A systematic review of the 5‐year survival and complication rates of implant‐supported single crowns

Abstract

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...

Biomechanical evaluation of internal and external hexagon platform switched implant-abutment connections: An in vitro laboratory and three-dimensional finite element analysis

“…From a biomechanical perspective, previous in vitro studies [12][13][14][15][16][17] have shown reduced levels of stress on peri-implant bone in platform-switched implants relative to matched implant-abutment diameters. Such potential for crestal bone level preservation has been shown in animal [18][19][20] and clinical studies [11,21,22].…”

“…On the other hand, complications with implant-abutment connections is still a common clinical problem, especially in single-tooth replacements [18,23,24]. When considering platform-switched implants, previous studies [14,17] have shown an increased stress on the abutment and fixation screw, which may compromise the system biomechanical performance.…”

Prosthodontic complications associated with implant retained crowns and bridgework: a review of the literature

“…3,14,15 A lack of keratinised mucosa does not appear to be associated with an increased incidence of peri-implantitis. 13 Jung et al 2 reported that 6.3% of implant supported single crowns had bone loss >2 mm over a 5 year observation period. Pjetursson et al 7 reported that less than 8.6% (95% CI; 5.1%-14.1%) of implant supported fixed partial dentures were affected by peri-implantitis over 5 years.…”

“…1 Systematic reviews have reported relatively high survival rates for dental implants supporting crowns 2 and fixed bridgework. [3][4][5][6][7] However, these reviews have also identified a variety of complications that may be associated with these prostheses.…”

“…[3][4][5][6][7] However, these reviews have also identified a variety of complications that may be associated with these prostheses. [2][3][4][5][6][7] Although these complications rarely result in the complete failure of treatment, their management can be frustrating, expensive and time consuming for the patient, clinician and technician. This review discusses the incidence, aetiology, prevention and management of common prosthodontic complications, which may occur following the delivery of implant retained crowns and bridgework.…”