Dra. Cléo Salustiano In this article
SummaryWhat can 'screwless dental implant' mean?Is a screwless implant better? How to decide, and what are the alternatives?FAQRead nextIs There Such a Thing as a Screwless Dental Implant? What the Term Means
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Quick summary of this article+
Dental implants with no threads in the bone are hardly used today: almost every implant is a threaded post that acts as the root. 'Screwless implant' usually means one of four things: a cement-retained crown (no screw hole in the crown), a one-piece titanium or zirconia implant (no connecting screw between implant and abutment), a removable denture that snaps onto implants (overdenture) or press-fit systems, which are a minority. No option is automatically better: a cemented crown has no hole but is harder to remove; a screw-retained crown is easy to take off for maintenance and the hole is usually hidden. Alternatives without implants include fixed bridges, removable partial dentures and full dentures. In Mooca, Dr. Cléo Salustiano (CRO-SP 170844) sees patients every day, from 8 a.m. to 10 p.m.
A screwless dental implant, in the sense of an implant that sits in the bone with no threads at all, is hardly used in dentistry today: almost every implant is a threaded post, similar to a screw, because those threads give it initial stability in the bone. When a clinic or an ad talks about a 'screwless implant', it's almost always referring to something else — usually the way the tooth on top is attached, not the implant itself.
In clinical practice, it's common for patients to come in afraid of the 'screw' — picturing visible metal, a hole in the tooth or something that will come loose. Understanding what each term means helps you compare proposals clearly and ask the right questions at the assessment, without being swayed by names that sound new but describe well-known techniques.
Dr. Cléo Salustiano (CRO-SP 170844), a dentist in Mooca who works with oral rehabilitation and dental implants, explains below the four most common meanings of 'screwless implant', what changes in each one and what alternatives exist for people who don't want or can't have an implant.
This article comes from Dr. Cléo Salustiano's dental office in Mooca, São Paulo (care in English, Portuguese and Spanish). See the dental implants page to learn how the treatment is done here and book your assessment.
What can 'screwless dental implant' mean?
'Screwless dental implant' usually means one of four things: a cement-retained crown, a one-piece implant, a removable denture that snaps onto implants, or a press-fit implant system. In every case there's an implant in the bone acting as the root; what changes is its design or the way the tooth on top is attached.
The most common meaning is the cement-retained crown. Every implant has three parts: the implant in the bone, the connecting abutment and the crown, which is the visible tooth. The crown can be held by a small screw that passes through it, called a screw-retained crown, or bonded to the abutment with cement, a cement-retained crown. The latter has no access hole in the crown, which is why it's called 'screwless' — but the implant in the bone is still threaded, and the abutment is usually still screwed to the implant.
The second meaning is the one-piece implant. Instead of a separate implant and abutment joined by an internal screw, it's all a single piece. There are one-piece implants in titanium and in zirconia, a white ceramic, sometimes advertised as 'metal-free' and 'screwless'. Even so, the part that sits in the bone is threaded. A one-piece design eliminates the connecting screw, but it limits angle adjustments and swapping components in the future.
The third is a removable prosthesis on implants, known as an overdenture or snap-on denture. Two or more implants receive attachments, like buttons, and the denture snaps onto them. You take the prosthesis out to clean it, and there's no screw in the prosthesis. The implants, however, are placed in the bone as usual.
The fourth is press-fit implant systems, with no threads on the surface and a conical connection, with no screw between implant and abutment. They exist, but they're a minority on the market and have their own indications. Whatever name is used, the question that clears things up is simple: 'what exactly has no screw — the implant, the abutment or the crown?'.
| Name used | What has no screw | What stays the same |
|---|---|---|
| Cement-retained crown | The crown, which is bonded to the abutment | Threaded implant in the bone; abutment usually screwed in |
| One-piece implant | The connection between implant and abutment | The part in the bone is threaded |
| Snap-on denture (overdenture) | The prosthesis, which snaps into place | The implants are placed as usual |
| Press-fit implant | Surface threads and the connecting screw | A minority system, with its own indications |
Is a screwless implant better? How to decide, and what are the alternatives?
A 'screwless' implant isn't automatically better or worse: each attachment method has advantages and limitations, and the choice depends on the tooth's position, the available space, the bite and aesthetics. A cement-retained crown, for example, has no access hole, which can help aesthetics in some cases; on the other hand, it's harder to remove for maintenance, and leftover cement under the gum, if not removed well, can promote inflammation around the implant.
The screw-retained crown, which many people want to avoid, has the advantage that the dentist can easily remove it to clean, retighten or replace it, without cutting the piece. The small hole the screw passes through is sealed with tooth-colored composite and, in most cases, sits on the inner side of the tooth, barely visible. So 'having a screw' doesn't mean visible metal or a less attractive result.
