Non-Cochrane · intervention · PM42293808
Clinical Efficacy of Cemented Versus Screw-Retained Zirconia Single Crowns: A Systematic Review and Meta-Analysis.
Mayta-Tovalino Frank, Espinoza-Carhuancho Fran, Alvitez-Temoche Daniel, et al. · International journal of dentistry · 2026 · PubMed · doi:10.1155/ijod/5497447
Findings
Population Adults with implant-supported zirconia single crowns
10 findings
| Cemented zirconia single crowns | Screw-retained zirconia single crowns | Marginal bone level (MBL) Follow-up range 0.5 to 10 years · Dental implant clinics (esthetic zone and posterior single-tooth gaps) | MD -0.04 [-0.08, -0.001] -0.04 [-0.08, -0.001] mm Moderate Downgraded: risk of bias 8 studies · 298 participants |
| Cemented zirconia single crowns | Screw-retained zirconia single crowns | Marginal bone level (MBL) change Follow-up range 0.5 to 10 years · Follow-up duration (<5 vs >=5 years): subgroup reported significant, described as longer follow-up in the abstract Unresolved: the two extractors disagree on this row. | MD -0.04 [-0.08, -0.00] GRADE not reported Studies not reported |
| Cemented zirconia single crowns | Screw-retained zirconia single crowns | Modified plaque index (MPLI) Follow-up range 0.5 to 10 years · Dental implant clinics (esthetic zone and posterior single-tooth gaps) | MD 5.01 [-7.05, 17.06] 5.01 [-7.05, 17.06] units Moderate Downgraded: risk of bias 2 studies · 57 participants |
| Cemented zirconia single crowns | Screw-retained zirconia single crowns | Fracture Follow-up range 0.5 to 10 years · Dental implant clinics (esthetic zone and posterior single-tooth gaps) | RR 0.99 [0.82, 1.19] 487 per 1000 vs 482 per 1000 Low Downgraded: risk of bias, imprecision 4 studies · 145 participants |
| Cemented zirconia single crowns | Screw-retained zirconia single crowns | Bleeding on probing (BoP) Follow-up range 0.5 to 10 years · Dental implant clinics (esthetic zone and posterior single-tooth gaps) | MD 5.18 [-5.92, 16.29] 5.18 [-5.92, 16.29] % Very low Downgraded: risk of bias, imprecision, inconsistency 5 studies · 178 participants |
| Cemented zirconia single crowns | Screw-retained zirconia single crowns | Width of keratinized mucosa (KT) Follow-up range 0.5 to 10 years · Dental implant clinics (esthetic zone and posterior single-tooth gaps) | MD -0.44 [-1.13, 0.26] -0.44 [-1.13, 0.26] mm Moderate Downgraded: risk of bias 2 studies · 56 participants |
| Cemented zirconia single crowns | Screw-retained zirconia single crowns | Plaque index (PI) Follow-up range 0.5 to 10 years · Dental implant clinics (esthetic zone and posterior single-tooth gaps) | MD 0.01 [-0.13, 0.14] 0.01 [-0.13, 0.14] units Low Downgraded: risk of bias, imprecision 3 studies · 121 participants |
| Cemented zirconia single crowns | Screw-retained zirconia single crowns | Marginal bone level (MBL) change Follow-up range 0.5 to 10 years · Population type (adult, mixed, older): subgroup reported significant, described as adult populations in the abstract Unresolved: the two extractors disagree on this row. | MD -0.04 [-0.08, -0.00] GRADE not reported Studies not reported |
| Cemented zirconia single crowns | Screw-retained zirconia single crowns | Probing depth (PD) Follow-up range 0.5 to 10 years · Dental implant clinics (esthetic zone and posterior single-tooth gaps) | MD 0.03 [-0.16, 0.22] 0.03 [-0.16, 0.22] mm Moderate Downgraded: risk of bias 5 studies · 178 participants |
| Cemented zirconia single crowns | Screw-retained zirconia single crowns | Screw loosening Follow-up range 0.5 to 10 years · Dental implant clinics (esthetic zone and posterior single-tooth gaps) | RR 0.94 [0.5, 1.77] 338 per 1000 vs 318 per 1000 Low Downgraded: risk of bias, imprecision 3 studies · 119 participants |
