Thanks!
Ramsey Amin
equal assuming both are done correctly
Joyce Stringer
I had a implant crown chip and dentist removed crown ( had a cement abutment) then replaced with a new crown but screwed into my implant. It came loose after 6 months. He just unsealed… and rescrewed it in. Says if this happens again and comes loose… I will have to have the implant in my upper jaw completely removed and replaced… EXTREMELY COSTLY AND SURGICAL!!! Does this sound right?
RamseyAminDDS
For him to say that, there must be something wrong with the implant….like maybe it fractured?? Find out why!
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
Sha may
Hello I’ve lost two lower jaw teeth due to big fillings and no crown it cracked and shattered had to extract it. My dentist sent me to oral surgeon to take it out when I took it out the surgeon suggested bone graft tht was the first time I found out abt bone graft after bone craft I delayed the implants waiting caz of financial situation n lack of knowledge like 4-5 yrs went back to get implants to same doctor she suggested to get bone graft osseous/bul graft and guided tissue reg nonresorb again caz the previous graft has dissolved before getting endosteal implant placement. She gave me the price I left and scheduled an appointment with my general dentist he also does implants but he’s not oral surgeon or periodontist but some dentist do implants as well after examination he said I don’t need bone graft I left and made an appointment with a periodontist he also said I dnt need bone graft as well. I need to make a decision soon I’m confused what to do caz my upper teeth are coming down it already has I didn’t know abt tht I just found out abt tht recently by looking to my recent X-ray can u let me know if I need to get the graft n guided tissue reg or not need to please need to make a decision soon and I need your suggestions I found your site online and I learned so much by reading all the info abt implants I learned about full porcelain implants from your site please suggest me if I need to just go for implants or get the graft and guided tissue reg before implants thank u
RamseyAminDDS
Thank you for your kind words. Without a detailed examination and 3-dimensional scan there is no way for me to help you with this particular situation. Standard panoramic image is not enough to diagnosis and treatment plan dentistry of this magnitude. Find a dentist that is experienced and that you trust to perform the procedures for you.
Ann Wright
Dr. Amin:
are you planning to open any dental offices on the east coast?
RamseyAminDDS
LOL…no…one is enough and I enjoy it very much!
Latifa
Hello Dr. Amin. I have written one comment an hour ago but it is not posted yet.
plz Doctor my situation is, 10 years before I got a two small screws ceramic front teeth (in Morocco), 2 years earlier I broke the crowns and got two new glued crowns ( in China). Last week the right front tooth broken and fell with one screw (the screw got brownish dark color); FYI I re-glued the this same tooth 6 weeks earlier. When I presented to my Doctor in China still, she suggested the implants and the flipping bridge.
My question is: Can I do the same first option the ceramic + screw? As the implant is very expensive and the long terms effect of flipping bridge are esthetically dis-encouraging for the front teeth.
I appreciate your soon advice.
RamseyAminDDS
It is a little bit hard to fully understand your question. I don’t know what a flipping bridge is… I’m thinking this is a typo? Perhaps you can re-post your question with a little bit more clarity?
Without seeing you it would be impossible to answer these details. It sounds like you need to see an expert in dental Implantology rather than just a “regular dentist.” They should be able to help you develop a long-term stable and predictable solution. Your teeth should not be falling out!
Latifa
Hello Dr. Amin. I would like to hear your advice on my situation please.
I got two front teeth old school two small screws ceramic root (in Morocco 10 years ago) of which the crown replaced by glued one two years ago (in China). Now the right tooth, one of the screws loosen and led to the fell of the crown. Now my Doctor gave me two choices the detachable bridge or the implants. Can I just process as the first time, because here dental care is very expensive? waiting for your kind reply.
By the way I m located in Shanghai province in where the life standards are high and all specialties are available.
Susan martin
Hi I have had 6 implants n my upper jaw and then a fixed denture but I have a gap between the gum and the denture where food gets in the dentist said that it’s do you can clean properly is this true.
RamseyAminDDS
On the upper jaw there is not supposed to be a gap between a Prettau style implant bridge and the gums. On the lower jaw it is okay to have this open. If the space is present on the upper jaw it will prevent you from speaking clearly. The design of the bridge has to be made to be butted up against the gum. If it is screw retained, a could be removed and porcelain added to the underside to close in that space. You will likely have to have the dentist take a pickup impression.
ethman
hello dr amin iam young man who went to the dentist and have exam and xray he said I have gum disease and bone lost but my top teeth looks very healthy and strong still he suggest to remove all my top and bottom teeth and replace them what my next step should be should I get second opinion or what you advice thank you
RamseyAminDDS
Second opinion for sure! This shouldn’t be a surprise to you. Even though they look good, the bone and gum may be damaged.
Paula
Hello Dr Amin. Two years ago I lost two implants which caused my overdenture to become unstable. The surgeon added three additional bicon implants. My dentist couldn’t use screws and cemented a full upper arch bridge. I am constantly searching for my bite and have terrible jaw and neck pain. I saw a diplomate of implantology and was told it has to be removed to begin the process again as she can see the rivet part of the screws and I need something that can be removed yearly for cleaning.
RamseyAminDDS
Ugh. Sounds like you need an expert. Implant dentistry is not as easy as the commercials make it seem. It is a highly complex field.
I am not a huge fan of Bicon especially when missing all teeth.