One-piece zirconia implants are an option for people who prefer to avoid metal, and they may be suitable in specific cases. They call for careful planning, because the piece doesn't allow the angle to be corrected after placement. At the assessment, the dentist explains whether your case is suitable for this alternative and what changes in maintenance.
For people who don't want or can't have an implant, there are alternatives for replacing teeth. A fixed bridge uses the neighboring teeth as support and requires reshaping them. A removable partial denture rests on teeth and gums and is taken out for cleaning. A conventional full denture replaces all the teeth in an arch. Each has pros and cons in comfort, appearance and care for the support teeth.
In Mooca, Dr. Cléo Salustiano explains the tooth replacement options for your case at the assessment, using the real name of each technique, so you can compare proposals with confidence. A prior condition, such as little bone, inflamed gums or teeth with cavities, doesn't rule out rehabilitation: it becomes a step in the plan. No technique has a guaranteed result, and the choice is always based on the exam.
Is there such a thing as a screwless dental implant?
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An implant with no threads in the bone is rare today: almost all are threaded posts, because the threads provide initial stability. What does exist is a screwless crown (cement-retained), a one-piece implant with no connecting screw, a snap-on removable denture and some press-fit systems. It's worth asking what exactly has no screw.
What is a cement-retained implant crown?
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It's a crown, the visible tooth, bonded with cement to the abutment attached to the implant, instead of being screwed on. It has no screw access hole, which is why it's sometimes called 'screwless'. The implant in the bone is still threaded, and the abutment is usually still screwed to it.
Screw-retained or cement-retained crown: which is better?
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It depends on the case. A screw-retained crown is easy to remove for cleaning, retightening or replacement, and the hole usually sits on the inner side, sealed with composite. A cemented crown has no hole, which can help aesthetics in some positions, but it's harder to remove and requires care with leftover cement under the gum.
Does the implant screw show when I smile?
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Normally, no. The implant sits inside the bone, covered by the gum. With a screw-retained crown, the small access hole is usually on the inner side of the tooth or the chewing surface and is sealed with tooth-colored composite. Visible metal can appear if the gum recedes, which calls for an assessment.
Are zirconia implants screwless?
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Many zirconia implants are one-piece, meaning the implant and abutment form a single piece with no connecting screw between them. But the part in the bone is threaded. They're an alternative for people who prefer to avoid metal and have specific indications, which the dentist assesses.
What is a snap-on denture on implants?
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It's an overdenture: two or more implants receive attachments, like buttons, and the denture snaps onto them, staying firmer than a regular denture. You remove the prosthesis to clean it. There's no screw in the prosthesis, but the implants are placed in the bone as usual.
Can the implant screw come loose?
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The screw holding the crown or abutment can loosen over time, especially with a strong bite or bruxism. It's usually simple maintenance: the dentist removes the crown and retightens or replaces the screw. That's different from the implant in the bone becoming loose, which indicates bone loss and needs an assessment.
Can a tooth be replaced without an implant?
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Yes. The main alternatives are a fixed bridge, supported by the neighboring teeth, which need to be reshaped; a removable partial denture, which rests on teeth and gums; and a conventional full denture, when all the teeth in an arch are missing. Each option has its own advantages and care.
Does a screwless implant hurt less?
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How the crown is attached doesn't change the discomfort of surgery, because the implant is placed in the bone the same way. Surgery is done under local anesthesia, and discomfort afterward is usually managed with the recommended instructions and medications. What makes a difference is how extensive the procedure is, such as grafts and the number of implants.
Does a screwless implant last longer?
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There's no rule that it lasts longer. Durability depends mainly on integration with the bone, the health of the surrounding gum, hygiene, checkups and habits like smoking and teeth grinding. The attachment method affects maintenance more than the lifespan of the implant itself.
Is a zirconia implant better than titanium?
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There's no one-size-fits-all answer. Titanium has the largest body of long-term studies and allows separate components. Zirconia is a metal-free alternative, usually one-piece, with more specific indications. The choice depends on the bone, the tooth's position, the bite and the patient's informed preference.
Does every implant prosthesis have a screw?
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Not all. A crown can be screw-retained or cement-retained, and a denture on implants can be held by attachments, with no screw in the prosthesis. A full-arch fixed bridge on implants is usually screw-retained so the dentist can remove it during maintenance.
Where can I get my dental implant questions answered in Mooca?
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In Mooca, Dr. Cléo Salustiano (CRO-SP 170844) explains tooth replacement options, with and without implants, and what each term means at the assessment. The office is at Rua Hipódromo, 1141, near Bresser-Mooca station (Metro Line 3-Red), and is open Monday to Sunday, from 8 a.m. to 10 p.m., via WhatsApp (11) 97409-7834. She sees patients in Portuguese, English and Spanish.