Included primary studies 9
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Amorfini 2018 Comparison of Cemented vs Screw-Retained, Customized Computer-Aided Design/Computer-Assisted Manufacture Zirconia Abutments for… PMID:29624628 | 2018 | this review only | Marginal bone level (MBL) change; Bleeding on probing (BoP); Plaque index (PI); Probing depth (PD) | not extracted yet |
| Heierle 2019 Randomized Controlled Clinical Trial Comparing Cemented Versus Screw-Retained Single Crowns on Customized Zirconia Abutments: 3-Year… PMID:30856641 | 2019 | this review only | Marginal bone level (MBL) change | not extracted yet |
| Kraus 2019 Cemented vs screw-retained zirconia-based single implant reconstructions: A 3-year prospective randomized controlled clinical trial. PMID:30861635 | 2019 | this review only | Marginal bone level (MBL) change; Fracture; Screw loosening | not extracted yet |
| Kraus 2022 Five-year randomized controlled clinical study comparing cemented and screw-retained zirconia-based implant-supported single crowns. PMID:35224774 | 2022 | this review only | Marginal bone level (MBL) change; Bleeding on probing (BoP); Plaque index (PI); Probing depth (PD); Fracture; Screw loosening | not extracted yet |
| Kraus 2024 A 7.5-year randomized controlled clinical study comparing cemented and screw-retained one-piece zirconia-based implant-supported single… PMID:39172056 | 2024 | this review only | Fracture; Screw loosening | not extracted yet |
| Lamperti 2022 Cemented versus screw-retained zirconia-based single-implant restorations: 5-year results of a randomized controlled clinical trial. PMID:35051314 | 2022 | this review only | Marginal bone level (MBL) change; Bleeding on probing (BoP); Probing depth (PD); Modified plaque index (MPLI); Width of keratinized mucosa (KT); Fracture | not extracted yet |
| Lv 2023 One-piece versus two-piece zirconia abutment supported single implant crown in the esthetic region: 3-Year results from a split-mouth… PMID:37655630 | 2023 | this review only | Marginal bone level (MBL) change; Bleeding on probing (BoP); Plaque index (PI); Probing depth (PD) | not extracted yet |
| Thoma 2018 Randomized controlled clinical study of veneered zirconia abutments for single implant crowns: Clinical, histological, and microbiological… PMID:30328283 | 2018 | this review only | Marginal bone level (MBL) change; Bleeding on probing (BoP); Probing depth (PD); Modified plaque index (MPLI); Width of keratinized mucosa (KT) | not extracted yet |
| Weigl 2019 Screw-retained monolithic zirconia vs. cemented porcelain-fused-to-metal implant crowns: a prospective randomized clinical trial in… PMID:29946832 | 2019 | this review only | Marginal bone level (MBL) change | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults with implant-supported zirconia single crowns | Adults with implant-supported zirconia single crowns, esthetic zone mostly (n=298) |
| Intervention | Cemented zirconia single crowns | Cemented zirconia single crowns |
| Comparison | Screw-retained zirconia single crowns | Screw-retained zirconia single crowns |
| Outcomes | Primary: marginal bone level, bleeding on probing, plaque index; secondary: probing depth, modified plaque index, keratinized mucosa width, fracture, screw loosening | MBL (8 RCTs), BoP (5), PI (3), PD (5), MPLI (2), KT (2), fracture (4), loosening (3) |
| Study designs | RCTs | 9 RCTs |
| Timing | Follow-up duration not restricted | Follow-up 6 months to 10 years |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | Yes | No | no |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |