To determine the survival rate and marginal bone loss (MBL) of zirconia dental implants restored with single crowns or fixed dental prostheses. An electronic search was conducted up to November 2015 (without any restriction regarding the publication time) through the databases MEDLINE (PubMed), Cochrane Library, and EMBASE to identify randomized controlled clinical trials and prospective clinical trials including >15 patients. Primary outcomes were survival rate and MBL. Furthermore, the influence of several covariates on MBL was evaluated. Qualitative assessment and statistical analyses were performed. This review was conducted according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines for systematic reviews. With the applied search strategy, 4,196 titles could be identified. After a screening procedure, 2 randomized controlled clinical trials and 7 prospective clinical trials remained for analyses. In these trials, a total of 326 patients received 398 implants. The follow-up ranged from 12 to 60 mo. Implant loss was mostly reported within the first year, especially within the healing period. Thereafter, nearly constant survival curves could be observed. Therefore, separate meta-analyses were performed for the first and subsequent years, resulting in an implant survival rate of 95.6% (95% confidence interval: 93.3% to 97.9%) after 12 mo and, thereafter, an expected decrease of 0.05% per year (0.25% after 5 y). Additionally, a meta-analysis was conducted for the mean MBL after 12 mo, resulting in 0.79 mm (95% confidence interval: 0.73 to 0.86 mm). Implant bulk material and design, restoration type, and the application of minor augmentation procedures during surgery, as well as the modes of temporization and loading, had no statistically significant influence on MBL. The short-term cumulative survival rates and the MBL of zirconia implants in the presented systematic review are promising. However, additional data are still needed to confirm the long-term predictability of these implants. analyses. In these trials, a total of 326 patients received 398 implants. The follow-up ranged from 12 to 60 months. Implant loss was mostly reported within the first year, especially within the healing period. Thereafter, nearly constant survival curves could be observed. Therefore, separate meta-analyses were performed for the first and subsequent years, resulting in a survival rate of the implants of 95.6% (95%CI:93.3% -97.9%) after 12 months, and thereafter an expected decrease of 0.05% per year (0.25% after 5 years). Additionally, a meta-analysis was conducted for the mean MBL after 12 months, resulting in 0.79 mm of MBL (95%CI: 0.73 mm -0.86 mm).Implant bulk material, implant design, restoration type, the application of minor augmentation procedures during surgery as well as the modes of temporization and loading had no statistically significant influence on MBL.Conclusions: The short-term cumulative survival rates and the MBL of zirconia implants in the presented systemati...
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.
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