Choosing the right method of retention for an implant prosthesis will subsequently affect long-term survival, esthetics, and long-term management of the case. Choosing the method of retention, whether it is cement-retained, screw-retained, or screw-and-cement retained, has a noticeable impact on the aforementioned factors. Here at EVOQ DDS, we benefit from the digital precision of implant restorations, so it is important to understand how the choice of retention will affect success for the clinician and the patient.
About EVOQ DDS
EVOQ DDS (EVOQ Digital Dental Solutions) is a dental lab created and run by dentists, where a technology-based approach will provide CAD/CAM-based restorations, implant supported prosthesis, and custom abutments. EVOQ DDS is located in Ahmedabad and utilizes digital design, craft, and premier materials to manufacture restorations that fit ideally and look natural.
Our experience in cement-retained prosthesis or screw-retained restoration will allow you to provide the best solution for each case's esthetic, functional, and biological needs.
Understanding Retention Types
Implant restorations can be greatly categorized based on how they connect to the implant or to the suggested implant section:
- Cement-Retained Implant Prosthesis – The prosthetic crown or bridge is secured to an abutment that has been attached to the implant using a dental cement.
- Screw-Retained Prosthesis – The prosthesis is affixed with a screw directly to the implant or abutment through a screw access hole in the prosthesis. In this type of case, there is no usage of cement.
- Screw-and-Cement-Retained Prosthesis (SCRP) – A hybrid design utilizing both screw-retention retrieval capabilities while maintaining the esthetics of cementation.
Every method has some unique advantages and disadvantages, making the case selection essential.
Cement-Retained Implant Prosthesis
Advantages
- Excellent Esthetics - A seamless occlusal surface offers a more natural look and feel, especially in the anterior zone, without a screw access hole.
- Passive Fit - The cement layer compensates for small misfits to assist in passive seating of the prosthesis.
- Simplified Occlusal Design - Balanced occlusion and contact are easier to achieve without screw access channels.
- Reduced Cost - Balanced occlusion and contact are easier to achieve without screw access channels.
Disadvantages
- Limited Retrievability– Once the prosthesis is cemented, it often has to be cut into or replaced for removal.
- Residual Cement Risks– Residual cement can lead to soft tissue irritation or peri-implantitis.
- Maintenance Difficulties – Any repairs, as well as screw tightening, will require the removal of the crown.
- Technique Specificity– Placement of the cement margin and the amount of residual cement left over are critical to the long-term success of a cemented restoration.
When to Choose
A cement-retained prosthesis is perfect then implants are well aligned, esthetics are major, and the margin is placed at or above the gingival level for safe cement removal.
See Also – What Are Dental Implants? A Complete Guide
Screw-Retained Implant Prosthesis
Advantages
- Retrievability- The restoration is easily retrievable for hygiene, screw tightening, or repair.
- No Cement Complications- It eliminates the risk of excess cement and cement-related tissue inflammation.
- Efficiency at Maintenance- The ideal solution for full-arch or multi-unit cases where you may expect multiple follow-up appointments to maintain hygiene.
- Space Effective- Requires less inter-occlusal height than a cement-retained crown.
Disadvantages
- Aesthetic Compromise- The appearance of anterior crowns can be affected by the screw access hole, but modern composites do a good job of masking it.
- Technical Complexity - Passive fit and accurate torque control can be more complex.
- 3. Potential for screw loosening - Even though it is improved with newer designs, it still needs to be monitored.
When to Choose
A screw-retained prosthesis is selected while retrievability and long-term preservation are priorities, such as full-arch bridges, posterior regions, or sufferers with a history of headaches.
Hybrid Approach: Screw-and-Cement-Retained Prosthesis
The screw-and-cement-retained prosthesis (SCRP) seeks to take advantage of the best features of both systems. Generally, the framework is screwed into the implant, and then the crown or veneer is cemented to the framework.
Key Benefits
- Retrievability with Esthetics - The prosthetic is easily disassembled to facilitate maintenance while the exposed crown remains cemented to provide a natural aesthetic.
- Ideal for Angulation Problems - This is helpful if the placement of the implant has resulted in the screw access hole being positioned poorly.
- Controlled Cementation - Given the amount of distance between the screw access hole and the soft tissue margin, the removal of excess cement will be easier than if it were deeper to the sub-gingival margins.
Considerations
SCRP restorations may take a little longer for design and fabrication, yet they provide a fair solution in complexity. Cases requiring both function and aesthetics may benefit from utilizing an SCRP.
Comparing Cement vs Screw Retention
| Feature | Cement-Retained | Screw-Retained |
|---|---|---|
| Esthetics | Excellent – no access hole | Slightly compromised by an access hole |
| Retrievability | Limited | Excellent |
| Residual Cement Risk | Higher | Minimal |
| Passive Fit | Achieved via a cement layer | Requires precise fabrication |
| Maintenance Ease | Difficult once cemented | Easy to remove/repair |
| Inter-occlusal Space | Needs more space | Needs less space |
| Best Used For | Single units, aesthetic zones | Full-arch or posterior cases |
| Complexity | Simpler chairside process | Higher technical precision required |
Read More: Implant-Supported Prosthesis: Types, Benefits & More
Clinical and Laboratory Factors to Consider
- Implant Position & Angulation - When implants are misaligned, cementation will help avoid visible access holes.
- Restorative Space - If vertical height is restricted, screw retention can be better.
- Esthetic Demands - In the esthetic zone, cement retained will be generally better.
- Maintenance Requirements - In the long run, screw retention helps with ease of service.
- Soft Tissue Health - Margins too deep for cementation will create a risk of residual cement; screw retention will eliminate the risk of residual cement.
- Cost & Workflow - Cementation may be more affordable in the short term, but screw retention will limit long-term replacement costs.
See Also: Digital Smile Design: A Quick Guide
EVOQ DDS: Precision in Every Restoration
At EVOQ DDS, our state-of-the-art CAD/CAM systems and digital workflows provide you with confidence in your accuracy for each and every implant restoration, regardless of whether it is cement-retained, screw-retained, or screw-and-cement-retained prosthesis. Here’s how we support clinicians in achieving predictable results:
- Custom Abutments– Digitally designed to achieve desirable soft tissue contours while providing access to the screw.
- High-Precision Frameworks- Provides a passive fit to minimize stress to the implant system.
- Digital Workflow Process – Every aspect of the process is under our control, from intraoral scan to final restoration.
- Material Expertise – We use zirconia, titanium, or hybrid materials depending on their intended use and esthetics.
- Collaborative Case Planning – Our lab collaborates with the clinician to determine the best retention type and clinical efficiency.
By combining advanced technology with dental expertise, EVOQ DDS ensures every implant prosthesis achieves the perfect balance between form, function, and retrievability.
Final Thoughts
The discussion over whether a cement-retained implant prosthesis or a screw-retained implant prosthesis is superior, and it is not to say which path is better, but which is the appropriate path for the patient and the case.
- Select a cement-retained prosthesis when the esthetics and simplicity are the top priorities.
- Select a screw-retained prosthesis when maintenance, retrievability, and long-term flexibility are priorities.
- Choose a screw-and-cement-retained prosthesis option for complex or angulated cases requiring both advantages.
At EVOQ DDS, we help clinicians make these decisions based on science, technology, and collaboration with their lab. Whatever the chosen path, we ensure that the esthetics, function, and longevity of the restoration, as well are at the highest level.
EVOQ DDS – Elevating Implant Dentistry through Digital Precision Visit evoqdds.com to explore our implant solutions and case planning support.
