Objective This review aimed at evaluating the survival and technical complication rates of all‐ceramic implant‐supported single crowns (SC). Material and Methods Three electronic databases were searched for clinical studies conducted at ≥ 15 patients examining implant‐supported all‐ceramic SCs over ≥ 12 months. Survival rates of implants and restorations plus technical complication rates of SCs were calculated and tested for statistical correlation with confounding variables. Statistical analysis was performed using a negative binomial distribution model to calculate 5‐ and 10‐year survival and complication estimates. Results Forty‐one included studies reported on implant‐supported SCs made of veneered and monolithic high‐strength oxide ceramics, monolithic, and veneered glass‐based ceramics and of a monolithic resin‐nano‐ceramic (RNC). Survival estimates for SCs of 93% (95% CI: 86.6%–96.4%) after 5 years and 94.4% (95% CI: 91.1%–96.5%) after 10 years were calculated, corresponding values for implant survival were 95.3% (95% CI: 90.6%–97.7%) and 96.2% (95% CI: 95.1%–97.1%). Technical complication rates after 5/10 years were as follows: chipping 9.0% (95% CI: 5.4%–14.8%)/2.7% (95% CI: 2.1%–3.5%), framework fractures 1.9% (95% CI: 0.7%–4.9%)/1.2% (95% CI: 1%–1.5%), screw loosening 3.6% (95% CI: 1.6%–8.4%)/5.2% (95% CI: 3.6%–7.5%), and decementations with 1.1% (95% CI: 0.4%–2.8%) after 5 years. Some confounding variables influenced the above‐mentioned estimates significantly. Conclusions All‐ceramic implant‐supported SCs showed—with the exception of a RNC material—high survival rates. However, failures and technical complications occurred which have to be considered when informing patients on the treatment with implant‐supported all‐ceramic SCs.
Objective: To assess the survival and technical complication rate of partial and fullarch all-ceramic implant-supported fixed dental prostheses (P-FDP/FA-FDP) and supporting implants. Materials and methods:An electronic search through three databases (MEDLINE/ Pubmed, Cochrane Library, Embase) was conducted to identify relevant clinical studies with an observation period of at least 12 months, including ≥15 patients.Reconstruction and implant survival rates, technical complications and confounding variables such as processed/installed materials, retention mode and location in the mouth were obtained. Failure and complication rates were analyzed using standard Poisson regression models to calculate 5-year survival and complication estimates. Results:A total of five studies for the P-FDP group and seven studies for the FA-FDP group were included, throughout evaluating veneered zirconia reconstructions. In the P-FDP group, reconstructions were located in posterior regions. Meta-analysis indicated survival estimates on the reconstruction level of 98.3% and 97.7% for Pand FA-FDPs after 5 years. However, chipping of the veneering ceramic was frequent, resulting in estimated 5-year complication rates of 22.8% (P-FDPs) and 34.8% (FA-FDPs). Five-year survival estimates of implants supporting P-FDPs and FA-FDPs of 98.5% and 99.4% were calculated, respectively. Including a total of 540 FDPs, one screw-loosening and 11 de-cementations were reported. Confounding variables were not found to have a significant influence on survival and complication rates.Conclusions: All-ceramic implant-supported P-and FA-FDPs comprising veneered zirconia frameworks showed high survival but clinically inacceptable fracture rates of the veneering ceramic. Their suitability with regard to this indication and a successful long-term outcome needs to be further evaluated.
Objective To assess the survival, failure, and complication rates of veneered and monolithic all‐ceramic implant‐supported single crowns (SCs). Methods Literature search was conducted in Medline (PubMed), Embase, and Cochrane Central Register of Controlled Trials until September 2020 for randomized, prospective, and retrospective clinical trials with follow‐up time of at least 1 year, evaluating the outcome of veneered and/or monolithic all‐ceramic SCs supported by titanium dental implants. Survival and complication rates were analyzed using robust Poisson's regression models. Results Forty‐nine RCTs and prospective studies reporting on 57 material cohorts were included. Meta‐analysis of the included studies indicated an estimated 3‐year survival rate of veneered‐reinforced glass‐ceramic implant‐supported SCs of 97.6% (95% CI: 87.0%–99.6%). The estimated 3‐year survival rates were 97.0% (95% CI: 94.0%–98.5%) for monolithic‐reinforced glass‐ceramic implant SCs, 96.9% (95% CI: 93.4%–98.6%) for veneered densely sintered alumina SCs, 96.3% (95% CI: 93.9%–97.7%) for veneered zirconia SCs, 96.1% (95% CI: 93.4%–97.8%) for monolithic zirconia SCs and only 36.3% (95% CI: 0.04%–87.7%) for resin‐matrix‐ceramic (RMC) SCs. With the exception of RMC SCs (p < 0.0001), the differences in survival rates between the materials did not reach statistical significance. Veneered SCs showed significantly (p = 0.017) higher annual ceramic chipping rates (1.65%) compared with monolithic SCs (0.39%). The location of the SCs, anterior vs. posterior, did not influence survival and chipping rates. Conclusions With the exception of RMC SCs, veneered and monolithic implant‐supported ceramic SCs showed favorable short‐term survival and complication rates. Significantly higher rates for ceramic chipping, however, were reported for veneered compared with monolithic ceramic SCs.
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