Clinical evidence and Science 43 Stability of cemented vs screw-retained restorations The prosthetic reconstructions can be either screw- retained on implants or on designated abutments or cemented on standardized or customized abutments. Both retention methods can be used with single crowns, fixed partial dentures, or with fullarch reconstructions, but each have their own benefits and drawbacks. According to a systematic review by Sailer et al. (2012), cemented reconstructions may be easier to manipulate in the mouth but, on the other hand, experience more biological complications due to the difficulty to remove excess cement which is deemed associated with inflammatory processes in the peri-implant tissues (22). With screw-retained reconstructions more technical problems, like loss of retention, loosening, and chipping associated with the open screw access hole, could be observed. However, they can easily be removed in case of problems and biological complications are unlikely. However, the review could not show significant differences related to the survival of both type of retention after five years in function. Obermeier et al. (2017) performed a mechanical test using artificial aging with thermal cycling and dynamic loading (23). The aim was to compare different veneering concepts on zirconia molar crowns either cemented or screw-retained with titanium bases to CONELOG® implants. They concluded that the mode of retention had no influence on the fracture strength of the reconstruction. A fact which could clinically be shown by Cacaci et al. (2017) (24). They analyzed any influence of screw-retained reconstructions compared to cemented ones in a clinical study with 58 patients. A mixture of 114 CAMLOG® and CONELOG® SCREW-LINE implants in the molar or pre-molar region were randomly assigned to a specific retention group. After a healing period of four months, the crowns made from zirconia with sintered veneering caps were placed and followed-up for three years. The results revealed no significant differences between screw-retained and cemented reconstructions regarding soft tissue health and technical failures. During the observation time, no implant loss nor crown fracture could be observed and only in 1.8% of all cases veneering fractures occurred. The authors pointed out the importance of checking by radiographs for excess cement after placing the definitive reconstruction. Then, both retention methods will show high success rates. Fixation and patient-reported outcome of restorations KEY TAKE OUTS: CEMENTED AND SCREW-RETAINED RESTORATIONS Clinically, cemented and screw-retained restorations on CAMLOG® or CONELOG® implants revealed successful outcomes and no differences regarding survival, soft tissue health and technical failures. Both have their justification in clinical application. PROSTHETIC RESTORATIONS: SCIENTIFICALLY BASED TREATMENT OPTIONS
RkJQdWJsaXNoZXIy MTE0MzMw