**Clinical situations that prefer cemented restoration:**


Very valuable information for clinicians was identified in a more recent review by Hamed et al, which comprised 12 clinical research (randomized controlled trials,

#### *Prosthetic Concepts in Dental Implantology DOI: http://dx.doi.org/10.5772/intechopen.104725*

clinical trials, prospective studies and retrospective cohort studies) with at least 2 years' follow-up time and published between 2010 and 2020 [16]. One of the most important advantages of cement-retained restorations is it's the passivity and simplicity in manufacturing process in comparison with screw-retained restorations. This feature comes to light especially when zirconia is used as material for framework. The review indicates that the cement-retained implant approach is appropriate when enhanced predictability, a patient's desire for superior aesthetic outcomes and a cost-effective method are present. Due to the significant complications associated with screw-retained restorations in terms of technical and prosthetic outcomes, cement-retained implant restoration results in more successful outcomes. Whereas a biological complication associated with the cemented implant promotes the use of screw-based implant reconstruction. Additionally, the screw-retained repair is more suitable for multiple unit implantation for patients with restricted inter-arch space. For instance, screw retention reconstruction is advised when inter-arch space is restricted (less than 4 mm) and retrievability is necessary. Similarly, cement retention can be used to compensate for inappropriately angled implants and when occlusion is easier to control without the hole.

It must be emphasized that prosthodontics plays a crucial role in maintaining mucosal homeostasis. Plaque accumulation and the soft tissue reaction are directly related to design, structural connections (screw-retained or cement-retained) and characteristics of materials. Proper prosthetic design with an appropriate emergence profile that promotes excellent oral hygiene and prevents plaque accumulation is unquestionably critical in preventing peri-implant mucositis [17]. According to de Tapia et al, when peri-implant tissue inflammation arises, the prosthetic design should be evaluated and, if necessary, adjusted to correct design issues that may obstruct good hygiene and to reduce biomechanical stress factors that may be involved [18].
