Lack of evidence to highlight differences in peri-implant bone loss between cement and screw retained prosthesis

shutterstock_70163050 dental implants

Peri-implant bone loss is one parameter used to evaluate the success of dental implants.  The aim of this review was to compare peri-implant bone loss between cement and screw retained prosthesis.

The Medline, SCOPUS, ISI Web of Knowledge and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched. Five journals were hand searched.

Randomised or comparative dental implant trials and prospective or retrospective studies on dental implants that reported on peri-implant marginal bone loss assessed radiographically were included.  Only studies with at least 12-months follow up in  English were included.  Studies were independently selected and data abstracted.  Random-effects models were used to obtain estimates of peri-implant marginal bone loss.

  • Nine studies were included; only two studies included both cement- and screw-retained prostheses, three assessed only screw-retained prostheses, and four evaluated only cement-retained prostheses.
  • Pooled mean marginal bone loss was 0.53 mm (CI 95%, 0.31–0.76 mm) for cement- retained prostheses and 0.89 mm (CI 95%, 0.45–1.33 mm) for screw-retained prostheses

The authors concluded

There is no evidence to support differences in the marginal bone loss through indirect comparison between cement and screw-retained restorations.


The authors discuss issues related to the quality of the included studies with none of the included studies reporting sample size calculations. The limited number of direct comparisons is also an issue when trying to answer the question posed.


de Brandão ML, Vettore MV, Vidigal Júnior GM. Peri-implant bone loss in cement- and screw-retained prostheses: Systematic review and meta-analysis. J Clin Periodontol. 2012 Nov 28. doi: 10.1111/jcpe.12041. [Epub ahead of print] PubMed PMID: 23297703.

Esposito M, Murray-Curtis L, Grusovin MG, Coulthard P, Worthington HV. Interventions for replacing missing teeth: different types of dental implants. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD003815. DOI: 10.1002/14651858.CD003815.pub3.

Grusovin MG, Coulthard P, Worthington HV, George P, Esposito M. Interventions for replacing missing teeth: maintaining and recovering soft tissue health around dental implants. Cochrane Database of Systematic Reviews 2010, Issue 8. Art. No.: CD003069. DOI: 10.1002/14651858.CD003069.pub4.



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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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