Clinical Performance of Screw- Versus Cement-Retained Fixed Implant-Supported Reconstructions- A Systematic Review.

Wittneben, Julia; Millen, Christopher; Brägger, Urs (2014). Clinical Performance of Screw- Versus Cement-Retained Fixed Implant-Supported Reconstructions- A Systematic Review. International journal of oral & maxillofacial implants, 29(Suppl), pp. 84-98. Quintessence Publ. 10.11607/jomi.2014suppl.g2.1

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PURPOSE

To assess the survival outcomes and reported complications of screw- and cement-retained fixed reconstructions supported on dental implants.

MATERIALS AND METHODS

A Medline (PubMed), Embase, and Cochrane electronic database search from 2000 to September 2012 using MeSH and free-text terms was conducted. Selected inclusion and exclusion criteria guided the search. All studies were first reviewed by abstract and subsequently by full-text reading by two examiners independently. Data were extracted by two examiners and statistically analyzed using a random effects Poisson regression.

RESULTS

From 4,324 abstracts, 321 full-text articles were reviewed. Seventy-three articles were found to qualify for inclusion. Five-year survival rates of 96.03% (95% confidence interval [CI]: 93.85% to 97.43%) and 95.55% (95% CI: 92.96% to 97.19%) were calculated for cemented and screw-retained reconstructions, respectively (P = .69). Comparison of cement and screw retention showed no difference when grouped as single crowns (I-SC) (P = .10) or fixed partial dentures (I-FDP) (P = .49). The 5-year survival rate for screw-retained full-arch reconstructions was 96.71% (95% CI: 93.66% to 98.31). All-ceramic reconstruction material exhibited a significantly higher failure rate than porcelain-fused-to-metal (PFM) in cemented reconstructions (P = .01) but not when comparing screw-retained reconstructions (P = .66). Technical and biologic complications demonstrating a statistically significant difference included loss of retention (P ≤ .01), abutment loosening (P ≤ .01), porcelain fracture and/or chipping (P = .02), presence of fistula/suppuration (P ≤ .001), total technical events (P = .03), and total biologic events (P = .02).

CONCLUSIONS

Although no statistical difference was found between cement- and screw-retained reconstructions for survival or failure rates, screw-retained reconstructions exhibited fewer technical and biologic complications overall. There were no statistically significant differences between the failure rates of the different reconstruction types (I-SCs, I-FDPs, full-arch I-FDPs) or abutment materials (titanium, gold, ceramic). The failure rate of cemented reconstructions was not influenced by the choice of a specific cement, though cement type did influence loss of retention.

Item Type:	Journal Article (Review Article)
Division/Institute:	04 Faculty of Medicine > School of Dental Medicine > Department of Prosthodontics [discontinued]
UniBE Contributor:	Wittneben, Julia, Millen, Christopher, Brägger, Urs
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0882-2786
Publisher:	Quintessence Publ.
Language:	English
Submitter:	Eveline Carmen Schuler
Date Deposited:	27 Jan 2015 11:12
Last Modified:	05 Dec 2022 14:39
Publisher DOI:	10.11607/jomi.2014suppl.g2.1
PubMed ID:	24660192
Uncontrolled Keywords:	cement, dental implants, fixed dental prostheses, prosthodontics, screw, single crown
URI:	https://boris.unibe.ch/id/eprint/61741