A Current Perspective on Screw‐Retained Single‐Implant Restorations: A Review of Pertinent Literature

Abstract

Screw-retained single-implant crowns should be reconsidered for many clinical situations for the following reasons: Predictable retention and retrievability No potential for the biologic consequences associated with residual cement As with cement-retained restorations, the choice between metal ceramics or all ceramics Only one margin, at the implant/abutment interface A single abutment/crown ceramic margin that can extend gingivally to the implant interface Nearly imperceptible blend of a composite resin in ceramic abutment access openings One component instead of two, which may simplify the restorative process CLINICAL SIGNIFICANCE: Innovations in implant and ceramic technology now give screw-retained prostheses the potential for esthetic, functional, and biologic outcomes that are comparable to those for cement-retained prostheses, while providing the advantages of predictable retrievability and avoidance of residual cement. Angled implants, however, remain a major indication for cement-retained single-implant prostheses. (J Esthet Restor Dent 29:161-171, 2017).

Mechanical behavior of posterior all‐ceramic hybrid‐abutment‐crowns versus hybrid‐abutments with separate crowns—A laboratory study

“…However, after fracture load test, all specimens in groups ZC, LS and LC fractured after the fracture load test, while three specimens from group ZS did not fracture even after reaching loads above 3,500 N. This explains that the combination of high strength zirconia ceramic with the hybrid-abutment-crown design was capable of withstanding these unrealistically high forces and transferring the load to the weakest component, implant-base connection, causing bending. These findings support what has been addressed in a recently published systematic review, where the findings supported the use of screw-retained restorations (Priest, 2017).…”

“…Only few studies evaluated the difference between hybrid-abutment-crowns and hybrid-abutments with separate crowns (Elsayed et al, 2017(Elsayed et al, , 2018Hussien et al, 2016;Roberts, Bailey, Ashcraft-Olmscheid, & Vandewalle, 2018). Initial laboratory investigations and systematic reviews demonstrated promising results for monolithic crowns on prefabricated titanium bases (Conejo, Kobayashi, Anadioti, & Blatz, 2017;Joda, Bürki, Bethge, Brägger, & Zysset, 2015;Priest, 2017).…”

Fracture Resistance of Titanium‐Based Lithium Disilicate and Zirconia Implant Restorations

“…Another prosthetic concern beyond material properties themselves, is the method of attaching the prosthetic crown to the abutment via a screw‐ or a cement‐retained restoration. Cement‐retained restorations were developed to overcome the esthetic and functional demands of screw‐retained implant restorations and the problem of less‐optimal implant angulation . However, a recent systematic review of clinical studies found that periimplantitis and/or mucositis occurred in 1.9% to 75% of cemented implant restorations with 33% to 100% associated with excess cement .…”

“…Cementretained restorations were developed to overcome the esthetic and functional demands of screw-retained implant restorations and the problem of less-optimal implant angulation. 11 However, a recent systematic review of clinical studies found that periimplantitis and/or mucositis occurred in 1.9% to 75% of cemented implant restorations with 33% to 100% associated with excess cement. 12 The cement-retained technique has the disadvantage of making excess cement removal critical to the subsequent, long-term survival of the implant itself.…”

Influence of Biologically Oriented Preparation Technique on Peri-Implant Tissues; Prospective Randomized Clinical Trial with Three-Year Follow-Up. Part II: Soft Tissues

“…Screw-retained prostheses are associated with higher rates of mechanical complications [22][23][24][25], as seen in the present trial with four cases of screw loosening and two of chipping in the GS group. Nevertheless, the advantages of screw-retained crowns should be noted, such as the reversibility of the treatment with a single component instead of two, which simplifies the restoration process; moreover, it is easy to resolve complications and these are generally less severe [36]. Other factors such as platform switching could influence the amount of bone loss.…”