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Healing Abutment vs Cover Screw: Implant Part Differences

Both healing abutments and cover screws are transitional dental implant components and that means they are temporary and not permanent.


cover screw vs healing abutment

However, despite their similarities they also have quite a few differences such as in how they look, how they feel, and when they're used.


Below is a comparison table for cover screws vs healing abutments.


Attributes

Healing Abutment

Cover Screw

Purpose

Transitional implant part

Transitional implant part

Appearance

Large screw with different heights and widths

Small screw with different widths

Feel

Detectable

Undetectable

Use

Right before implant is ready for the crown

For undisturbed implant healing

Complications

Can fall off

Can fall off

Table of Contents:


Purpose

The primary purpose for healing abutments and cover screws are to be used as transitional components until the implant is finished healing. In other words, they're not permanent.

  • Once the screw fixture has completed its osseointegration with the jaw bone, it will be ready to receive the implant crown.

  • These transitional parts will be swapped out for the permanent tooth cap.


In summary, both of these components are used temporarily during the healing process but get replaced by the final crown later on.


 

Appearance

Cover screws look very different from healing abutments, namely in their size. The healing abutment screw is significantly larger than the cover screw which pales in comparison.


Different sized healing abutments vs cover screw
Size comparison

Healing abutment physical features:

  • Large looking screw.

  • Top has insertion hole.

  • Bottom has long threads.

  • Varying widths.

  • Varying heights.


healing abutment vs cover screw

Cover screw physical features:

  • Small looking screw.

  • Top has insertion hole.

  • Bottom has long threads.

  • Varying widths only.


healing abutment vs cover screw
top view

Overall, you can describe the healing abutment cap as a larger version of the screw cover.


 

How they feel

In the mouth, the healing abutment cap is detectable while the cover screw is undetectable.

  • You can see, feel, and touch the healing abutment screw because it sticks up above the gum line.

  • You cannot see, feel, and touch the implant cover screw because it is submerged below the gums.


The primary difference between these two parts is that one makes its presence known while the other is hidden away. The difference is due to how they're placed because one is left exposed while the other is left intentionally covered.


Below are images which demonstrate what we mean by how you can only feel one of them. Both parts are placed onto an implant model with fake gums to show you how they would look inside of the mouth.



Now the next set of images show you how the cover screw and the healing cap would look on an implant alone.



Key points:

  • Implant abutment screw is placed above the gums.

  • Implant cover screw is submerged beneath the gums.


 

When they're used

Each of these implant parts are used during different stages of the implant process. They're also used for a different amount of time as well.


When cover screws are used:

  • Immediately after implant placement.

  • Typically stays on the screw fixture for a minimum of 3-4 months.


When healing abutments are used:

  • After implant has osseointegrated and is ready for crown restoration.

  • Only used for about 2-4 weeks while you wait for the tooth cap to be made.


Essentially, you'll be wearing the cover screw for a much longer period of time than the healing abutment cap.


Exception: Some dentists like to place the healing abutment during the same day as implant placement. They use the abutment in lieu of the cover screw.

  • This is a personal preference but in our opinion, the cover screw allows the implant to heal undisturbed a lot better.

  • When you have the abutment sticking up above the gums, food and various other substances can come into contact with and interact with it. That has a higher chance of disturbing the healing screw fixture in the jaw bone.


 

Complications

The two most common complications that are shared with both of these implant parts.

  • Can fall off. Both the cover screw and the healing abutment screw can fall off. If they do, you will find it in your mouth. Since they're both screws, they can unscrew and fall out.

  • May get stuck. Perhaps your dentist had a strong hand and they overtightened the implant parts. If they do, they will have a difficult time removing them. Worst case scenario may result in these components becoming cold welded to the implant.


Both of these complications are at opposite ends of the spectrum. If they're placed onto the implant too tightly, they may not come off. The opposite is also true in that if they're not screwed on tight enough, they'll fall off.


Does it not remind you of the three little bears where you want it just right.


How to fix it

If either of these pieces fall off, the solution is to return to your dentist with the fallen off implant part. They can simply screw back on the piece by tightening it.


If the pieces are too tight and refuse to come off, your dentist will have alternative ways to remove them.

  • Reverse torque it.

  • Remove with rongeur.

  • Remove with implant driver and hemostat.

  • Drill through it with an implant removal kit.


Honestly, the too tight implant part isn't really perceived as a problem for you until your dentist goes in to try removing it. It is only when you're ready to get the crown that it is now an issue.


Verdict

To sum it all up and drive the point home, we made a comparison video between a healing abutment vs cover screw. Seeing the differences live really helps elevate your understanding of this topic.





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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

Association Memberships:

Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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