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 ion 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.
Objectives
To compare the survival and complication rates of posterior screw‐retained monolithic lithium disilicate (LS2)/veneered zirconia (ZrO2) single implant crowns (SICs), as well as analyze the ...occlusal changes observed during a 3‐year follow‐up period.
Materials and Methods
Thirty‐three patients were included and randomly divided into two groups. The test group consisted of 17 patients who received monolithic‐LS2–SIC, while the control group consisted of 16 patients who received veneered‐ZrO2‐SIC. Implant/prosthesis survival rates, technical complications, peri‐implant soft tissue conditions, and quantitative occlusal changes of SIC (obtained by the intra‐oral scanner and analyzed in reverse software Geomagic Control 2015) were assessed at 1‐ and 3‐year follow‐ups. Bone loss and Functional Implant Prosthodontic Score (FIPS) were evaluated at a 3‐year follow‐up.
Results
After a 3‐year follow‐up period, one patient dropped out of the follow‐up. No implant loss was observed. One crown was fractured, resulting in prosthesis survival rates of 93.75% for the monolithic group and 100% for the veneered group. A technical complication rate of 25% (4/16) was observed in the veneered group (p = .333). No significant differences in the marginal bone loss were observed at the 3‐year follow‐up (0.00 (−0.22, 0.17) mm versus 0.00 (−0.12, 0.12) mm, p = .956). The total FIPS scores for the test group were 9.0 (9.0, 9.0), while the control group received scores of 9.0 (8.0, 10.0) (p = .953). The changes in mean occlusal clearance were 0.022 ± 0.083 mm for the test and 0.034 ± 0.077 mm for the control group (at 3 years, p = .497). The changes in occlusal contact area were 1.075 ± 2.575 mm2 for the test and 1.676 ± 2.551 mm2 for the control group (at 3 years, p = .873).
Conclusion
After a 3‐year follow‐up, screw‐retained monolithic LS2 and veneered ZrO2 SIC demonstrated similar survival rates. The occlusal performance of implant prostheses needs to be closely examined during follow‐up, and appropriate occlusal adjustments need to be considered.
Objectives
To analyse whether there is a difference in marginal bone levels (MBL) and the respective changes between cemented and screw‐retained reconstructions at 3 and 5 years of loading.
Methods
...Radiographic data from 14 prospective multicentre clinical trials following implant loading with fixed cemented (CEM) or screw‐retained (SCREW) reconstructions with a 3‐ to 5‐year follow‐up were retrieved from a database. MBL and MBL changes were assessed at initiation of implant loading (BL), at 3 (FU‐3) and 5 years (FU‐5) thereafter. The presence of peri‐implantitis was also determined.
Results
Data from 1,672 implants at BL, 1,565 implants at FU‐3 and 1,109 implants at FU‐5 were available. The mean MBL amounted to 0.57 mm (SD 0.87) at BL, 0.55 mm (SD 0.86) at FU‐3 and 0.65 mm (SD 1.18) at FU‐5. At FU‐3, the mean MBL was 0.44 mm (SD 0.65) in group CEM and 0.63 mm (SD 0.99) in group SCREW showing a significant difference between the groups (intergroup <0.05). At FU‐5, the mean MBL was 0.42 mm (SD 0.77) in CEM and 0.80 mm (SD 1.37) in SCREW, again with significant differences between both groups (p < .05). MBL changes between BL and FU‐3 amounted to 0.11 mm (SD 1.02) (bone loss) in SCREW and −0.17 mm (SD 1.03) (bone gain) in CEM. Similarly, mean MBL changes from BL to FU‐5 amounted to 0.23 mm (SD 1.31) (bone loss) in SCREW and −0.26 mm (SD 1.27) (bone gain) in CEM. The prevalence of peri‐implantitis amounted to 6.9% in CEM and 5.6% in group SCREW (intergroup p = .29063) at FU‐3. At FU‐5, peri‐implantitis amounted to 4.6% in CEM and 6.2% in group SCREW (intergroup p = .28242).
Conclusion
Cemented implant reconstructions compared with screw‐retained reconstructions revealed higher marginal bone levels and similar rates of peri‐implantitis during 5 years. The difference in MBL and the respective changes between the two groups, however, appear to be clinically negligible.
Objectives
The aim of this intrasubject clinical study was to measure and compare prosthodontic and patient‐reported outcome measures (PROMs) in the fabrication of implant‐supported, all‐ceramic ...single crowns with a full digital workflow and a conventional workflow.
Materials and methods
Thirty‐one patients were subjected to first a digital (test group) and then a conventional impression (control group) at the same visit. From the intraoral optical scanner (IOS), a screw‐retained, monolithic crown was delivered according to a complete digital workflow (no cast), whereas a veneered crown on a zirconia (Zi) frame was provided as a control treatment. Both crowns were assessed during the clinical stages of try‐in. Prosthodontic outcomes (contact points, occlusion, PROMs, and esthetic results using the white esthetic score WES) were assessed.
Results
Occlusion and interproximal contacts showed comparable results for the two workflows (p = 0.37 and p = 0.36, respectively), whereas the global WES was significantly higher (p < 0.0001) in the control group. Patient satisfaction scores, using visual analog scales (VAS), were significantly better for IOS than for conventional impressions (p = 0.0098). On the contrary, patients’ perception of the esthetic outcomes showed significantly higher value (p < 0.0001) in the control group.
Conclusions
Both workflows allowed the delivery of ceramic crowns within two appointments. The clinical fit was acceptable in both groups. A better esthetic outcome, in both patients’ and clinicians’ opinions, was found in the control group. PROMs showed higher satisfaction with the IOS.
Objectives
To evaluate the peri‐implant tissue changes and esthetic outcomes of cemented and screw‐retained crowns of single‐tooth implants in the esthetic zone using zirconia abutments.
Material and ...methods
An electronic search was performed on nine databases. The risk‐of‐bias was assessed by the revised Cochrane risk‐of‐bias tool for randomized (RoB 2) and non‐randomized (ROBINS‐I) clinical trials. Marginal bone level change, soft tissue thickness, bleeding on probing, probing depth, survival rates of implants and crowns, complications, plaque and papilla indexes, and pink esthetic score data were extracted and analyzed. The certainty of evidence was accessed through the GRADE approach.
Results
Nine records were included and 7 were used in the meta‐analyses. Screw‐retained crowns presented greater marginal bone level change (MD −0.04 −0.08, −0.00 p = 0.04, I2 = 0%) compared to cemented crowns up to 1‐year. At 3 and 4 years no significant differences (p > 0.05) were observed. Soft tissue thickness did not differ between groups (p > 0.05). The bleeding on probing was higher in cemented group than in screw‐retained crowns at 1‐year (MD 0.17 0.08, 0.27 p = 0.0005, I2 = 0%), at medium‐term periods (3 and 4 years) no statistically significant differences (p > 0.05) were observed for this outcome. Probing depth, survival rates of implants and crowns, complications, and plaque index, as well as esthetic analysis using the papilla index and pink esthetic score did not differ statistically (p > 0.05) between both retention systems at short and medium‐term periods.
Conclusion
The connection system considering zirconia abutments presented no influence on peri‐implant parameters and esthetics evaluation for medium‐term periods (3 and 4 years).
Objectives
To compare cemented and screw‐retained one‐piece zirconia‐based restorations in terms of clinical, radiographic, and technical outcomes 5 years after insertion.
Materials and methods
...Thirty‐four patients with single‐tooth implants were randomly restored with either a cemented lithium disilicate crown on a one‐piece customized zirconia abutment (CEM, 17 patients) or a screw‐retained crown based on a directly veneered one‐piece customized zirconia abutment (SCREW, 16 patients). All patients were recalled for a baseline examination (7–10 days after crown insertion) and then annually up to 5 years. The following outcomes were assessed: marginal bone level (changes), technical, and clinical (bleeding on probing, plaque control record, probing depth, and keratinized tissue) parameters. The Mann–Whitney U‐test was used to assess differences between the two groups.
Results
At 5 years, 26 patients (13 in each group) were re‐examined. The survival rates on the implant and restorative levels were 100% and 82.4% (equally for both groups), respectively. At 5 years, the median marginal bone level was located at −0.15 mm (IQR: −0.89 mm; 0.27 mm) (CEM) and −0.26 mm (IQR: −0.38 mm; 0.01 mm) (SCREW) below the implant shoulder (intergroup p = .9598). The median changes between baseline and the 5‐year follow‐up amounted to −0.23 mm (CEM; intragroup p = .0002) and −0.15 mm (SCREW; intragroup p = .1465) (intergroup p = .1690). The overall technical complication rate at 5 years was 15.4% (CEM) and 15.4% (SCREW) (intergroup p = 1.00). Clinical parameters remained stable over time (baseline to 5 years).
Conclusions
At 5 years, screw‐retained and cemented restorations rendered largely the same clinical, technical, and radiographic outcomes. Technical complications were frequent in both groups.
This article presents the design of customized resin scan bodies with different forms and their use to facilitate intraoral scanning of a maxillary full arch implant case with five implants. The aim ...is to limit the distance between the scan bodies and to create definite landmarks to facilitate the scanning process in full arch implant cases.
Objectives
To compare screw‐retained and cemented all‐ceramic implant‐supported single crowns regarding biological and technical outcomes over a 5‐year observation period.
Materials and methods
In 44 ...patients, 44 two‐piece dental implants were placed in single‐tooth gaps in the esthetic zone. Patients randomly received a screw‐retained (SR) or cemented (CR) all‐ceramic single crown and were then re‐examined annually up to 5 years. Outcome measures included: clinical, biological, technical, and radiographic parameters. Data were statistically analyzed with Wilcoxon–Mann–Whitney, Wilcoxon, and Fisher's exact tests.
Results
During the observation period, three patients (6.8%) were loss to follow‐up. Eight restorations (18.2%, CI (8.2%, 32.7%)) were lost due to technical (6 patients, 13.6% (CI (5.2%, 27.4%)), 2 CR and 4 SR group, intergroup p = .673; implants still present) or biological complications (2 patients, 4.5% (CI (0.6%, 16.5%)), only CR group, intergroup p = .201, both implants lost). This resulted in a survival rate of 81.2% (CI (65.9%, 90.1%)) on the restorative level (18 SR; 15 CR, 3 lost to follow‐up). At the 5‐year follow‐up, the median marginal bone levels were located slightly apical relative to the implant shoulder with 0.4 mm (0.5; 0.3) (SR) and 0.4 mm (0.8; 0.3) (CR) (intergroup p = .582). Cemented restorations demonstrated a significantly higher biological complication rate (36.8%, SR: 0.0%; intergroup p = .0022), as well as a significantly higher overall complication rate (68.4%, SR: 22.7%, intergroup p = .0049). All other outcomes did not differ significantly between the two groups (p > .05).
Conclusions
All‐ceramic single‐tooth restorations on two‐piece dental implants resulted in a relatively low survival rate. Cemented restorations were associated with a higher biological and overall complication rate than screw‐retained restorations.
The aim was to assess the peri-implant clinicoradiographic status and prostaglandin E2 (PGE2) levels in peri-implant sulcular fluid (PISF) samples collected from individuals with cement-retained and ...crew-retained implants.
In this observational study, participants with cement-retained and screw-retained implants were enrolled. A questionnaire was utilized to gather demographic information and assess the educational background of the participants. Peri-implant modified plaque and bleeding indices, probing depth, and crestal bone loss were measured. Subsequently, PISF samples were collected, and corresponding volumes were recorded. Commercial kits employing enzyme-linked immunosorbent assay were employed to quantify PGE2 levels. The sample size was determined, and group comparisons were conducted using the Student t test and the Mann-Whitney U-test. Logistic regression models were constructed to evaluate the correlation between PGE2 levels and clinicoradiographic and demographics. The predefined level of significance was established at P < .05.
Sixty-seven participants, consisting of 33 with cement-retained implants and 34 with screw-retained implants, were included in the study. The mean ages for individuals with cement and screw-retained implants were 54.2 ± 8.7 and 58.7 ± 7.4 years, respectively. The majority of participants had completed university-level education. Reportedly, 87.9% and 82.4% of individuals with cement and screw-retained implants, respectively brushed teeth twice daily. No significant differences were observed in clinicoradiographic parameters, PGE2 volume, and levels between cement-retained and screw-retained implants. There was no correlation between PGE2 levels and peri-implant clinicoradiographic parameters among individuals with either cement-retained or screw-retained implants.
Cement-retained and screw-retained implants exhibit a consistent peri-implant clinicoradiographic status, accompanied by stable levels of PGE2 in PISF provided oral hygiene maintenance regimens are stringently followed.
Purpose
Analog and digital impressions are established procedures for restoration of single‐tooth implants. In this study, single‐tooth implants were restored with definitive restorations during ...second‐stage surgery. Analog and digital workflows were compared.
Material and Methods
Eighty single‐tooth implants were examined in total. In 40 implants, an index was taken immediately after implant placement using composite resin to fabricate the final crowns (analog workflow). For the other 40 single‐tooth implants, intraoral intraoperative scans were performed (digital workflow) during primary surgery. The custom‐fabricated screw‐retained crowns were placed during second‐stage surgery. Photographs and examinations for the scores were taken at the time of the follow‐up visit, 1–4 years after placement of the crowns. The number of treatment appointments required was recorded and the modified pink esthetic score (PES) was determined. Additionally, the functional implant prosthetic score (FIPS) was measured.
Results
The mean PES was 12.15/14 for the digital workflow and 11.95/14 for the analog workflow. The most common deficit was incomplete papillae for both workflows. Three treatment appointments were required for both workflows: (1) Scan and/or impressions making and patient consent, (2) implant placement, and (3) second‐stage surgery with crown insertion. The FIPS was 9.1/10 for the digital workflow group and 9.2/10 for the analog workflow group. Common deficits presented as missing papillae as well as open approximal contacts. The FIPS was not significantly different between workflows (p = 0.679). The PES also did not show a statistically significant difference for both workflows (p = 0.654), however, the analog workflow showed better values for the papillae (p < 0.05). A significant difference was also found in the other PES values, with the digital workflow showing better results here (p < 0.05). A chronological analysis of the results of the digital technique showed that the cases treated last had significantly better values than the cases treated first.
Conclusions
According to the results of this study, both workflows allowed placement of the definitive crowns on single‐tooth implants during second‐stage surgery. Both workflows were found to be equivalent in terms of esthetic results in this study, although the digital workflow demonstrated a learning curve.
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