Study Finds Similar Peri-Implant Disease Incidence in Cement- and Screw-Retained Implant-Supported Prostheses

Unveiling the Connection Between Retention Methods and Peri-Implant Diseases

BRAZIL: A recent systematic review and meta-analysis have delved into the intriguing question of whether the retention method used for implant-supported prostheses, cement- or screw-retained, influences the incidence of peri-implant diseases. This study, led by Isabella Neme Ribeiro dos Reis, DDS, PhD, and an team of Brazilian researchers, aimed to provide clarity on this matter and bridge the gap in existing knowledge.

Cement vs. Screw: Examining the Pros and Cons

In the world of implant-supported fixed dental prostheses, two primary methods for retaining these prostheses on implants or abutments have gained prominence: cement- and screw-retained. Each method has its own set of advantages and disadvantages. 

Cemented prostheses, while widely used, have drawn attention due to their association with peri-implant diseases. This concern stems from the remnants of cement, which can serve as a bacterial reservoir and hinder effective biofilm control. However, existing evidence on this matter has been conflicting, leading to the need for a systematic review and meta-analysis to provide clarity.

Analysing Peri-Implant Disease Incidence

The main objective of this systematic review and meta-analysis was to address a critical question: “In patients who have received implant-supported prostheses, does the incidence of peri-implant diseases differ between cemented and screw-retained prostheses?” The study aimed to analyze this question comprehensively, considering the different aspects associated with these two retention methods.

The research team conducted a search across reputable databases, including the National Library of Medicine (MEDLINE-PubMed), SCOPUS, EMBASE, and ISI Web of Science. Their focus was on randomized clinical trials (RCTs) that specifically explored the incidence of peri-implant diseases in cement- and screw-retained prostheses. Rigorous screening processes, data extraction, and bias assessments were performed independently by two authors to ensure robust findings.

Key Findings: Cement vs. Screw

The search process identified a substantial pool of 4455 articles. However, only six RCTs met the stringent inclusion criteria for comprehensive analysis. The meta-analysis outcomes provided valuable insights:

For the risk of peri-implant mucositis, the study revealed no significant difference between cement- and screw-retained prostheses (RR: 1.36, 95% CI: 0.42–4.38, P=.61).

Similarly, for the incidence of peri-implantitis, no significant difference was observed between cement- and screw-retained prostheses (RR: 1.00, 95% CI: 0.23–4.31, P=1.00).

Cement and Screw-Retained Prostheses

Based on the findings, this study presents moderate-certainty evidence that cement- and screw-retained prostheses carry similar risks for peri-implant mucositis and peri-implantitis. These insights contribute to a better understanding of the implications of retention methods in implant-supported prostheses, ultimately guiding clinical decisions and patient care.