By Dr. Lee Ann Brady
The decision of how to retain an implant restoration used to be an easy one. In the earlier years of dental, screw retained implants were the default approach. However, with further practice it suddenly became that people were almost exclusively using cement retained implants. Today, it appears that we have come full circle back to using primarily screw retained, as we continue to learn about the implant failures due to cement left behind. When deciding between a screw retained and a cement retained implant, it is important to remember there are benefits and liabilities to using each method, often related to location of the implant.
Esthetics tend to be the biggest obstacle, especially in anterior cases. With screw retained implants, the screw emergence has to be placed in such a position that it won’t compromise the overall esthetics of the case, while still allowing for adequate thickness of the restorative materials to avoid premature fracture. For this reason, when restoring an anterior, cement retained tends to be the better option as it eliminates the screw retained access holes. It can also be favorable for cases with mesial to distal space concerns. Remember that when choosing cement retained, it is imperative to clean all the excess cement to avoid complications.