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| Title |
Cement-retained prosthesis for single implant restoration has less technical complications than screw-retained prosthesis |
| Clinical Question |
For a patient needing single implant restoration, would cement-retained prosthesis result in fewer biological and technical complications as compared to screw-retained prosthesis? |
| Clinical Bottom Line |
For partially edentulous patients requiring single implant restoration, cement-retained prosthesis has less technical complications and similar rate of biological complications compared to screw-retained prosthesis based on the evidence from three systemic 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) 29243683 | Ragauskaitė/2017 | 10 studies/443 patients in vivo/167 implant restoration in vitro | Systematic review of randomized trials | | Key results | For technical complications, studies showed more failures in porcelain fractures and screw loosening for screw-retained restoration (38%; P<0.001 and 32%; P=0.001) than cement-retained restoration (4% and 9%). For biological complications, studies showed cement-retained restoration has more severe outcome in bone resorption (>2mm) compared with screw-retained restoration (frequency of 2.8% to 0%), but less on peri-implantitis, fistulas, and mucosal hypertrophy (P<0.005) | | #2) 28385429 | Ramamoorthi/2017 | 104 studies/9568 prostheses | Systematic review of randomized trials | | Key results | Technical and biological complications were grouped into major complication (restoration needed major correction to continue its function) and minor complication (restoration remained in situ but needed minor modification). Screw-retained restoration (8.5%; 95% CI:5.5%-12.9%) demonstrated double amount of minor complications than cement-retained restoration (4.2%; CI:3.2-5.4%). No significant difference was noted for major complications (P>0.05). | | #3) 25615920 | Millen/2015 | 73 studies/5858 prostheses | Systematic review of randomized trials | | Key results | For single implant technical complication, in general there was no significant difference but a tendency toward more complications with screw-retained restoration (P = .071). For single implant biological complication, no significant difference was found. | |
| Evidence Search |
Cement-retained[All Fields] AND Screw-retained[All Fields] AND (systematic[sb] OR Meta-Analysis[ptyp]) |
Comments on
The Evidence |
Validity: The systemic reviews covered large amount of studies with adequate pool of patients and prostheses to allow inclusion in the review. Search was detailed, comprehensive and replicable
Perspective: Based on current evidence, cement-retained restoration demonstrate less technical complications and similar rate of biological complications compared to screw-retained restoration. It should be noted that biological complication of cement-retained restoration highly depends on margin position relative to gingival margin and associated excess retained cements.
|
| Applicability |
This evidence serves to assist providers when deciding prosthesis design for single implant restoration and educate patients of potential complications which can occur as a result of these types of implant restoration. |
| Specialty/Discipline |
(General Dentistry) (Prosthodontics) (Restorative Dentistry) |
| Keywords |
Cement-retained, screw-retained, complications
|
| ID# |
3351 |
| Date of submission: |
10/26/2018 |
| E-mail |
leep4@livemail.uthscsa.edu |
| Author |
Paul T. Lee, DDS |
| Co-author(s) |
N/A |
| Co-author(s) e-mail |
N/A |
| Faculty mentor/Co-author |
Jon M. Dossett, DMD |
| Faculty mentor/Co-author e-mail |
dossett@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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