When it comes to the restoration of implants, we typically have two treatment options: screw-retained or cement-retained.
Although both treatment options can be used predictably, they each have their own advantages and disadvantages:
Screw-retained
Advantages:
- Known retention
- Easy to remove/re-tighten if it were to become loose
- No risk of leaving residual cement
Disadvantages:
- Dependent on implant orientation/angulation
- May be unesthetic
Cement-retained
Advantages:
- Independent of implant orientation/angulation
- Enhanced esthetics
Disadvantages:
- Unknown retention
- Can be difficult to remove
Although a majority of the implants I restore are done as cement-retained restorations, in the past few years I have transitioned into restoring an increasing number of implants as screw-retained. Why this transition? Mainly because there is a lot of good research showing the problems associated with leaving residual cement.
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References
The positive relationship between excess cement and perio-implant disease: A prospective clinical endoscopic study. Wilson TG Jr. J Periodontol 2009 80(9): 1388 – 92