Dental Implants Without Screws: What Are They and Are They Better?
The term dental implants without screws refers to implant restorations where the crown or prosthesis is attached to the abutment using dental cement rather than a retaining screw. Both approaches — cement-retained and screw-retained — use the same titanium implant fixture placed in the jawbone. The difference is only in how the visible crown is fixed to the abutment on top.
This is a common question from patients who have heard conflicting information about implant systems, or who have been told by one clinic that their preferred approach is superior. In practice, both methods have clinical indications and the choice depends on the specific case — implant position, abutment angle, aesthetic requirements and the surgeon’s preference. At Asensio Advanced Dentistry in Valencia, Dr. Lucía Asensio Romero, specialist in implantology and oral surgery with over 30 years of experience, selects the appropriate retention method for each individual case.
Screw-retained vs cement-retained implant crowns
| Factor | Screw-retained | Cement-retained (without screws) |
|---|---|---|
| How crown is fixed | Small access screw through the crown into the abutment | Dental cement — no visible screw hole |
| Retrievability | Crown can be removed by dentist for maintenance or adjustment | Fixed permanently — removal risks damage to crown |
| Aesthetics | Small access hole visible on biting surface — covered with composite | No visible hole — cleaner appearance on biting surface |
| Cement excess risk | No cement used — no risk of sub-gingival cement residue | Cement excess below gum line can cause peri-implant inflammation |
| Maintenance access | Easy — crown can be removed if abutment needs attention | Difficult — abutment cannot be accessed without removing crown |
| Best indicated for | Most implant cases — preferred for posterior teeth and full arch restorations | Cases where implant angulation makes screw access difficult, or where aesthetics at biting surface are critical |
Which is better — screws or cement?
The current clinical consensus favours screw-retained restorations for most implant cases, primarily because of retrievability and the elimination of cement excess risk. Excess cement left below the gum line is one of the contributing factors to peri-implant mucositis and peri-implantitis — the bacterial infection that is the leading cause of implant failure. With screw-retained crowns this risk does not exist.
However, cement-retained crowns remain a valid option in specific situations — particularly when the implant angle makes screw access impossible or when the access hole would compromise aesthetics in a highly visible position. The decision is made case by case based on clinical assessment.
For full arch restorations such as All-on-4, screw-retained prostheses are standard practice — the prosthesis is fixed to the implant abutments with screws and can be removed by the dentist for professional cleaning or adjustment. See our All-on-4 dental implants abroad page for more information.
Does the patient feel or notice the screw?
No. The access hole for the retaining screw is on the biting surface of the crown — not on the visible front face. It is covered with a small composite filling that is invisible in normal use. Patients with screw-retained crowns cannot feel the screw and are not aware of it during eating or speaking.
Frequently asked questions
Are dental implants without screws more comfortable?
There is no difference in comfort between screw-retained and cement-retained implant crowns once fitted. Both feel identical to the patient in everyday use. The choice of retention method is a clinical decision, not a comfort one.
Can a cement-retained crown be converted to screw-retained?
Not directly — the two systems use different abutment designs. If a cement-retained crown needs to be replaced, the replacement can be designed as screw-retained if the implant position allows it. This is sometimes done when a cement-retained crown causes problems such as peri-implant inflammation from cement excess.
What happens if the screw loosens on a screw-retained crown?
Screw loosening is one of the most common minor implant complications. The crown is removed by the dentist, the screw is replaced or retightened and the crown is refitted. It is a straightforward procedure that does not affect the implant. If you notice a crown that feels loose or moves slightly, contact us promptly — a loose screw should not be left untreated as it can cause damage to the implant connection over time. Call us on 0800 048 8058.
Are implants without screws cheaper?
The retention method does not significantly affect the overall cost of an implant restoration. The main cost components are the implant fixture, abutment and crown — not how the crown is attached. At Asensio the complete single implant price of £850 includes all components regardless of retention method. View the full breakdown on our prices page.
Related guides
- Dental implants abroad at Asensio — full overview of implant treatments for UK patients
- Dental implant abutments — the connector between implant and crown
- Types of dental implants — which solution is right for your case
- Peri-implantitis — why cement excess is a risk factor
- Care of dental implants — daily routine and professional review guide
- All-on-4 dental implants abroad — full arch replacement with same-day fixed teeth
