Próteses cimentadas e parafusadas na reabilitação oral: comparação e critérios de seleção – uma revisão de literatura

The retention method of implant-supported prostheses, either cemented or screw-retained, is a frequent clinical decision in oral rehabilitation and affects maintenance, esthetics, and the risk of biological and technical complications. This study aimed to compare cemented and screw-retained implant-supported fixed prostheses and to discuss the clinical criteria that guide the choice between both systems. This is a narrative literature review, with a guided search in PubMed/MEDLINE and SciELO based on controlled descriptors (DeCS/MeSH), without systematic selection of studies. Articles, mainly in Portuguese and English, published between 2004 and 2025 that compared retention systems regarding survival, marginal bone loss, biological and technical complications, maintenance, and esthetics were considered. Results show that survival of the restorations is similar between systems in most reviews, although one meta-analysis found statistically favorable results for cement retention regarding marginal bone loss and implant survival, with a small-magnitude difference for bone loss. Retention type seems to influence mainly the profile of complications: part of the literature reports a higher occurrence of certain technical complications, such as screw loosening and ceramic fracture, in screw-retained prostheses, whereas for cemented prostheses the central concern is residual cement, whose relationship with peri-implant disease is described but remains controversial. It is concluded that no retention system is universally superior. The choice should consider interocclusal space, implant position, margin depth, prosthesis span, need for retrievability, esthetics, and individual patient risk, and clinical trials with greater methodological rigor are needed.