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Clinical performance of screw- versus cement-retained fixed implant-supported reconstructions--a systematic review
- Source :
- The International journal of oralmaxillofacial implants.
- Publication Year :
- 2014
-
Abstract
- PURPOSE To assess the survival outcomes and reported complications of screw- and cement-retained fixed reconstructions supported on dental implants. MATERIALS AND METHODS A Medline (PubMed), Embase, and Cochrane electronic database search from 2000 to September 2012 using MeSH and free-text terms was conducted. Selected inclusion and exclusion criteria guided the search. All studies were first reviewed by abstract and subsequently by full-text reading by two examiners independently. Data were extracted by two examiners and statistically analyzed using a random effects Poisson regression. RESULTS From 4,324 abstracts, 321 full-text articles were reviewed. Seventy-three articles were found to qualify for inclusion. Five-year survival rates of 96.03% (95% confidence interval [CI]: 93.85% to 97.43%) and 95.55% (95% CI: 92.96% to 97.19%) were calculated for cemented and screw-retained reconstructions, respectively (P = .69). Comparison of cement and screw retention showed no difference when grouped as single crowns (I-SC) (P = .10) or fixed partial dentures (I-FDP) (P = .49). The 5-year survival rate for screw-retained full-arch reconstructions was 96.71% (95% CI: 93.66% to 98.31). All-ceramic reconstruction material exhibited a significantly higher failure rate than porcelain-fused-to-metal (PFM) in cemented reconstructions (P = .01) but not when comparing screw-retained reconstructions (P = .66). Technical and biologic complications demonstrating a statistically significant difference included loss of retention (P ≤ .01), abutment loosening (P ≤ .01), porcelain fracture and/or chipping (P = .02), presence of fistula/suppuration (P ≤ .001), total technical events (P = .03), and total biologic events (P = .02). CONCLUSIONS Although no statistical difference was found between cement- and screw-retained reconstructions for survival or failure rates, screw-retained reconstructions exhibited fewer technical and biologic complications overall. There were no statistically significant differences between the failure rates of the different reconstruction types (I-SCs, I-FDPs, full-arch I-FDPs) or abutment materials (titanium, gold, ceramic). The failure rate of cemented reconstructions was not influenced by the choice of a specific cement, though cement type did influence loss of retention.
- Subjects :
- Ceramics
Bone Screws
Dentistry
Dental Cements
Dental Abutments
Dental Prosthesis Retention
symbols.namesake
Dental porcelain
Medicine
Humans
Poisson regression
Dental Restoration Failure
Survival rate
Dental Implants
Crowns
business.industry
Dental prosthesis
General Medicine
Random effects model
Dental Porcelain
Confidence interval
Inclusion and exclusion criteria
symbols
Denture, Partial, Fixed
Dental Prosthesis, Implant-Supported
Oral Surgery
business
Abutment (dentistry)
Subjects
Details
- ISSN :
- 19424434
- Database :
- OpenAIRE
- Journal :
- The International journal of oralmaxillofacial implants
- Accession number :
- edsair.doi.dedup.....6b502462413ef2c2a53dfa1f81ef4b08