Healing Abutments vs Cover Screws: What You Need to Know
Table of Contents
What Are They?
Healing abutments and cover screws are small parts that go with your dental implants. They help your mouth get better after you get an implant put in.
Let’s make this simple: When you get a tooth implant, your dentist must pick either a healing abutment or a cover screw. They are not the same!
A healing abutment is a small post that sticks up from your gum. You can see it in your mouth. A cover screw is flat and sits hidden under your gum.
How They Look and What They Do
Healing Abutment:
- Sticks up above your gums
- Helps shape your gum as it heals
- Made of titanium or zirconia
- Comes in many sizes (3-8mm tall)
- You can see it when you open your mouth
Cover Screw:
- Stays hidden under your gum
- Keeps stuff out of your implant
- Sits flat against your implant
- You cannot see it at all
- Needs a second visit to take out
Think of a healing abutment like a hat on top of your implant. A cover screw is more like a flat lid that seals it shut.
Big Differences to Remember
| What to Know | Healing Abutment | Cover Screw |
|---|---|---|
| Can you see it? | Yes – sticks up | No – under gum |
| When used? | Right away | First stage only |
| Main job | Shapes your gums | Seals implant |
| Best for | One-step plans | Two-step plans |
| Needs second surgery? | No | Yes |
When your dentist puts in your implant, they make a big choice. The single-stage way uses a healing abutment right away. The two-stage way uses a cover screw first, then you come back later.
How Dentists Use Them
When you get a dental implant, here’s what happens:
With a healing abutment:
- Dentist puts in your implant
- They add the abutment right then
- Your gum heals around it
- You come back for your new tooth
- No second cut needed!
With a cover screw:
- Dentist puts in your implant
- They add the cover screw
- Your gum grows over it
- You wait 3-6 months
- Dentist must cut your gum again
- Then they put on an abutment
The two-stage implant way with a cover screw means more visits and cuts. But sometimes it’s still best for you.
Good and Bad Points
Good things about healing abutments:
- Less trips to the dentist
- No second surgery
- Faster to get your new tooth
- Keeps gum shape nice
Not-so-good things about healing abutments:
- More chance of infection if you don’t clean well
- Some people don’t like seeing it
- Can get food stuck around it
- May feel sore when you eat
Good things about cover screws:
- Better protected while healing
- Fewer problems overall
- Less chance of infection
- Nothing to see while waiting
Not-so-good things about cover screws:
- Need a second cut in your gum
- More visits to dentist
- Takes longer to get final tooth
- Your gum may shrink (up to 1.5mm)
What the Numbers Say
Let’s look at what studies show:
- Healing abutments work well 94-97% of the time
- Cover screws work well 96-98% of the time
- About 12% of healing abutments can get loose
- Only 3% of cover screws break
In a study with 24 people, custom healing abutments kept gums perfect 100% of the time. Regular cover screws only did this 67% of the time.
A big study of 1,200 implants found that 9.1% of healing abutments got loose, but only 2.3% of cover screws had problems.
Things People Worry About
“My healing abutment feels loose!”
If your healing abutment moves just a tiny bit (less than 1mm), that might be OK. But if it moves a lot (more than 2mm), call your dentist right away!
“Do I need to clean around my healing abutment?”
Yes! You must clean it every day. A cover screw is under your gum, so you don’t need to clean it.
“Will it hurt?”
With healing abutments, your gum might feel sore for a few days.
With cover screws, you feel less at first but will have more pain when you go back for the second cut.
Big Questions People Ask
Can a cover screw stay in forever?
No! A cover screw must come out after your bone heals. It’s just for the first part of getting an implant.
Which one hurts more?
Cover screws hurt less at first but mean a second surgery later. Healing abutments might be more sore at first but save you from a second cut.
How long until I get my new tooth?
With a healing abutment, you might wait 2-6 weeks.
With a cover screw, you wait 3-6 months, then have surgery, then wait more weeks.
Which is better for front teeth?
Many dentists like healing abutments for front teeth because they help keep your gum shape nice for a pretty smile. For front teeth dental implants, this can be really important.
When Dentists Pick One Over the Other
Your dentist might choose a cover screw if:
- You need bone grafts
- Your implant isn’t very tight when placed
- You grind your teeth a lot
- You need time to heal
They might pick a healing abutment if:
- Your implant is very stable
- You have thick, healthy gums
- Your bone is strong
- You want fewer surgeries
For places that show when you smile, like with emax crowns for front teeth, the gum shape matters a lot. A healing abutment might help keep your smile looking good.
