A Preliminary Randomized Trial on the Efficiency and Clinical Value of a Cementless Screw-Retained Implant Workflow in Single-Implant Restorations

This randomized controlled clinical trial compared a conventional combined screw- and cement-retained prosthesis (CSCRP) workflow (control group) with a fully digital cementless screw-retained prosthesis (CL-SRP) system (test group) for single posterior implant restorations. A total of 40 implants in 35 patients were allocated to either workflow. Clinical procedure times, prosthetic accuracy, peri-implant soft tissue changes, and marginal bone loss (MBL) were assessed. The test group demonstrated significantly shorter total prosthetic time (p < 0.001) and impression-taking time (p < 0.001) compared with the control group. Prosthetic adjustment time (p = 0.211) and adjustment volume (p = 0.474) did not differ significantly. Gingival shape changes were likewise not statistically significant (p = 0.966). MBL was significantly lower in the test group (p < 0.05). From a prosthetic standpoint, both workflows yielded clinically acceptable outcomes; however, the digital CL-SRP approach improved procedural efficiency and early peri-implant bone preservation without compromising prosthetic quality. This trial had inherent limitations, including a short follow-up duration, a relatively small sample size, combined test conditions, and restriction to single posterior implants. Therefore, further long-term studies are warranted to confirm durability and broader clinical applicability.