Systematic review evaluating the influence of the prosthetic material and prosthetic design on the clinical outcomes of implant‐supported multi‐unit fixed dental prosthesis in the posterior area

Abstract

ObjectiveThe objectives of the study were to assess the survival, failure, and technical complication rates of implant‐supported fixed dental prosthesis (iFDPs) with pontic or splinted crown (iSpC) designs in the posterior area and compare the influence of prosthetic materials and prosthetic design on the outcomes.MethodsElectronic and manual searches were performed to identify randomized‐, prospective‐, and retrospective clinical trials with follow‐up time of ≥12 months, evaluating the clinical outcomes of posterior iFDPs with pontic or iSpCs. Survival and complication rates were analyzed using robust Poisson's regression models.ResultsThirty‐two studies reporting on 42 study arms were included in the present systematic review. The meta‐analysis of the included studies indicated estimated 3‐year survival rates of 98.3% (95%CI: 95.6–99.3%) for porcelain‐fused‐to‐metal (PFM) iFDPs, 97.5% (95%CI: 95.5–98.7%) for veneered zirconia (Zr) iFDPs with pontic, 98.9% (95%CI: 96.8–99.6%) for monolithic or micro‐veneered zirconia iFDPs with pontic, and 97.0% (95%CI: 84.8–99.9%) for lithium disilicate iFDPs with pontics. The survival rates for different material combination showed no statistically significant differences. Veneered restorations, overall, showed significantly (p < .01) higher ceramic fracture and chipping rates compared with monolithic restorations. Furthermore, there was no significant difference in survival rates (98.3% [95%CI: 95.6–99.3%] vs. 99.1% [95%CI: 97.6–99.7%]) and overall complication rates between PFM iFDPs with pontic and PFM iSpCs.ConclusionsBased on the data identified by this systematic review, PFM, veneered Zr, and monolithic Zr iFDPs with pontic and iSpCs showed similarly high short‐term survival rates in the posterior area. Veneered restorations exhibit ceramic chipping more often than monolithic restorations, with the highest fracture rate reported for veneered Zr iFDPs.

Bonding Effectiveness of Zirconia to Veneering Ceramic after Different Sandblasting Treatments

“…Yttrium oxide-stabilized tetragonal zirconia polycrystals (Y-TPZ), among high strength ceramics, has been widely investigated as a core material for single crowns and fixed partial dentures. Overall, survival rate and success rate of all ceramic restorations have been reported to be ≥90% at 5 to 10 years [1][2][3]7,17,18]. However, chipping and delamination are still considered as major failures due to technical factors in single crowns or fixed partial dentures and, nowadays, in implant supported restorations as well [1][2][3]7,18,29].…”

“…Overall, survival rate and success rate of all ceramic restorations have been reported to be ≥90% at 5 to 10 years [1][2][3]7,17,18]. However, chipping and delamination are still considered as major failures due to technical factors in single crowns or fixed partial dentures and, nowadays, in implant supported restorations as well [1][2][3]7,18,29]. Moreover, failures due to chipping or delamination seem not to differ significantly from that of the porcelain fused to metal restorations (PFMs) [1][2][3]18,29].…”

“…In the last few decades, the application of zirconia in prosthodontics has grown and zirconia has been used as a metal-free alternative for all-ceramic restorations thanks to its mechanical properties, biocompatibility, optical characteristics and improved aesthetics [1][2][3][4]. All-ceramic single crowns and anterior fixed partial dentures (FPDs) have been used successfully since nineties.…”

Short and Extra Short Dental Implants in Osseous Microvascular Free Flaps: A Retrospective Case Series

“…The survival and successful outcomes of the implants were evaluated using Kaplan-Meier (K-M) survival analyses (lifelines version 0.26.0, Python). Survival was defined as the implant or prosthesis remaining in situ throughout the duration of the study [30][31][32], while success was defined by the implant or prosthesis being in situ without complication or modification. Log-rank tests were performed to test for differences in K-M outcomes across different study parameters.…”

Group 2 ITI Consensus Report: Technological developments in implant prosthetics

“…Working Group-2 «Technology» of the 7th ITI Consensus Conference has addressed these questions. The aim was to systematically examine the available scientific literature on the three core topics: (Ioannidis et al, 2023) additive versus subtractive manufacturing of implant restorations; (Chantler et al, 2023) survival and complications rates as well as esthetic outcomes comparing prefabricated versus customized abutments; and (Pjetursson et al, 2023) clinical performance of implant-supported fixed dental prostheses with different prosthetic designs and restorative material for treatment of multiple missing teeth in the posterior area. In the context of the above-mentioned core topics, Group-2 also addressed the patient perspective.…”