Cemented versus screw-retained posterior implant-supported single crowns: A 24-month randomized controlled clinical trial.

Abstract

To compare the incidence of biological and technical complications of cemented and screw-retained monolithic lithium-disilicate implant-supported posterior single crowns. Forty-one subjects with a total of 56 implants received randomly allocated 28 cemented and 28 screw-retained crowns. In the screw-retained group, monolithic lithium-disilicate restorations were luted to titanium bases extraorally. In the cemented group, monolithic lithium-disilicate crowns were cemented on individualized titanium abutments intraorally. All restorations were examined according to modified FDI criteria within 2weeks of inserting the crowns (baseline) and after 12 (n=46) and 24 (n=43) months. Bone loss was evaluated by standardized radiographs at baseline and 12months. After 12months, the incidence of mucositis (positive bleeding on probing) was 14.2% (screw-retained) and 17.9% (cement-retained). The gingival and plaque index and a mean marginal bone loss between 0.03-0.15mm showed no significant difference between the groups. In the cemented group, cement residues were detected at baseline at two restorations (6.9%) by radiographic examination. A complete digital workflow was realized in most cases (85.7%). At 24months, no restoration had failed, and no chipping of the ceramic had occurred. In the screw-retained group, screw loosening occurred in one implant. In both groups, there was obvious deterioration in the quality of 32% of the occlusal and of 18% of the proximal contact points. The type of retention mode of monolithic implant-retained lithium-disilicate posterior crowns had no influence on the biological and technical complication rate.