Insight 100 — Adjusting the Occlusion of an Implant Crown: Before or After Cementation?

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Sometimes an implant crown looks slightly high at the try-in stage. We adjust the occlusion and everything seems fine, but after cementing the crown and having the patient bite down, we find that the crown has become shorter. The reason is that the crown had not fully seated at try-in, and the soft tissue around the implant was holding it slightly up. During cementation, with more pressure and displacement of the tissue, the crown seats in its true position.

When the crown needs only a minor adjustment, for example in digital work, where a few high contact points usually remain, and we are not sure the crown has seated fully, it is better not to adjust the occlusion at try-in. We cement the crown and make the adjustment in the mouth after cementation. Implant crowns are usually cemented with temporary cement from the start, so the order of work is simple: cement, adjust the occlusion, and polish.

Do not forget to polish after the adjustment, because grinding in the mouth removes the glaze, and a rough surface is both abrasive to the opposing tooth and collects more plaque.

The criterion for adjustment should not be only the patient's feeling. An implant has no PDL, and the patient does not feel a high spot the way they would with a natural tooth, so it is better to check whether the adjacent teeth hold shim stock or not.

This page is intended for educational use by dentists and dental students.