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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/2012 | 18 patients; each received two identical implants | Randomized Controlled Trial | | Key results | The 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/2013 | 23 articles were evaluated | Systematic 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) 24660192 | Wittneben/2014 | 73 articles were evaluated | Systematic Review of Randomized Trials | | Key results | Data 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: |
06/25/2014 |
| 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 |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
| None available | |
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