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Angulated Screw-Retained Versus Cemented Crowns Following Type 1C Treatment in Aesthetic Zone: A 5-Year Cohort Study
Zheng-Zhen Cai1, Xiao-Lei Lv1, Ying-Xin Gu1
1Department of Oral and Maxillofacial Implantology, Shanghai PerioImplant Innovation Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.
Background:
Immediate implant placement provides an effective solution for replacing a single maxillary anterior tooth, offering several distinct advantages. Screw-retained implant crowns are often favored for their biological benefits, particularly their elimination of excess cement, which reduces the risk of peri-implant complications. However, their application is restricted when the screw channel's access hole must be positioned in a visible area, as this would undermine the aesthetic outcome, a common challenge in immediate implant placement scenarios.
Purpose:
To evaluate the 5-year clinical, radiographic, aesthetic, and patient-reported outcomes of angulated screw-retained versus cemented implant crowns following immediate implant placement in the aesthetic region.
Material And Methods:
This prospective cohort study included a 5-year follow-up. Eligible patients were divided into two groups according to the type of restoration: angulated screw group (AG) and the cemented group (CG). Implant survival, bleeding on probing (BOP%), probing depth (PD), marginal bone loss (MBL), buccal bone thickness (BBT), mechanical complications, pink esthetic score (PES), and patient's satisfaction assessed by visual analog scale (VAS) were evaluated at the 5-year follow-up.
Results:
A total of 38 patients with 38 implants (AG = 20; CG = 18) attended the 5-year examination. After 5 years of loading, the implant survival rate was 100% in both groups with 2 cases of screw loosening in AG (13%) and 1 case of retention loss in CG (5%). No significant difference in BOP% was found between the 2 groups (mean, 18.33% ± 27.52% vs. 24.07% ± 26.34%, p = 0.331). Furthermore, the comparison of PD (3.28 ± 0.87 vs. 2.81 ± 0.75 mm, p = 0.112), MBL (0.38 ± 0.42 vs. 0.35 ± 0.32 mm, p = 0.633), BBT (1.87 ± 0.55 vs. 1.77 ± 0.61 mm, p = 0.613), PES (9.50 ± 2.30 vs. 9.61 ± 1.98, p = 0.942), and VAS (8.60 ± 0.88 vs. 8.56 ± 0.78, respectively, p = 0.96) revealed no significant differences.
Conclusion:
Both treatment options can provide high implant survival, achieve acceptable clinical, radiographic, and aesthetic outcomes, and obtain a high level of patient satisfaction, with no significant differences observed after 5-year function.
