What is the seating and cementation workflow for an Implant Crown and Bridge?

Delivery differs between the two retention designs, but both share a disciplined sequence: sanitize, confirm seating radiographically, torque to the manufacturer value, and finish with meticulous cleanup and polishing. The steps below follow ROE's implant crown workflow guidance.

Sanitize before placement

For either design, immerse the crown in a 0.12% chlorhexidine gluconate solution for two minutes to achieve proper sanitization before placement.

Screw-retained delivery sequence

Position the crown onto the implant and finger-tighten the abutment screw, ensuring initial engagement and alignment with the internal connection. Here, "finger tight" means screwing the abutment down until it bottoms out, then snugging it with your thumb to the point where it does not wobble and feels firm. Avoid the torque wrench at this stage, because you will need to untorque for removal and abutment screws are typically good for only three cycles before they require replacement.

Check and adjust proximal contacts, emergence profile, and occlusal contacts in both centric and excursive movements. Obtain a periapical radiograph to confirm complete seating of the crown-abutment interface, then, using a calibrated torque wrench, tighten the screw to the manufacturer's specified value, typically between 25 and 35 Ncm. Fill the screw access channel with teflon tape or a cotton pellet to the appropriate depth, then place and cure composite resin to seal it. Polish all adjusted surfaces thoroughly.

Clinical rule of thumb: more torque is not better. The screw is engineered to fail under excessive torque as a safety mechanism that protects the implant, so always follow the manufacturer's specified value.

Cement-retained delivery sequence

Trial fit the crown and check margins, contacts, occlusion, embrasure form, and esthetics. Position the abutment onto the implant and finger-tighten, then obtain a periapical radiograph to confirm complete seating of the abutment-implant interface. Torque the abutment screw to the manufacturer value, typically between 25 and 35 Ncm, then pack teflon tape or a cotton pellet into the screw access hole to protect the screw head and allow future retrieval.

Apply only a thin layer of cement along the internal walls of the crown, seat it firmly under finger pressure, have the patient bite down, and position a wood stick across the occlusion to hold the crown while the cement sets. Remove excess cement while it is still in the rubbery stage, using floss and scalers for complete subgingival and marginal cleanup. Check and adjust contacts, then polish all adjusted surfaces.

Cement control is critical Studies cited by ROE show dentists routinely use roughly twenty times more cement than needed, resulting in about 95% extrusion beyond the margins. For implant crowns this is particularly dangerous because margins are often subgingival, making excess removal nearly impossible, and retained cement acts as a bacterial reservoir that significantly raises peri-implantitis risk and the chance of implant failure. Apply only a thin film, just enough to create retention while preventing marginal extrusion.

The table below contrasts the two final-securing pathways.

Polishing is the shared final step for both designs, because rough contacts can wear adjacent natural teeth and create spacing, and rough occlusal surfaces can abrade opposing teeth over time.

Additional Resources

For more information concerning Implant Crown and Bridge:

• Implant Crown and bridge product page
• Video: Ti Base vs Custom Milled Abutments - The Best Fit for Doctors

Contact Information

For help with a Locator Fixed solution for your next case, contact ROE Dental Laboratory:

• Phone: (216) 663-2233
• Email: info@roedentallab.com