A systematic review and meta‐analysis of removable and fixed implant‐supported prostheses in edentulous jaws: post‐loading implant loss

Abstract

ObjectivesThe aim of this systematic review was to analyze post‐loading implant loss for implant‐supported prostheses in edentulous jaws, regarding a potential impact of implant location (maxilla vs. mandible), implant number per patient, type of prosthesis (removable vs. fixed), and type of attachment system (screw‐retained, ball vs. bar vs. telescopic crown).Material and methodsA systematic literature search for randomized‐controlled trials (RCTs) or prospective studies was conducted within PubMed, Cochrane Library, and Embase. Quality assessment of the included studies was carried out, and the review was structured according to PRISMA. Implant loss and corresponding 3‐ and 5‐year survival rates were estimated by means of a Poisson regression model with total exposure time as offset.ResultsAfter title, abstract, and full‐text screening, 54 studies were included for qualitative analyses. Estimated 5‐year survival rates of implants were 97.9% [95% CI 97.4; 98.4] in the maxilla and 98.9% [95% CI 98.7; 99.1] in the mandible. Corresponding implant loss rates per 100 implant years were significantly higher in the maxilla (0.42 [95% CI 0.33; 0.53] vs. 0.22 [95% CI 0.17; 0.27]; P = 0.0001). Implant loss rates for fixed restorations were significantly lower compared to removable restorations (0.23 [95% CI 0.18; 0.29] vs. 0.35 [95% CI 0.28; 0.44]; P = 0.0148). Four implants and a fixed restoration in the mandible resulted in significantly higher implant loss rates compared to five or more implants with a fixed restoration. The analysis of one implant and a mandibular overdenture also revealed higher implant loss rates than an overdenture on two implants. The same (lower implant number = higher implant loss rate) applied when comparing 2 vs. 4 implants and a mandibular overdenture. Implant loss rates for maxillary overdentures on <4 implants were significantly higher than for four implants (7.22 [95% CI 5.41; 9.64] vs. 2.31 [1.56; 3.42]; P < 0.0001).ConclusionsImplant location, type of restoration, and implant number do have an influence on the estimated implant loss rate. Consistent reporting of clinical studies is necessary and high‐quality studies are needed to confirm the present results.

Clinical outcomes of partial and full‐arch all‐ceramic implant‐supported fixed dental prostheses. A systematic review and meta‐analysis

“…Compared to the failure rates calculated for implants supporting metal ceramic P-(Pjetursson, Thoma, Jung, Zwahlen & Zembic, 2012) and FA-FDPs(Kern et al, 2016), the presented failure rates for implants supporting all-ceramic reconstructions are within the same range. Implant failure in both studies was not stated to be associated with the prosthetic reconstructions.…”

“…Sufficient data seems to be available for conventionally fabricated metal-based prostheses (Abou-Ayash, Strasding, Rücker & Att, 2017;Kern, Kern, Wolfart & Heussen, 2016), but frequent occurrence of technical complications when used for implant-borne reconstructions (mainly chipping of the veneering layer), cost-intensive production and increasing esthetic demands contributed to push the development toward digitally driven processing methods and metal-free solutions. In fact, a variety of treatment modalities in terms of prosthesis retention (screw-retained vs. cemented), abutment design and manufacture (stock, customized stock, fully customized), framework design and material (metallic vs. non-metallic), veneering technique (over-pressed, hand-layered or fused) and veneering mode (full-, partially or nonveneered) are available.…”

A 5-year prospective clinical study of Neobiotech implants for partially edentulous patients

“…16,[28][29][30] A recent meta-analysis that includes 54 clinical studies of no less than 3 year follow up period were evaluated, and resulted to an annual implant failure rate that is significantly higher in that of the maxilla than the mandible. 31 Oral rehabilitation with osseointegration can be successful and predictable in patients with favorable bone quality and quantity. However, dental implant placed in the maxilla can be associated with poor bone quality and loading condition especially on the posterior region resulting to increased number of implant failures.…”

Cumulative survival rate and associated risk factors of Implantium implants: A 10-year retrospective clinical study

“…According to a meta-analysis of 54 clinical studies with at least 3-years observation period, the annual implant failure rate of maxillary implants is significantly higher than that of mandibular implants 22. This might be due to the fact that the quality and quantity of jaw bone are more often compromised in the maxillary region than in the mandibular region 2324.…”