Both healing abutments and cover screws are transitional dental implant components and that means they are temporary and not permanent.
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.
Healing abutment physical features:
Large looking screw.
Top has insertion hole.
Bottom has long threads.
Varying widths.
Varying heights.
Cover screw physical features:
Small looking screw.
Top has insertion hole.
Bottom has long threads.
Varying widths only.
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.
