Tomar Sidhartha, Saxena Deepesh, Rawat Pragati, Madaan Sukhmeen, Kumar Ayush
Prosthodontics and Crown & Bridge, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, IND.
Dentistry, Tri-Town Dental Clinic, Haileybury, CAN.
Cureus. 2025 May 2;17(5):e83370. doi: 10.7759/cureus.83370. eCollection 2025 May.
This systematic review and meta-analysis aimed to compare marginal bone loss (MBL), bleeding on probing (BOP), and the incidence of complications between cement-retained and screw-retained (SR) single implant-supported zirconia crowns to provide evidence-based guidance for clinicians. A comprehensive search of PubMed/MEDLINE, Scopus, Embase, Google Scholar, and Lilac databases was conducted by two independent reviewers for studies published between January 2000 and March 2024. Studies evaluating the success rates and complications of single zirconia implant crowns with either cement or screw retention were included. Data on complication frequency, types, and overall success rates were extracted and analyzed. A total of 168 cement-retained and 166 SR zirconia crowns from seven studies with follow-ups ranging from 3 to 10 years were included. Meta-analysis of three to six studies per outcome indicated that SR crowns had significantly lower MBL at six months (standardized mean difference (SMD): -0.63; p = 0.002), though no significant differences in MBL were found at one, three, and five years. BOP outcomes were similar between both retention types. Notably, SR restorations demonstrated a 46% reduced risk of complications compared to cement-retained ones (RR: 0.54; p = 0.02). In conclusion, SR implant-supported zirconia crowns are associated with fewer early MBL and complications. However, long-term bone loss and peri-implant mucosal health appear comparable between the two retention methods.
本系统评价和荟萃分析旨在比较黏固式和螺丝固位（SR）单颗种植体支持的氧化锆全冠的边缘骨吸收（MBL）、探诊出血（BOP）及并发症发生率，为临床医生提供循证指导。两名独立研究者全面检索了PubMed/MEDLINE、Scopus、Embase、谷歌学术和Lilac数据库，查找2000年1月至2024年3月发表的研究。纳入评估黏固或螺丝固位的单颗氧化锆种植全冠成功率和并发症的研究。提取并分析并发症频率、类型及总体成功率的数据。共纳入7项研究中的168颗黏固式和166颗SR氧化锆全冠，随访时间为3至10年。每个结局对3至6项研究进行的荟萃分析表明，SR全冠在6个月时MBL显著更低（标准化均数差（SMD）：-0.63；p = 0.002），但在1年、3年和5年时MBL未发现显著差异。两种固位类型的BOP结局相似。值得注意的是，与黏固式修复体相比，SR修复体并发症风险降低了46%（RR：0.54；p = 0.02）。总之，SR种植体支持的氧化锆全冠早期MBL和并发症更少。然而，两种固位方法在长期骨吸收和种植体周围黏膜健康方面似乎相当。
