Survival and prosthetic complications of monolithic ceramic implant-supported single crowns and fixed partial dentures: A systematic review with meta-analysis

Cleidiel Aparecido Araujo Lemos; Fellippo Ramos Verri; Jéssica Marcela de Luna Gomes; Joel Ferreira Santiago Junior; Eduardo Miyashita; Gustavo Mendonça; Eduardo Piza Pellizzer

doi:10.1016/j.prosdent.2022.11.013

Survival and prosthetic complications of monolithic ceramic implant-supported single crowns and fixed partial dentures: A systematic review with meta-analysis

J Prosthet Dent. 2022 Dec 21:S0022-3913(22)00736-3. doi: 10.1016/j.prosdent.2022.11.013. Online ahead of print.

Authors

Cleidiel Aparecido Araujo Lemos¹, Fellippo Ramos Verri², Jéssica Marcela de Luna Gomes³, Joel Ferreira Santiago Junior⁴, Eduardo Miyashita⁵, Gustavo Mendonça⁶, Eduardo Piza Pellizzer⁷

Affiliations

¹ Adjunct Professor, Department of Dentistry, Federal University of Juiz de Fora - Campus Governador Valadares (UFJF/GV), Governador Valadares, Minas Gerais, Brazil. Electronic address: cleidiel.lemos@ufjf.br.
² Adjunct Professor, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil.
³ Professor, Centro Universitário FACOL (UNIFACOL), Vitória de Santo Antão, Pernambuco, Brazil.
⁴ Professor, Departament of Health Sciences, School of Dentistry, Centro Universitário Sagrado Coração-UNISAGRADO, Bauru, São Paulo, Brazil.
⁵ Titular Professor, Department of Dentistry, UNIP - Universidade Paulista, São Paulo, Brazil.
⁶ Clinical Associate Professor, Department of Biological and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, Mich.
⁷ Titular Professor, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil.

PMID: 36564291
DOI: 10.1016/j.prosdent.2022.11.013

Abstract

Statement of problem: Monolithic ceramic implant-supported restorations have been used to rehabilitate partially edentulous patients. However, knowledge of the survival and prosthetic complications of single crowns (SCs) and fixed partial dentures (FPDs) is limited.

Purpose: The purpose of this systematic review with meta-analysis was to evaluate the clinical performance of monolithic ceramic implant-supported SCs and FPDs in terms of survival and prosthetic complication rates.

Material and methods: The systematic review was registered on the prospective register of systematic reviews (PROSPERO) (CRD42017078568). Five electronic databases were independently searched by 2 authors for articles published until May 2022. In addition, a hand search was performed in the nonpeer-reviewed literature, specific journals, and reference lists of included articles. A single-arm meta-analysis was performed by using the R program. The risk of bias and quality were assessed using the Cochrane risk of bias tools and the Newcastle-Ottawa scale.

Results: Twenty-eight studies were included in the quantitative synthesis. A total of 1298 monolithic ceramic implant-supported restorations (1116 SCs and 182 FPDs) were evaluated in 1193 participants, with a median observation time of 24 months (range: 12 to 72 months). Meta-analysis indicated the proportion of failures and prosthetic complication rates of 2% (95% confidence interval [CI]: 1% to 4%) for SCs. No difference was observed for monolithic zirconia and lithium disilicate SCs. In the FPDs, only monolithic zirconia was considered, with 1 failure reported totaling the proportion of failures of 0% (0% to 1%) and complication rates of 4% (0% to 12%). The most complications reported for both types of restorations were screw loosening, debonding, and minor chipping and were considered repairable. The included studies showed a low risk of bias and good quality.

Conclusions: The use of monolithic ceramic implant-supported SCs, independent of ceramic material, and monolithic zirconia implant-supported FPDs should be considered an effective and safe treatment option because of favorable short-term survival and low prosthetic complications. However, additional well-conducted studies with a longer-term follow-up and direct comparison between veneered restorations are recommended to reassess clinical performance.

Publication types

Review