Network meta-analysis of survival rate and complications in implant-supported single crowns with different abutment materials

Menglong Hu; Junyu Chen; Xibo Pei; Jianmin Han; Jian Wang

doi:10.1016/j.jdent.2019.04.007

Network meta-analysis of survival rate and complications in implant-supported single crowns with different abutment materials

J Dent. 2019 Sep:88:103115. doi: 10.1016/j.jdent.2019.04.007. Epub 2019 Apr 12.

Authors

Menglong Hu¹, Junyu Chen¹, Xibo Pei¹, Jianmin Han², Jian Wang³

Affiliations

¹ State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China.
² Dental Medical Devices Testing Center, Dental Materials Laboratory, Peking University School and Hospital of Stomatology, Beijing, 100081, China.
³ State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China. Electronic address: ferowang@hotmail.com.

PMID: 30986515
DOI: 10.1016/j.jdent.2019.04.007

Abstract

Objectives: To compare the survival rate of abutments, marginal bone loss and peri-implant soft tissue discoloration among implant-supported single crowns with different abutment materials.

Data: Randomized controlled trials (RCTs), controlled clinical trials, and cohort studies of implant-supported single crowns with different dental abutment materials.

Sources: A systematic search was conducted by an electronic search in 6 databases without restrictions on September 16, 2018, complemented by a manual search. "Grey" literatures were also searched.

Study selection: Of 3417 studies initially retrieved, thirteen were eligible for inclusion. After studies selected and data extraction, pair-wise and network meta-analyses were performed to analyze the survival rate of the abutment, the marginal bone loss and the soft tissue discoloration. The risk of bias was assessed based on the Cochrane guidelines, Newcastle-Ottawa scale, and funnel plots. Statistical heterogeneity, inconsistencies, and cumulative ranking were also evaluated.

Results: Fourteen RCTs and nine non-RCTs were included. No significant differences was detected among titanium (Ti), zirconia (Zr), gold (Au), and alumina (Al) abutments in terms of survival rate (excluding Al < Ti (P < 0.05), marginal bone loss (excluding Zr < Ti (P < 0.05) and Au > Zr (P < 0.05)), or discoloration of peri-implant soft tissue. Additionally, Ti abutment had the highest cumulative ranking of survival rate (97.9%); Al abutment had the lowest marginal bone loss (81.4%) and Zr abutment had the least discoloration of peri-implant soft tissue (84.8%).

Conclusions: Ti abutment has a comparable survival rate with Zr, but better than Al. In addition, Zr abutment has a better effect in maintaining the marginal bone level, compared with Au and Ti. However, there was no difference in the discoloration of peri-implant soft tissue among Au, Ti, and Zr abutment.

Clinical significance: Based on the results of our network meta-analysis, Zr might be a recommended abutment material considering the clinical efficacy of implant-supported single crowns.

Keywords: Complications; Dental abutment; Implant-supported; Network meta-analysis; Single crown; Survival rate.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review

MeSH terms

Color
Crowns*
Dental Abutments / adverse effects*
Dental Implant-Abutment Design
Dental Implants, Single-Tooth*
Esthetics
Humans
Network Meta-Analysis
Survival Rate
Titanium / adverse effects*
Zirconium / adverse effects*

Substances

Zirconium
Titanium