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Title No Significant Difference Was Found in Success or Failure Rate Between Cement-and Screw-Retained Prostheses
Clinical Question For a patient with a missing posterior tooth replaced by an implant, does the cemented-type prosthesis have a higher success rate than the screw-type prosthesis?
Clinical Bottom Line For patients receiving a dental implant for a missing tooth, the data analysis shows no significant difference in the success rate between the two types of prosthesis, cement- and screw-retained. This is supported by a randomized controlled trial and two systematic reviews.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 23304689 Vigolo/201218 patients; each received two identical implantsRandomized Controlled Trial
Key resultsThe results of the study show that "The mean marginal bone resorption at 10 years after implant placement, measured on intraoral radiographs, was 1.1 +/- 0.2 mm for both types of restorations." Also, no significant difference was found between the two types of restoration for the facial keratinised gingiva.
#2) 24382004 Sherif/201323 articles were evaluatedSystematic Review of Randomized Trials
Key results"Data were extracted from 23 level one and two research studies. Fliess' kappa interevaluator agreement ranged from almost perfect to moderate. Major failures included 0.71 screw-retained and 0.87 cement-retained failures per 100 years." The authors concluded that there was "no significant difference between cement- and screw-retained restorations for major and minor outcomes with regard to implant survival..."
#3) 24660192Wittneben/201473 articles were evaluatedSystematic Review of Randomized Trials
Key resultsData showed that there is no difference in the retention of cement-retained prostheses and screw-retained prostheses when grouped as single crowns or fixed partial dentures. "The failure rate of cemented reconstructions was not influenced by the choice of a specific cement, though cement type did influence loss of retention." The 5-year survival rates of cemented and screw-retained crowns were 96.03% (95% confidence interval [CI]: 93.85% to 97.43%) and 95.55% (95% CI: 92.96% to 97.19%), respectively.
Evidence Search ("dental cementum"[MeSH Terms] OR ("dental"[All Fields] AND "cementum"[All Fields]) OR "dental cementum"[All Fields] OR "cement"[All Fields] OR "dental cements"[MeSH Terms] OR ("dental"[All Fields] AND "cements"[All Fields]) OR "dental cements"[All Fields]) AND versus[All Fields] AND ("bone screws"[MeSH Terms] OR ("bone"[All Fields] AND "screws"[All Fields]) OR "bone screws"[All Fields] OR "screw"[All Fields]) AND implant[All Fields]
Comments on
The Evidence
Validity: Both systematic reviews identified a good number of studies with sufficient information to allow inclusion in the review. It should be noted that the Vigolo RCT was a split-mouth study with a 10-year follow-up and an 83% follow-up rate (30 of 36 implants were followed up); these factors increase the validity of the study. Perspective: The findings of the studies agree with current teachings and guidelines.
Applicability This information can help the practitioner in deciding the best prosthetic treatment options for a patient with a dental implant. Based on this evidence, the dentist can select a screw-retained or cemented restoration based on personal preference or other factors, without concern that either type has a higher failure rate.
Specialty/Discipline (General Dentistry) (Prosthodontics) (Restorative Dentistry)
Keywords Screw-retained implant crown, cement–retained implant crown, implant outcomes
ID# 2741
Date of submission: 06/25/2014spacer
E-mail Adel.qarni@hotmail.com
Author Adel S. Alqarni
Co-author(s) Mohammed M. Aljameel & Luke Tibbitts
Co-author(s) e-mail mhd-aljameel@hotmail.com, tibbitts@livemail.uthscsa.edu
Faculty mentor/Co-author Stephan J. Haney, DDS
Faculty mentor/Co-author e-mail Haneys2@uthscsa.edu
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