Five Reasons Screw Holes Cause More Problems Than You Think

Introduction

If you’ve ever researched dental implants, you’ve probably heard of screw-retained implant restorations. For years, they’ve been considered the “go-to” solution — stronger than dentures, more reliable than cement. But while screw-retained systems like All-on-4 have helped many patients, the truth is that screw holes bring along hidden problems that most people never hear about until it’s too late.

At Smileloc, we use a screwless, cementless system that eliminates these issues entirely. But before we explain why screw holes create problems, it’s worth understanding why screws became the gold standard in the first place.

Why Screw-Retained Implants Became the Standard

1. Retrievability

Unlike cement-retained crowns, screw-retained prostheses can be removed if something goes wrong. Dentists can unscrew the prosthesis to repair fractured porcelain, replace components, or tighten parts. This retrievability became a major safety net.

2. No Excess Cement

Cement-retained implants often cause peri-implantitis because excess cement seeps below the gumline and is hard to clean. Research shows cement residue is a leading cause of peri-implant disease (Wilson et al., 2009). Screw retention avoids this issue entirely.

3. Strong and Time-Tested

Screw-retained implants have 30+ years of clinical history and thousands of studies confirming their success. They became especially favored in full-arch reconstructions where retrievability and precision matter most.

4. Predictable Fit and Occlusion

With screw retention, the prosthesis can be fully seated against the implant or abutment. Cement-retained crowns sometimes don’t seat fully, which can throw off the bite.

5. Professional Familiarity

For decades, dental schools and implant companies have taught screw retention as the safe choice. It’s what most clinicians know best, which reinforced its role as the “default” method.

The Problem With Screw Holes

While screws solved the problems of cement, they created new issues of their own. Here are five reasons screw holes may not be the best choice for your long-term health, comfort, and smile.

1. Screw Holes Trap Bacteria

Tiny screw access channels act like caves for bacteria. Even when covered with resin, they can collect food debris, become breeding grounds for bacteria, and contribute to bad breath or peri-implant disease (Zurdo et al., 2009; Korsch et al., 2014).

2. Staining and Discoloration

Resin fillings used to cover screw holes are porous. Over time, they pick up stains from coffee, wine, and even mouthwash. Patients often notice dark spots, discoloration, or resin plugs popping out (Shah et al., 2017).

3. Weakening of the Prosthesis

Drilling screw holes into ceramic or zirconia compromises their strength. Over time, this increases the risk of chipping, fractures, and expensive repairs. Reviews show screw-retained prostheses experience more veneer fractures than cement-retained designs (Goodacre et al., 2018).

4. More Complicated Maintenance

Removing screw-retained implants isn’t always simple. Resin plugs must be drilled out, screws can strip or loosen, and appointments take longer. Smileloc, by contrast, uses a shape-memory alloy system that dentists can remove in seconds with a special key (Linsley et al., 2019).

5. Risk of Implant Failure

Bacteria in screw channels can spread to the bone, causing peri-implantitis, bone loss, and even implant failure. Once an implant fails, replacing it can be difficult because the same bone site may no longer be usable (Kreissl et al., 2007; Wilson et al., 2009).

The Screwless, Cementless Solution: Smileloc

At Smileloc, we believe dental implants should:

• Look natural (no resin plugs)
• Stay clean (no bacterial traps)
• Last a lifetime (no weakened restorations)
• Be easy to maintain (removable in seconds)

That’s why we use a shape-memory alloy abutment system that locks your teeth in place securely — with no screws, no cement, and no hidden headaches.

Final Thoughts

Screw-retained implants became the gold standard because they solved the problems of cement. But over time, new problems have emerged — from staining and maintenance headaches to bacterial risks. Smileloc represents the next evolution in implant dentistry: a solution that combines the retrievability of screws with the clean esthetics of cement, while eliminating the downsides of both.