Evaluation of Marginal Bone Loss and Esthetics in Screw vs Cement-retained Single Implant Prosthesis: A Systematic Review

Abstract

Purpose: The aim of this systematic review was to evaluate marginal bone loss and esthetics in single implant zirconia prostheses of screw- and cement-retained prosthesis.

Materials and methods: An electronic search on MEDLINE/PubMed, Google Scholar, Scopus, Embase, Web of Science was conducted to identify randomized controlled clinical trials (RCTs) published within the past five years from 2018 upto January 2023. Additionally, a manual search of relevant references was performed. Two reviewers independently selected studies based on predefined inclusion criteria. Marginal bone loss values and esthetic parameters were extracted, and meta-analysis was conducted where applicable.

Results: The initial search yielded 61 articles, of which nine articles were thoroughly analyzed, resulting in five RCTs which were included. Due to limited available data on esthetic parameters, meta-analysis could not be performed. However, 164 implants revealed that screw-retained implant restorations were more likely to retain screws than cemented ones after one year (z-test value = 3.18, p = 0.001), with a mean difference of -0.30 (95% CI).

Conclusion: Marginal bone loss around implants was lower in screw-retained prostheses compared to cement-retained ones. These findings support the preference for zirconia prostheses in esthetically demanding cases.

Clinical significance: Screw-retained ceramic prosthesis exhibit optimal esthetics and minimal marginal bone loss. Cement-retained prosthesis fail in terms of marginal bone loss and esthetics due to excess cement around the prostheses. Inadvertence of excess cement removal around implant prosthesis led to inflammation of peri-implant tissue, which consequently increased probing depth. A stringent protocol in the procedure of cementation of prosthesis aids in the removal of excess cement, which reduces marginal bone loss and enhances esthetic. How to cite this article: Sajjanar J, Mohite V, Benakatti V, et al. Evaluation of Marginal Bone Loss and Esthetics in Screw vs Cement-retained Single Implant Prosthesis: A Systematic Review. J Contemp Dent Pract 2025;26(1):103-109.

Keywords: Cement-retained implant prosthesis; Esthetics; Marginal bone loss Screw-retained implant prosthesis..