Dental Implants Without Screws: How This Technology Is Used Today

Modern “screwless” solutions in implant dentistry are often misunderstood as implants that are literally placed without threads. In everyday clinical use, the term more commonly describes how the final tooth (the crown or bridge) is retained—by cement, friction, or a locking interface—rather than by a screw that passes through the biting surface. Understanding where screws are avoided, where they are still used, and why, helps patients and clinicians set realistic expectations about function, appearance, and maintenance.

How screwless dental implants are designed and used

In most cases, the part placed in bone is still a threaded fixture, because threads help achieve initial stability during healing. “Screwless” typically applies to the connection between the implant and the restoration. Common approaches include cement-retained crowns (where cement bonds the crown to an abutment), friction-fit designs (where closely matched surfaces hold components together), and locking-taper or Morse-taper connections (a conical interface that can create a strong mechanical lock).

Clinically, these designs are used to reduce or eliminate a screw access hole through the crown, which can be valuable in highly visible teeth. They may also simplify the contour of the biting surface and avoid placing restorative materials inside a screw channel. However, every design choice shifts the trade-offs: what is gained in aesthetics can affect retrievability (how easily a dentist can remove the crown later) and how complications are managed.

Differences between screwless and traditional dental implant systems

Traditional screw-retained restorations use a screw to secure the crown (or a crown-on-abutment) so that it can be removed for repair, cleaning, or component replacement. Screw-retained designs are often favored when future access is important, when limited vertical space exists, or when controlling excess cement is a priority.

Screwless restorative concepts—especially cement-retained crowns—tend to improve appearance by avoiding a visible access channel and can provide flexibility in angling the crown. The main clinical concern is cement control: if excess cement remains under the gumline, it can irritate soft tissue and contribute to inflammation around the implant.

Locking-taper systems aim to be screwless while maintaining stability and, in some cases, easier removal than a deeply cemented crown. Still, “easier” is relative: removal techniques, component availability, and clinician familiarity matter. In practice, many clinicians choose between screw-retained and screwless strategies case-by-case rather than treating one as universally superior.

Clinical considerations for screwless implant placement

Even though “screwless” is often a restorative choice, placement planning should anticipate it from the start. Implant position and angulation influence whether a screw access hole would emerge in an undesirable location (such as the front surface of a front tooth). If angulation would compromise aesthetics for a screw-retained approach, a screwless restoration may be considered—provided cement control and tissue health can be managed.

Soft-tissue thickness, gumline architecture, and the depth of the restoration margin all matter. Deep margins can hide the crown edge for aesthetics, but they can also make it harder to remove excess cement. Bite forces and parafunctional habits (such as clenching or grinding) also influence the choice of retention, materials, and occlusal design. For example, high bite forces may favor designs that are predictable to maintain and repair.

This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.

Patient factors that influence implant system selection

Patient-specific factors often drive the decision more than marketing terms. Oral hygiene capability is crucial: patients who struggle to clean around restorations may benefit from designs that allow simpler professional maintenance, or from contours that reduce plaque retention. Medical conditions, medications, and smoking status can affect healing and long-term gum stability, which indirectly affects how well different restorative margins and retention methods perform.

Aesthetic priorities also vary. Some patients strongly prefer avoiding any possibility of a visible access channel, especially for front teeth. Others prioritize the ability to remove the crown easily if complications arise. Previous dental history can matter too: a patient with repeated crown debonding on natural teeth may need a design that addresses retention and bite mechanics rather than focusing only on whether a screw is present.

Material sensitivities and preferences can play a role (for example, choices involving titanium or ceramic components), but these decisions should be grounded in documented compatibility, functional needs, and clinician experience with the system.

In real clinics worldwide, screwless options are typically delivered through established implant ecosystems rather than entirely separate “screw-free” categories. Examples of widely used implant manufacturers that offer restorative solutions supporting cement-retained, friction-fit, or conical/locking-style connections include Straumann, Nobel Biocare, Dentsply Sirona, Zimmer Biomet, and BioHorizons. Specific connection types and restorative workflows differ by product line, and availability varies by region.

A practical way to think about screwless technology today is as a toolkit. Dentists select from screw-retained, cement-retained, and locking/friction-based approaches to match the patient’s anatomy, aesthetic goals, cleaning ability, and risk profile. No single method eliminates all complications; instead, careful planning and follow-up help keep outcomes predictable.

In summary, “dental implants without screws” most often describes how the visible tooth is attached, not necessarily how the implant is anchored in bone. Screwless restorations can improve aesthetics and sometimes simplify crown design, while traditional screw-retained solutions can improve retrievability and maintenance control. The best choice depends on placement planning, soft-tissue conditions, bite forces, and patient-specific factors that influence long-term health and serviceability.