What is a screwmentable crown?

 Lately I have been utilizing tibased screw retained implant crowns, using original tibased prefab parts from the manufacturers. These are less costly than screw retained pfm crowns and they tend to look better as well. Also, Zirconium can be more biocampatable than the metal used in pfm screw retained restorations. Tibased crowns are fine most of the time but occasionally are not the best option. They only come in certain lengths and configurations for the titanium components. Sometimes the metal sleeve is too short to be retentive and sometimes the base of the part can be too close to the bone housing the implant, especially when the bone around the implant is at uneven levels. This can make torquing the implants down difficult since they are not passively fitting.

I have become aware of an alternative to use in these situations which involve having a custom titanium abutment designed and milled to fit passively and then the lab cements on a milled zirconium crown with a hole in it. Voila, the resulting "screwmentable" restoration is better designed and more likely to fit passively. 

I know my labs have been using Atlantis to mill these , but they may also be available by milling centers that are affiliated with implant manufacturers as well. I believe I will be employing these types of implant crowns more and more since they seem to have a better chance to have a more perfect emergence profile for my implant restorations. Yes, they involve some additional expense, but I am willing to absorb that cost if it results in a more well adapted implant restoration.