There were no implant failures during the study period; after 10 years, 94% of crowns were functional. Prosthetic complications were recorded in both groups (three FCA and two ZrC), and no significant difference was found (P = .65). Two cases of mucositis were recorded, one in each group. Esthetic outcomes were assessed using PES and WES scores. MBL was 0.95 mm in the ZrC group and 0.82 mm in the FCA group, with no significant difference between groups. These encouraging preliminary results need to be confirmed with long-term follow-up on larger study samples.
Objectives To investigate in which clinical situations a cantilever fixed implant supported restorations can be a treatment alternative and which complications are reported. Materials and Methods Two operators screened the literature (MEDLINE, EMBASE) and performed a hand search on the main journals dealing with implantology and prosthetics until 31 December 2017. Only articles that considered cantilever implant fixed restorations with at least 10 patients and with a mean follow‐up of at least 5 year were selected. The outcome variables were survival of implants and prosthesis, mechanical, technical and biological complications, marginal bone loss. The review was performed according to the PRISMA statements. Risk of bias assessment was evaluated. Failure and complication rates were analysed using random effect Poisson regression models to obtain summary estimate of 5‐ and 10‐year survival and complication rates. Results A total of nine papers were selected for partially edentulous patients and reported high survival rate of the prosthesis. The estimated survival rate for 5–10 years was calculated to be 98.4% for the implants and 99.2% for the rehabilitations. Mechanical, technical and biological complications were reported with a cumulative 5–10 years complication rate of 28.66% and 26.57% for the patients and for the prosthesis, respectively. Two papers for single implant supporting 2‐unit cantilever were not sufficient to draw conclusions. Conclusions There is evidence that cantilever can be successful treatment in partially edentulous patients. In two adjacent edentulous sites, data are not yet sufficient.
The first use of dental implant was documented in restorations of fully edentulous patients. These reconstructions were provided in both jaws and consisted in 4-6 implants supporting a complete fixed prosthesis. Implants were often placed only in intra-foramina area or in the anterior maxilla. The restorations were then mainly delivered with bilateral cantilevers (Adell, Hansson, Brånemark, & Breine, 1970;Brånemark et al., 1969). The use of implant-supported restorations with cantilevers has been documented over time. Studies have analysed this type of restoration and assessing the survival rate of restorations and implants as well as the rate and type of complications. The rational of the use of cantilevers in fully edentulous patients is the possibility of providing full-arch reconstructions by placing implants in more anterior areas, thus avoiding resorbed or low quality bone regions. More evidence has been published (Heydecke, et al., 2012) reporting that the use of only four or six implants could be sufficient to support a full-arch restoration: whether the last implant should be placed underneath the last tooth or not is still in debate. The positioning of an implant in posterior areas may often require more complex procedure, such as bone augmentations procedures, Abstract Aim: To investigate fully edentulous patients rehabilitated with cantilever-fixed implant-supported restorations and to analyse which complications are reported for this type of treatment. MaterialsandMethods: Two operators screened the literature (MEDLINE, EMBASE) and performed a hand search on the main journals dealing with implantology and prosthetics until 31 December 2017. Only articles that considered cantilever implantfixed restorations with at least 10 patients and with a mean follow-up of at least 5 years were selected. The outcome variables were survival of implants and prosthesis, mechanical, technical and biological complications, marginal bone loss. The review was performed according to the PRISMA statements. The risk of bias was evaluated for each article. Failure and complication rates were analysed using random effect Poisson regression models to obtain summary estimate of 5-and 10-year survival and complication rates.Results: Fourteen papers for fully edentulous patients were selected. The estimated 5 to 10 years survival rate was calculated to be 99.00% and 96.7% for the implants and the prosthesis, respectively. A total of 299 complications (technical and biological) were reported with a cumulative 5-10 years complication rate of 44.41% and 39.46% for the patients and for the prosthesis, respectively. Conclusions:There is evidence that cantilever can be successful treatment in fully edentulous patients.
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