Dental Implants - Crown Placement

Dental Crown Placement (Prosthetic Phase)

What is this procedure?

Once the embedded implants have properly integrated with the bone, you are now ready for the next phase of the implant treatment, which is fabricating the dental crown (artificial teeth) and securing it to the implant unit with the use of an abutment (connector). This is also known as the prosthetic phase of the treatment.

A prosthodontist or restorative dentist will carry out the procedures, which typically involves the following steps:

  • Impression taking of the implants, the remaining natural teeth, and gums.
  • Fabrication of the teeth in a dental laboratory by a highly skilled dental technician.
  • Trial fitting of the artificial teeth over the implants. The teeth will be matched in terms of color, shape and size. Sometimes, it may take several visits before achieving this.
  • Delivery of your new teeth.
  • Review and sealing of screw access holes, if any.

There are two ways the new teeth can be secured to your implants:

  • The titanium components called abutments are firstly screwed onto the implants. The artificial teeth are then glued onto the abutments. Once cemented (Figure 19), it is virtually impossible to retrieve the crowns.

Left Figure: Healing cap covering the underlying implant.
Right Figure: A cement-retained crown secured onto implant.

  • Instead of being cemented or glued, the artificial teeth are held onto the underlying abutments by screws. This requires openings (figure 20) to be made at the top of the artificial teeth for the screws to pass through. These holes are not visible when you smile as they are sealed with tooth-coloured filling material.

Figure: Screw-retained crowns with access holes before being sealed with tooth- coloured fillings.

Which is better – a Cement-retained or a Screw-retained Crown?

Screw-retained crowns offer retrievability should there even be a need to remove the crowns for repair before reinstalling them in your mouth. Cemented crowns cannot be removed without firstly being destroyed after which new crowns will have to be made thereby increasing the overall long term costs.

However, cemented crowns have the advantage of not having the access holes which may be a cosmetic issue to some.

The likelihood of having to retrieve the implant crowns is low as most of them function very well without giving any problems.

How long does it take to make the new tooth/teeth (dental crown)?

Depending on the complexity of the prosthesis, it may take one week to a month to make them.

How soon thereafter can I begin to eat and function?

You should be able to function immediately after the prosthesis have been installed in your mouth. Your dentist may seal the screw access holes at a separate visit. He or she may also want to see you again for a final review.