Framework Materials for Full-Arch Implant-Supported Rehabilitations: A Systematic Review of Clinical Studies

Abstract

The purpose of this systematic review was to investigate the clinical outcomes of frameworks made of different materials in patients with implant-supported full-arch prostheses. A literature search was conducted on MEDLINE, Scopus and Cochrane Library, until the 1st of March 2021, with the following search terms: framework or substructure combined with “dental implants”. The outcomes evaluated were: implant and prosthesis survival, bone resorption, biological and technical complications. The Cochrane Handbook for Systematic Reviews of Interventions was employed to assess the risk of bias in randomized clinical trials. The Newcastle–Ottawa quality assessment scale was used for non-randomized studies. In total, 924 records were evaluated for title and abstract, and 11 studies were included in the review: 4 clinical randomized trials and 7 cohort studies. The framework materials investigated were: gold alloy, titanium, silver-palladium alloy, zirconia and polymers including acrylic resin and carbon-fiber-reinforced composites. High implant and prosthetic cumulative survival rates were recorded by all included studies. Various materials and different fabrication techniques are now available as alternatives to traditional cast metal frameworks, for full-arch implant-supported rehabilitations. Further long-term studies are needed to validate the use of these materials and clarify their specific clinical indications and manufacturing protocols to optimize their clinical outcomes.

Stress Distribution Pattern in Zygomatic Implants Supporting Different Superstructure Materials

“…With the application of CAD/CAM, there are several superstructure materials that are suggested for implant-supported, full-arch rehabilitations, such as a cobalt–chrome alloy [ 2 ], a titanium alloy [ 7 ], zirconia [ 15 , 16 ], carbon-fiber polymers [ 17 , 18 ] and the polyaryletherketone family [ 14 , 19 ]. Despite the extensive literature on the effects of superstructure materials for conventional implants [ 6 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ], the data regarding biomechanical behavior of zygomatic implants are limited [ 2 , 6 , 21 , 22 ].…”

The effect of framework fabrication technique on the fit accuracy of full arch screw retained implant supported prostheses

“…In contrast, with CAD/CAM and other rapid prototyping technologies, framework fit has been improved by the elimination of certain fabrication steps such as waxing, investing, and casting ( Abduo et al, 2011 ). Implant-supported frameworks have been successfully fabricated with CAD/CAM using variable span lengths and materials ( Delucchi et al, 2021 , Katsoulis et al, 2017 ). The vertical marginal fit of Implant-supported frameworks made with the CAD/CAM technology demonstrated significantly better fit than the conventional cast Co-Cr frameworks ( De Araújo et al, 2015 , Drago et al, 2010 , De França et al, 2014 , Mundathaje et al, 2014 ).…”

“…Frameworks for implant-supported fixed dental prostheses are made using a variety of metal alloys ranging from high noble alloys to titanium or base metal alloys ( Delucchi et al, 2021 , Teigen and Jokstad, 2012 ). Gold alloys have been considered the gold standard dental material used in fixed dental prosthesis due to their biocompatibility and ductility ( Kassapidou et al, 2017 ).…”

Fracture Resistance of CAD/CAM Implant-Supported 3Y-TZP-Zirconia Cantilevers: An In Vitro Study

“…An incidence of 5.6% prosthetic failure rate is described in most of the articles, but clinically we can observe a higher percentage that is not described [ 28 ].…”