Patient Guide for Your Implant Crown or Bridge

Q: What is the little spot on the chewing surface of my new crown?

That is the “screw access channel.” It is the sign of a modern, high-quality, screw-retained restoration. This small opening is where we accessed the screw to tighten your crown, and it has been sealed with a tooth-colored composite filling. It is a key feature that allows for the easy maintenance and “retrievability” of your crown.

Q: Why is cleaning so important if my implant can't get a cavity?

You are correct, an implant cannot decay. However, it can get a form of gum disease called “peri-implantitis,” which is an infection that destroys the bone supporting the implant. This is the leading cause of implant failure. It is caused by the same plaque that causes cavities and gum disease on natural teeth. Meticulous daily cleaning is the only way to prevent it.

Q: What happens if my implant crown feels loose?

If your crown ever feels loose, you must call our office immediately. In almost all cases, this is not a problem with the implant itself, but a simple mechanical issue of the retaining screw loosening. Because your crown is screw-retained, the solution is simple: we can easily access and re-tighten the screw. This is a major advantage over a cemented crown, where a loose crown often signals a much more complex problem.

Q: Can the porcelain on my implant crown break?

While modern dental ceramics are extremely strong, they can still fracture under extreme force, just like a natural tooth. A significant advantage of a screw-retained bridge with individual crowns is repairability. If a single crown chips, we can often unscrew the bridge, have our lab fabricate a new single crown, and replace only the damaged part without having to remake the entire prosthesis.

Care for Your New Restoration

The Adjustment Period

Now that your implant has fully healed, the process of making your new tooth or teeth is typically very comfortable.

Minimal Sensation: You should experience little to no sensitivity, as the implant itself has no nerve. The gum tissue around the implant may be slightly tender for a day after we work on it, but this is minor.
A New Shape: Your new crown or bridge will feel different to your tongue and cheeks. You will adapt to this new sensation very quickly.

Temporary Restoration Care

While your final crown or bridge is being custom-fabricated, you will have a “healing abutment” (a small metal cap) or a temporary plastic crown in place.

Be Gentle: It is critical that you do not chew directly on the healing abutment or temporary crown. The implant is still maturing, and any heavy force can compromise its long-term success.
Hygiene: Keep the area clean by gently swishing with your prescribed medicated rinse and by brushing very carefully with a soft toothbrush.

Bite Adjustment Information

We will carefully check your bite when we deliver your final crown or bridge.

If, after the numbness wears off, you feel that your bite is “high” or that you are hitting the new restoration first when you chew, this is a common issue that needs a simple adjustment. Please do not wait for it to “wear down” on its own. Call our office for a quick, 5-minute appointment to make it perfectly comfortable.

Permanent Prosthetic / Denture Care

Your new implant crown or bridge is the final result of a meticulous surgical and restorative process. Its design is based on decades of clinical research and a commitment to your long-term health.

Our Gold Standard: Screw-Retained Restorations

There are two ways to attach a crown to an implant: with dental cement or with a tiny screw. While both are options, our practice has a strong preference for screw-retained restorations whenever possible. This is a critical decision based on a philosophy of risk management and long-term predictability.

The Problem with Cement: Dental cement is the #1 enemy of a dental implant. During cementation, it is nearly impossible to guarantee that a microscopic amount of excess cement will not get trapped under the gums. This excess cement is toxic to the bone and is a leading cause of the inflammatory gum disease (peri-implantitis) that leads to implant failure.
The Screw-Retained Solution: A screw-retained crown completely eliminates this risk. The crown is attached to the implant with a small screw that passes through a tiny access hole on the chewing surface. We then seal this hole with a tooth-colored filling. There is zero cement, and therefore zero risk of cement-induced peri-implantitis.

The Power of Retrievability

The other major advantage of a screw-retained crown is “retrievability.” Because it is not permanently glued on, we can easily and non-destructively remove it at any time to manage common issues. If a screw ever loosens or if the porcelain chips, we can simply unscrew the crown, make the necessary repair, and screw it back in. With a cemented crown, these simple maintenance tasks can become complex and destructive procedures.

CRITICAL Hygiene Instructions

You can no longer floss normally in this area. You must clean around the implant and under the bridge (if you have one) every single day.

You will need special tools: a floss threader, a water flosser (like a Waterpik®), or “super floss” are essential.
The Technique: You will thread the floss under the bridge or around the single crown, cleaning the area where the implant meets the gum tissue. This must be done every single day to prevent peri-implantitis.