Influence of Abutment Retention Method on Dental Implant Prosthesis: Implant Stability and Screw Loosening

Abstract

Background:
Retention method for implant implant-supported crowns, screw retained or cement retained, may influence prosthesis stability and the risk of screw loosening, while implant survival typically remains high. Clarifying comparative mechanical outcomes can guide prosthodontic planning and maintenance.
Methods:
A systematic search of PubMed identified clinical trials and cohort studies from inception to 28 Feb 2025 comparing cement cement-retained with screw screw-retained restorations. Eligibility required human in in-vivo data reporting implant stability and screw loosening. Two reviewers screened, extracted data in duplicate, and assessed study quality. No meta meta-analysis was performed; results were synthesised narratively.
Results:
Ten studies met criteria
followfollow-up 2–10 years). Implant survival was high and similar between groups across studies, typically 93–100 percent. Marginal bone changes were small and comparable; one 10-year comparison reported mean bone loss ~1.1 mm for both retention types. Screw loosening occurred more often in screw screw-retained restorations. A cohort reported loosening in 32 percent of screw screw-retained partial prostheses versus 9 per cent of cement cement-retained. A randomised posterior single single-crown trial observed 1 of 28 screw screw-retained crowns loosening (3.6 percent) versus 0 of 28 cement cement-retained at 24 months. External quantitative syntheses within the included evidence indicated lower rete ntionntion-failure risk for cement cement-retained designs (risk ratio 0.26; 95% CI 0.09 0.09–0.74 short term; pooled ~0.31 at ≥5 years). Secondary findings noted rare decementation with modern adhesive protocols and context context-dependent biological complications when excess c ement was not controlled.
Conclusions:
Choice of retention did not affect implant survival or bone stability; it chiefly altered the complication
profile. Cement retention reduced screw loosening, whereas screw retention avoided cement cement-related biological risks; case case-specific selection remains essential.