Implant Crowns: Screw-Retained, Cemented and Materials

What implant-supported crown involves

This is the visible tooth: the crown fitted on top of an implant. Abutment-supported crowns are cemented or screwed onto a separate abutment component; implant-supported crowns connect directly to the implant itself. The material options mirror conventional crowns — all-ceramic, porcelain fused to metal, or full cast metal in various alloys. Clinically, fitting an implant crown is a comfortable appointment. There is no anaesthetic needed in most cases, because there is no nerve — the implant has no sensation, which is also why patients cannot feel how hard they are biting on it and why the bite has to be adjusted carefully.

When this treatment is used

Fitted once the implant has integrated and the abutment is in place, typically three to six months after placement. Reported once per implant crown.

Screw-retained or cement-retained

A screw-retained crown is held by a screw through the biting surface, with the access hole filled with composite. It can be unscrewed and removed for maintenance or repair, which is a real long-term advantage, and there is no cement to leak into the tissue. Its drawback is that the access hole must be positioned acceptably, which is not always possible in a front tooth. A cement-retained crown looks cleaner and works regardless of implant angle, but it cannot be removed easily, and excess cement left beneath the gum is a recognised cause of peri-implantitis. Where the margin sits deep, that risk is real. Most contemporary practice favours screw retention where the angle allows. It is worth asking which yours is, because it determines what can be done if something needs attention later.

Why the bite on an implant crown needs watching

A natural tooth sits in a ligament and moves slightly under load; an implant is rigidly fixed in bone and does not. So when you bite hard, the natural teeth depress a fraction of a millimetre and the implant does not — meaning an implant crown set level with the natural teeth ends up taking a disproportionate share of the force. Implant crowns are therefore deliberately adjusted a touch light, and the bite is rechecked at recall visits. Screw loosening, porcelain fracture and bone loss around the implant all follow from an overloaded crown, and all are avoidable with a few minutes of occlusal adjustment.

Costs and insurance in summary

Typical fee range across the group: $0–$0 where a single band applies. Several codes here are priced individually and carry their own range on their own page. Priced similarly to or slightly above a conventional crown of the same material, and reported separately from the implant and abutment.

Benefit category: Major, 0–50% on a typical plan. Covered only where the plan covers implant restorations. Alternate benefit clauses sometimes pay the allowance for a conventional crown or a bridge unit instead.

Common restrictions: Only payable where implant benefits exist; Alternate benefit clauses may reduce payment to a conventional crown allowance; Replacement typically limited to once every 5–10 years; Draws on the same annual maximum as the implant and abutment.