Dentistry/cemented crown or screwed in retention for implant
QUESTION: I having a crown restored on 19. My dentist gave me the option of cemented retention or screwed in retention. Which method do you think is better?
ANSWER: usually this is determined by the type of implant you have. some have to be cemented. if you have a choice, they each have advantages. cemented crowns are better looking (no cement hole in the middle). the advantage of screwed on crown is it can be re-accessed easily and have the screw retightened. i personally like to place a cotton pellet in the screw access hole and then cement crown. if i ever need to get to that screw and that is very, very infrequent, i can cut an access hole to the cotton, retighten the screw, and fill in the hole at that time. the odds of this happening are very small. sit and discuss all of this with your dentist
jeff dalin, dds
and sorry i did not get this email until today, sept 15th...i know you sent this in a few days ago...must be a glitch in their system
---------- FOLLOW-UP ----------
QUESTION: Doctor, thank you very much for your information. I like to be well informed on dental procedures.
I haven't heard about the method of using a cotton pellet. Please describe its purpose. You wrote that after placing pellet in access hole, you cement crown. Are you cementing the crown? Or sealing the access hole with composite?
Is it correct to assume that except for the access hole being sealed with composite, no cement is used in the screw retained system.
With the screw retained system, you also wrote that if you ever need to get that screw and that is very, very infrequent... But doesn't this system require you to get access? Isn't maintenance (getting the system unscrewed for cleanings) a necessity?
i like to put the cotton pellet down on the screw head so that cement does not lock into it. if you ever need to access it again to retighten it, you need to be able to find it cleanly. it is just that simple. and it works great when you are searching for it. so i merely place the cotton and then cement the crown. there is no access hole in the crown here. with screw retained crown, you have an access hole. no cement is used...the crown is screwed on and the access hole filled with resin. once everything is tightened down, you leave it alone...never touch it except to retighten things if they get loose.
jeff dalin, dds