OBJECTIVES: The objective of this systematic review was to assess the 5-year survival of implant-supported single crowns (SCs) and to describe the incidence of biological and technical complications. METHODS: An electronic MEDLINE search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on SCs with a mean follow-up time of at least 5 years. Failure and complication rates were analyzed using random-effects Poisson's regression models to obtain summary estimates of 5-year proportions. RESULTS: Twenty-six studies from an initial yield of 3601 titles were finally selected and data were extracted. In a meta-analysis of these studies, survival of implants supporting SCs was 96.8% [95% confidence interval (CI): 95.9-97.6%] after 5 years. The survival rate of SCs supported by implants was 94.5% (95% CI: 92.5-95.9%) after 5 years of function. The survival rate of metal-ceramic crowns, 95.4% (95% CI: 93.6-96.7%), was significantly (P=0.005) higher than the survival rate, 91.2% (95% CI: 86.8-94.2%), of all-ceramic crowns. Peri-implantitis and soft tissue complications occurred adjacent to 9.7% of the SCs and 6.3% of the implants had bone loss exceeding 2 mm over the 5-year observation period. The cumulative incidence of implant fractures after 5 years was 0.14%. After 5 years, the cumulative incidence of screw or abutment loosening was 12.7% and 0.35% for screw or abutment fracture. For supra-structure-related complications, the cumulative incidence of ceramic or veneer fractures was 4.5%. CONCLUSION: It can be concluded that after an observation period of 5 years, high survival rates for implants and implant-supported SCs can be expected. However, biological and particularly technical complications are frequent.
AbstractObjectives:The objective of this systematic review was to assess the 5 year survival of implant supported single crowns (SCs) and to describe the incidence of biological and technical complications.
Methods:An electronic Medline search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on SCs with a mean follow-up time of at least 5 years. Failure and complication rates were analyzed using random-effects Poisson regression models to obtain summary estimates of 5-year proportions.
Results:Twenty-six studies from an initial yield of 3601 titles were finally selected and data were extracted. In a meta-analysis of these studies survival of implants Periimplantitis and soft tissue complications occurred in 9.7% of the SCs and 6.3% of the implants had bone loss exceeding 2 mm over the 5 years observation period. Technical complications included implant fractures, connection-related and supra-structure related complications. The cumulative incidence of implant fractures after 5 years was 0.14%. After 5 years the cumulative incidence of connection-related complications was 12.7% for screw or abutment loosening and 0.35% for screw or abutment fracture. For supra-structure related complications the cum...
Within the limitations of this study, it is concluded that failing implants show a continuous decrease of stability until failure. Low RFA levels after 1 and 2 months seem to indicate an increased risk for future failure. This information may be used to avoid implant failure in the future by unloading implants with decreasing degree of stability with time as diagnosed with the RFA technique.
The immediate loading concept is a realistic treatment alternative in various jawbone regions except for the posterior part of the maxilla. High occlusal loads should be considered a risk factor. On the other hand, implants in combination with bone defects frequently are penetrating cortical layers to a higher extent, thereby contributing to implant stability during the healing phase and consequently do not inevitably jeopardize the treatment result. However, further controlled clinical studies with larger sample sizes need to be performed to evaluate the influence of different parameters on treatment outcome.
The present prospective multicenter study indicates that the prefabrication, on the basis of models derived from three-dimensional oral implant planning software, of both surgical templates for flapless surgery and dental prostheses for immediate loading is a very reliable treatment option. It is evident that the same approach could be used for staged surgery and in partial edentulism.
The applied immediate loading protocol in combination with a slightly tapered implant and a modified implant surface texture was shown to be a successful treatment alternative even in regions exhibiting soft bone.
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