How I Address Filling the Access Hole of a Screw-Retained Implant Crown 

April 17, 2024 Lee Ann Brady DMD

By Lee Ann Brady, DMD 

For addressing the access hole of a screw-retained implant crown, my preferred method involves applying Teflon tape over the hole followed by temporary filling material, such as Telio Inlay from Ivoclar Vivadent. 

I emphasize to patients the importance of maintaining accessibility to the screw for potential adjustments without jeopardizing the integrity of the ceramic crown. Hence, immediately after seating the crown, I ensure no adjustments are needed before doing the filling. 

Patients are scheduled for a final post-op appointment with the surgeon after the restoration is in place. If there are no issues requiring crown removal, the Teflon tape and Telio Inlay may remain indefinitely, monitored during hygiene recall appointments. As long as the temporary filling remains intact, replacement is unnecessary. 

In cases where the Telio Inlay dislodges but the Teflon tape remains intact, I inform the patient of our plan to reapply the temporary filling. However, if repeated dislodgment occurs, leading to inconvenience, we consider transitioning to a permanent filling. In such instances, fresh Teflon tape is applied, and the access hole is filled with composite that precisely matches the crown’s color. 

Even if years pass and the Telio Inlay needs replacement, I opt for a temporary filling for ease of identification if removal is necessary. Only if frequent filling replacements prove bothersome do I consider switching to a permanent filling because I prioritize easy retrievability of the screw. 

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Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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Two Tips for Placing Screw-Retained Implant Crowns

August 23, 2021 Kelley Brummett DMD

Most of us are placing implant crowns, using screw retained crowns. If the crown needs to be recovered, or the screw needs to be changed or tightened, the restoration can be removed by accessing the screw through the screw channel.

One of the main advantages of screw-retained crowns is the ease of retrieval. I have discovered two ways to make retrieval easier for myself, which involve the colors of the Teflon tape and composite I use.

  1. Now I have colored Teflon tape on hand, and when I place the screw, I put colored tape on top of the screw instead white tape. If I need to remove the composite, I more readily see my gray or yellow tape than I would white tape.
  2. I also like to use a composite color that is not be an exact match with the implant crown. This way I can easily see the material to be removed to access the screw channel… if I need to remove the crown.

If you plan ahead to have colored Teflon tape on hand, you can do what I do. Teflon tape is available in multiple colors at Home Depot and other hardware stores.

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Kelley Brummett DMD

Dr. Kelley D. Brummett was born and raised in Missouri. She attended the University of Kansas on a full-ride scholarship in springboard diving and received honors for being the Big Eight Diving Champion on the 1 meter springboard in 1988 and in 1992. Dr. Kelley received her BA in communication at the University of Kansas and went on to receive her Bachelor of Science in Nursing. After practicing nursing, Dr Kelley Brummett went on to earn a degree in Dentistry at the Medical College of Georgia. She has continued her education at the Pankey Institute to further her love of learning and her pursuit to provide quality individual care. Dr. Brummett is a Clinical Instructor at Georgia Regents University and is a member of the American Academy of Cosmetic Dentistry. Dr. Brummett and her husband Darin have two children, Sarah and Sam. They have made Newnan their home for the past 9 years. In her free time, she enjoys traveling, reading and playing with her dogs. Dr. Brummett is an active member of the ADA, GDA, AGDA, and an alumni of the Pankey Institute.

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