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

Bjarni E Pjetursson; Irena Sailer; Elizabeth Merino-Higuera; Benedikt Christopher Spies; Felix Burkhardt; Duygu Karasan

doi:10.1111/clr.14103

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

Clin Oral Implants Res. 2023 Sep:34 Suppl 26:86-103. doi: 10.1111/clr.14103.

Authors

Bjarni E Pjetursson^{1

2}, Irena Sailer², Elizabeth Merino-Higuera^{2

3}, Benedikt Christopher Spies⁴, Felix Burkhardt⁴, Duygu Karasan²

Affiliations

¹ Department of Reconstructive Dentistry, Faculty of Odontology, University of Iceland, Reykjavik, Iceland.
² Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland.
³ Department of Prosthodontics, University Center of Health Sciences, University of Guadalajara, Guadalajara, Mexico.
⁴ Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center, University of Freiburg, Freiburg, Germany.

PMID: 37750526
DOI: 10.1111/clr.14103

Abstract

Objective: The 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 (iS_p C) designs in the posterior area and compare the influence of prosthetic materials and prosthetic design on the outcomes.

Methods: Electronic 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 iS_p Cs. Survival and complication rates were analyzed using robust Poisson's regression models.

Results: Thirty-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 iS_p Cs.

Conclusions: Based on the data identified by this systematic review, PFM, veneered Zr, and monolithic Zr iFDPs with pontic and iS_p Cs 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.

Keywords: ceramics; dental crown; dental implants; fixed bridge; implant-supported dental prosthesis; meta-analysis; systematic review; zirconia.

Publication types

Systematic Review
Meta-Analysis
Review

MeSH terms

Ceramics
Crowns
Dental Porcelain
Dental Prosthesis Design*
Dental Prosthesis, Implant-Supported
Dental Restoration Failure*
Prospective Studies
Retrospective Studies
Zirconium

Substances

zirconium oxide
Dental Porcelain
Zirconium