Abstract
Implant-supported fixed dental prostheses can be cement- or screw-retained on the implant or abutment, with advantages and disadvantages for each method. Cemented prostheses have been associated with peri-implant disease because cement remnants act as a reservoir for bacteria and hinder biofilm control. However, contrasting evidence has been presented regarding this association based on studies with varying designs, and a systematic review and meta-analysis is required. The purpose of this systematic review and meta-analysis was to answer the focused question: In patients who received implant-supported prostheses, is the incidence of peri-implant diseases higher in cemented implant-supported prostheses than in screw-retained ones? The search was conducted using the National Library of Medicine (MEDLINE-PubMed), SCOPUS, EMBASE, and ISI Web of Science databases. Randomized clinical trials (RCTs) that assessed the incidence of peri-implant disease in cement- and screw-retained prostheses were included. Two authors independently screened the titles and abstracts, and analyzed the full texts, extracted data, and assessed the risk of bias. The findings were summarized using meta-analyses with random effects, and the level of certainty of the evidence was determined using the grading of recommendations, assessments, development, and evaluations (GRADE) approach. The search yielded 4455 articles that met the inclusion criteria based on the title and/or abstract selection. A total of 6 RCTs were included for analysis. The meta-analysis revealed no significant difference between cement- and screw-retained prostheses for the risk of peri-implant mucositis (RR: 1.36, 95% CI: 0.42-4.38, P=.61). Similarly, no significant difference was observed between cement- and screw-retained prostheses for the incidence of peri-implantitis (RR: 1.00, 95% CI: 0.23-4.31, P=1.00). Moderate certainty evidence suggests that cement- and screw-retained prostheses present a similar risk for peri-implant mucositis and peri-implantitis.
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