UZH-Logo

Maintenance Infos

Cemented and screw-retained implant reconstructions: a systematic review of the survival and complication rates


Sailer, Irena; Mühlemann, Sven; Zwahlen, Marcel; Hämmerle, Christoph H F; Schneider, David (2012). Cemented and screw-retained implant reconstructions: a systematic review of the survival and complication rates. Clinical Oral Implants Research, 23 Suppl:163-201.

Abstract

OBJECTIVES: To assess the 5-year survival rates and incidences of complications of cemented and screw-retained implant reconstructions. METHODS: An electronic Medline search complemented by manual searching was conducted to identify randomized controlled clinical trials (RCTs), and prospective and retrospective studies giving information on cemented and screw-retained single-unit and multiple-unit implant reconstructions with a mean follow-up time of at least 1 year. Assessment of the identified studies and data abstraction were performed independently by three reviewers. Failure rates were analyzed using Poisson regression models to obtain summary estimates and 95% confidence intervals of failure rates and 5-year survival proportions. RESULTS: Fifty-nine clinical studies were selected from an initial yield of 4511 titles and the data were extracted. For cemented single crowns the estimated 5-year reconstruction survival was 96.5% (95% confidence interval (CI): 94.8-97.7%), for screw-retained single crowns it was 89.3% (95% CI: 64.9-97.1%) (P = 0.091 for difference). The 5-year survival for cemented partial fixed dental prostheses (FDPs) was 96.9% (95% CI: 90.8-99%), similar to the one for screw-retained partial FDPs with 98% (95% CI: 96.2-99%) (P = 0.47). For cemented full-arch FDPs the 5-year survival was 100% (95% CI: 88.9-100%), which was somewhat higher than that for screw-retained FDPs with 95.8% (95% CI: 91.9-97.9%) (P = 0.54). The estimated 5-year cumulative incidence of technical complications at cemented single crowns was 11.9% and 24.4% at screw-retained crowns. At the partial and full-arch FDPs, in contrast, a trend to less complication at the screw-retained was found than at the cemented ones (partial FDPs cemented 24.5%, screw-retained 22.1%; full-arch FDPs cemented 62.9%, screw-retained 54.1%). Biological complications like marginal bone loss >2 mm occurred more frequently at cemented crowns (5-year incidence: 2.8%) than at screw-retained ones (5-year incidence: 0%). CONCLUSION: Both types of reconstructions influenced the clinical outcomes in different ways, none of the fixation methods was clearly advantageous over the other. Cemented reconstructions exhibited more serious biological complications (implant loss, bone loss >2 mm), screw-retained reconstructions exhibited more technical problems. Screw-retained reconstructions are more easily retrievable than cemented reconstructions and, therefore, technical and eventually biological complications can be treated more easily. For this reason and for their apparently higher biological compatibility, these reconstructions seem to be preferable.

Abstract

OBJECTIVES: To assess the 5-year survival rates and incidences of complications of cemented and screw-retained implant reconstructions. METHODS: An electronic Medline search complemented by manual searching was conducted to identify randomized controlled clinical trials (RCTs), and prospective and retrospective studies giving information on cemented and screw-retained single-unit and multiple-unit implant reconstructions with a mean follow-up time of at least 1 year. Assessment of the identified studies and data abstraction were performed independently by three reviewers. Failure rates were analyzed using Poisson regression models to obtain summary estimates and 95% confidence intervals of failure rates and 5-year survival proportions. RESULTS: Fifty-nine clinical studies were selected from an initial yield of 4511 titles and the data were extracted. For cemented single crowns the estimated 5-year reconstruction survival was 96.5% (95% confidence interval (CI): 94.8-97.7%), for screw-retained single crowns it was 89.3% (95% CI: 64.9-97.1%) (P = 0.091 for difference). The 5-year survival for cemented partial fixed dental prostheses (FDPs) was 96.9% (95% CI: 90.8-99%), similar to the one for screw-retained partial FDPs with 98% (95% CI: 96.2-99%) (P = 0.47). For cemented full-arch FDPs the 5-year survival was 100% (95% CI: 88.9-100%), which was somewhat higher than that for screw-retained FDPs with 95.8% (95% CI: 91.9-97.9%) (P = 0.54). The estimated 5-year cumulative incidence of technical complications at cemented single crowns was 11.9% and 24.4% at screw-retained crowns. At the partial and full-arch FDPs, in contrast, a trend to less complication at the screw-retained was found than at the cemented ones (partial FDPs cemented 24.5%, screw-retained 22.1%; full-arch FDPs cemented 62.9%, screw-retained 54.1%). Biological complications like marginal bone loss >2 mm occurred more frequently at cemented crowns (5-year incidence: 2.8%) than at screw-retained ones (5-year incidence: 0%). CONCLUSION: Both types of reconstructions influenced the clinical outcomes in different ways, none of the fixation methods was clearly advantageous over the other. Cemented reconstructions exhibited more serious biological complications (implant loss, bone loss >2 mm), screw-retained reconstructions exhibited more technical problems. Screw-retained reconstructions are more easily retrievable than cemented reconstructions and, therefore, technical and eventually biological complications can be treated more easily. For this reason and for their apparently higher biological compatibility, these reconstructions seem to be preferable.

Citations

54 citations in Web of Science®
37 citations in Scopus®
Google Scholar™

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic for Fixed and Removable Prosthodontics
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2012
Deposited On:06 Dec 2012 16:10
Last Modified:05 Apr 2016 16:05
Publisher:Wiley-Blackwell
ISSN:0905-7161
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1111/j.1600-0501.2012.02538.x
PubMed ID:23062142

Download

Full text not available from this repository.
View at publisher

TrendTerms

TrendTerms displays relevant terms of the abstract of this publication and related documents on a map. The terms and their relations were extracted from ZORA using word statistics. Their timelines are taken from ZORA as well. The bubble size of a term is proportional to the number of documents where the term occurs. Red, orange, yellow and green colors are used for terms that occur in the current document; red indicates high interlinkedness of a term with other terms, orange, yellow and green decreasing interlinkedness. Blue is used for terms that have a relation with the terms in this document, but occur in other documents.
You can navigate and zoom the map. Mouse-hovering a term displays its timeline, clicking it yields the associated documents.

Author Collaborations