Principles of screw - retained and cement - retained fixed implant prosthesis: A critical review

Abstract

Dental implants in the past were mainly restricted to completely edentulous patients and to a certain extent in the distal extension situations. In the present scenario with a dramatic increase in the survival rates of the dental implants and their widespread acceptance by the patients, they are often being used in partially edentulous conditions and as well as single tooth replacements. However, longevity of the restoration, both functionally as well as esthetically depends on various factors prevailing in the clinical situation. One such factor of immense importance is the selection of connection between the implant abutment and the final prosthesis. This connection can be screw-retained or cement-retained depending on the clinical situation of the particular case. Although, screw-retained restorations have been successfully used since many years, there has been a shift in paradigm toward cement-retained restorations. This article reviews the various complications associated with screw-retained restorations and subsequently analyzes the various factors associated with the selection of the attachment mechanism in implant dentistry. Clinical Relevance To Interdisciplinary Dentistry The article involves various disciplines of dentistry, particularly Prosthodontics, Periodontics, Oral Surgery and Dental Materials. As specified, in this literature, selection of connection system between implant and the prosthesis plays a significant role in reducing the prevalence of various periodontal (Peri-implantitis, bone loss), prosthetic (screw loosening or fractured prosthesis) and surgical complications associated with implant supported prosthesis. Thus, a thorough knowledge of this aspect, significantly increases the success rate of implant supported prosthesis in partially and completely edentulous patients.