Prosthetic outcome of cement-retained implant-supported fixed dental restorations: A systematic review

Department of Prosthodontics, School of Dentistry, Albert-Ludwigs University, Freiburg, Germany.
Journal of Oral Rehabilitation (Impact Factor: 1.68). 03/2011; 38(9):697-711. DOI: 10.1111/j.1365-2842.2011.02209.x
Source: PubMed


The aim of the article is to assess the current literature in terms of the prosthetic outcome of cement-retained implant-supported fixed restorations, as well as to determine the type of cement that can be recommended for clinical application. A review of the literature published up to May 2010 was conducted to identify clinical studies about cement-retained implant-supported fixed restorations. The search strategy applied was a combination of MeSH terms and free text words, including the following keywords: implants, implant-supported fixed dental prostheses (FDPs), bridges, implant-supported single crowns (SCs), cement-retained, cement fixation, cement, cementation, cement failure, retention, and loss of retention, technical complications, mechanical complications, prosthetic complication, retrievability and maintenance. Thirty-two studies met the inclusion criteria. The studies were divided into two categories: 15 short-term clinical studies with an observation period of less than 5 years, and 17 long-term clinical studies with an observation period of 5 years and more. The most common technical complications of cement-retained implant-supported fixed restorations were loss of retention, chipping and abutment screw loosening. The results of the current review revealed no guidelines about cement or cementation procedures. It may be stated that despite the questionable retrievability of cement-retained implant-supported fixed restorations, this treatment modality is a reliable and effective option, especially for implant-supported SCs and short-span FDPs. The literature does not provide accurate information about the clinical outcome of cement-retained implant-supported fixed restorations nor about the ideal type of cement that facilitates stability and maintains retrievability. Standardised randomised clinical trials will provide valuable information to this issue.

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Available from: Mohamed Sad Chaar, Aug 17, 2014
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    • "splinted frameworks, better esthetics (due to the lack of occlusal openings) and lower costs (Michalakis et al. 2003). On the other hand, literature suggests that, even after a careful removal procedure, some residual cement may remain in the periimplant sulcus (Chaar et al. 2011; Sailer et al. 2012). The risk of such event increases as the restorations' margins are located deeper subgingivally (Linkevicius et al. 2011, 2013a,b). "
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    ABSTRACT: Cement remnants were frequently associated with peri-implantitis. Recently, a shoulderless abutment was proposed, raising some concern about cement excess removal. To compare different cementation techniques for implant-supported restorations assessing the amount of cement remnants in the peri-implant sulcus. Additional aim was to compare the effect of these cementation techniques using two different abutment designs. Forty-six patients requiring double implant-supported restoration in the posterior maxilla were randomly divided in two groups according to the cementation modality: intraoral and extraoral. According to the abutment finishing line, implants in each patient were randomly assigned to shoulderless or chamfer subgroup. In the intraoral group, crowns were directly seated onto the titanium abutment. In the extraoral group, crowns were firstly seated onto a resin abutment replica and immediately removed, then cleansed of the cement excess and finally seated on the titanium abutment. After cement setting, in both groups, cement excess was carefully tried to remove. Three months later, framework/abutment complexes were disconnected and prepared for microscopic analysis: surface occupied by exposed cement remnants and marginal gaps were measured. Additionally, crown/abutment complexes were grinded, and voids of cement were measured at abutment/crown interface. Related-samples Friedman's two-way analysis of variance by ranks was used to detect differences between groups and subgroups (P ≤ 0.5). At the end of the study, a mean value of 0.45 mm(2) (±0.80), 0.38 mm(2) (±0.84), and 0.065 mm(2) (±0.13) and 0.07 mm(2) (±0.15) described surface occupied by cement remnants in shoulderless and chamfer abutment with intraoral cementation and shoulderless and chamfer abutment with extraoral cementation, respectively. A mean value of 0.40 mm(2) (±0.377), 0.41 mm(2) (±0.39) and 0.485 mm(2) (±0.47) and 0.477 mm(2) (±0.43) described cement voids at the abutment/crown interface; a mean value of 0.062 mm (±0.03), 0.064 mm (±0.35), 0.055 mm (±0.016) and 0.054 mm (±0.024) described marginal gaps. Statistics showed tendency of intraoral cementation to have significantly higher cement remnants compared with abutments with extraoral cementation groups. At the same time, the presence of voids was significantly higher in case of extraoral cementation. No significant differences between groups for the variable "gap". Despite the presence of more voids, extraoral cementation reduces cement excess. However, using low adhesivity cement and careful cement removal, a very limited quantity of cement remnants was observed also in the intraoral cementation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
    Clinical Oral Implants Research 04/2015; DOI:10.1111/clr.12589 · 3.89 Impact Factor
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    • "the incidence of technical complication with time (Simonis et al. 2010; Ravald et al. 2012; Chappuis et al. 2013). Fracture of the veneering porcelain has been considered a common complication in implant-supported fixed restorations (Kreissl et al. 2007; Chaar et al. 2011; Nissan et al. 2011). In this study, four restorations had ceramic fracture. "
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    ABSTRACT: Objectives: Rehabilitation with implant-supported fixed prostheses is a predictable modality to restore lost function and esthetics; however, fixed restorations are subject to biological and prosthetic complications, which may represent a problem in the long-term. The aim of this study was to evaluate the long-term survival and complication rates of fixed restorations supported by Morse-taper connection implants. Materials and methods: Between January 1992 and December 2002, 49 patients (age range 22-70 years), were included in this study. The restorations involved 58 fixed reconstructions (15 single crowns [SCS], 29 partial prostheses, 14 full-arches), supported by 178 Morse-taper connection implants with a follow-up ranging from 10 to 20 years. Outcomes such as implant survival, marginal bone loss, frequency of biological and prosthetic complications as well as "complication-free" survival of restorations were investigated. Results: The 20-year overall cumulative implant survival was 97.2%. A few biological (3.4%) and prosthetic (10.3%) complications were reported. The "complication-free" survival rate of restorations was 85.5%. No statistically significant differences were observed among patients' gender, age, smoking or parafunctional habits, prosthesis site and type. Conclusions: Satisfactory "complication-free" survival rates can be achieved after 20 years for fixed restorations supported by Morse-taper connection implants, with minimal marginal bone loss and complications.
    Clinical Oral Implants Research 06/2014; 26(10). DOI:10.1111/clr.12439 · 3.89 Impact Factor
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    The Journal of prosthetic dentistry 07/2010; 104(1):13-47. DOI:10.1016/S0022-3913(10)60087-X · 1.75 Impact Factor
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