IMPLANT CROWN

What Is a Dental Implant Crown?

A dental implant crown is the visible, tooth-shaped restoration that sits on top of a dental implant — the part you see when you smile, chew, and speak. While the implant post (buried in bone) and the abutment (connector) do the structural work beneath the gumline, the crown is what makes the entire system look and function like a natural tooth.

At Lake Norman Oral & Facial Surgery, Dr. Raymond J. Haigney II — a double board-certified oral and maxillofacial surgeon — ensures each implant is placed at the optimal depth, angle, and position to support a crown that blends seamlessly with your natural teeth.

How an Implant Crown Differs from a Traditional Crown

A traditional dental crown covers a damaged natural tooth — the tooth's root is still intact in the jawbone. An implant crown, by contrast, replaces the entire tooth structure:

• Implant post replaces the root (titanium screw fused into jawbone)
• Abutment replaces the core/build-up that connects root to crown
• Implant crown replaces the visible tooth

Because there is no natural tooth underneath, the implant crown must be designed to manage bite forces, gum tissue contours, and aesthetics entirely through engineering — making material selection and precision fit critical.

Crown Materials

Porcelain-Fused-to-Zirconia (PFZ)

A zirconia substructure (extremely strong ceramic) is layered with hand-built feldspathic porcelain for lifelike aesthetics. This combines the strength of zirconia with the translucency and color-matching capability of porcelain. Best for: front teeth where appearance is paramount.

Full-Contour Zirconia

Milled from a single block of zirconia with no porcelain overlay. Advantages: maximum strength (1,200+ MPa flexural strength vs. ~120 MPa for porcelain alone), virtually chip-proof, excellent for posterior teeth under heavy bite force. Modern multilayer zirconia offers improved aesthetics approaching layered restorations. Best for: molars and premolars.

Lithium Disilicate (e.max)

A glass-ceramic with exceptional translucency and a natural "glow" that mimics enamel beautifully. Moderate strength (~400 MPa). Best for: front teeth in patients with light-to-moderate bite force. Not recommended for bruxers (clenchers/grinders).

Porcelain-Fused-to-Metal (PFM)

A metal substructure (gold alloy, nickel-chromium, or cobalt-chromium) covered with porcelain. Once the standard, PFMs are gradually being replaced by all-ceramic options. Disadvantage: the metal substructure can create a dark line at the gumline if tissue recedes over time. Still a reliable, cost-effective option for posterior teeth.

Cemented vs. Screw-Retained Crowns

Implant crowns attach to the abutment in one of two ways:

• Cement-retained: the crown is bonded to the abutment with dental cement, similar to a traditional crown. Advantages: easier to achieve ideal aesthetics (no screw access hole to fill), simpler lab fabrication. Disadvantage: excess cement can be difficult to remove from beneath the gumline, potentially causing peri-implant inflammation.
• Screw-retained: a screw passes through the crown into the abutment/implant. A small access hole on the biting surface is filled with composite. Advantages: completely retrievable — the crown can be unscrewed for hygiene, repair, or replacement without any risk of cement complications. Disadvantage: the access hole slightly compromises the chewing surface.

Dr. Haigney and the restorative dentist determine the best approach based on implant angulation, tissue thickness, and the specific tooth being replaced.

The Crown Placement Process

After the implant has fully integrated (3–6 months post-surgery), the crown fabrication process begins:

1. Impression — a digital scan or traditional impression captures the exact position of the implant and surrounding teeth
2. Shade matching — the color, translucency, and surface texture are matched to adjacent natural teeth
3. Lab fabrication — a dental laboratory crafts the crown over 1–2 weeks using CAD/CAM design and milling or hand-layering techniques
4. Try-in and delivery — the crown is tested for fit, contacts with neighboring teeth, bite alignment, and aesthetics. Adjustments are made chairside. Once approved, the crown is permanently placed.

Longevity & Care

Implant crowns typically last 15–25 years with proper care — and many last a lifetime. Keys to longevity:

• Brush twice daily, floss or use an interdental brush around the implant
• Avoid using teeth as tools (opening packages, biting nails)
• Wear a nightguard if you clench or grind
• Visit the dentist every 6 months for professional cleaning and implant checks

The most common reason for implant crown replacement is not failure but cosmetic upgrading — patients electing to replace an older crown with newer ceramic technology for improved aesthetics.

More on Implant Crowns – Implant Abutment