A systematic review of the survival and complication rates of zirconia‐ceramic and metal‐ceramic multiple‐unit fixed dental prostheses

Abstract

Objectives:The aim of the present review was to compare the outcomes, that is, survival and complication rates of zirconia-ceramic and/or monolithic zirconia implant-supported fixed dental prostheses (FDPs) with metal-ceramic FDPs. Materials and Methods: An electronic MEDLINE search complemented by manual searching was conducted to identify randomized controlled clinical trials, prospective cohort studies and retrospective case series on implant-supported FDPs with a mean follow-up of at least 3 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data extraction was performed independently by two reviewers. Failure and complication rates were analyzed using robust Poisson regression models to obtain summary estimates of 5-year proportions. Results: The search provided 5,263 titles and 455 abstracts. Full-text analysis was performed for 240 articles resulting in 19 studies on implant FDPs that met the inclusion criteria. The studies reported on 932 metal-ceramic and 175 zirconia-ceramic FDPs. Meta-analysis revealed an estimated 5-year survival rate of 98.7% (95% CI: 96.8%-99.5%) for metal-ceramic implant-supported FDPs, and of 93.0% (95% CI: 90.6%-94.8%) for zirconia-ceramic implant-supported FDPs (p < 0.001). Thirteen studies including 781 metal-ceramic implant-supported FDPs estimated a 5-year rate of ceramic fractures and chippings to be 11.6% compared with a significantly higher (p < 0.001) complication rate for zirconia implant-supported FDPs of 50%, reported in a small study with 13 zirconia implant-supported FDPs. Significantly (p = 0.001) more, that is, 4.1%, of the zirconia-ceramic implant-supported FDPs were lost due to ceramic fractures compared to only 0.2% of the metal-ceramic implant-supported FDPs. Detailed analysis of factors like number of units of the FDPs or location in the jaws was not possible due to heterogeneity of reporting. No studies on monolithic zirconia implant-supported FDPs fulfilled the inclusion criteria of the present review. Furthermore, no conclusive results were found for the aesthetic outcomes of both FDP-types. Conclusion: For implant-supported FDPs, conventionally veneered zirconia should not be considered as material selection of first priority, as pronounced risk forThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

“…In a similar manner, Pieralli et al 208 207 this study demonstrated a high incidence of chipping of the veneering material and pointed out that clinical evidence descriptive of monolithic zirconia restorations is lacking.…”

A systematic review of the survival and complication rates of zirconia‐ceramic and metal‐ceramic single crowns

“…Therefore, the search strategy of our group has changed to apply a very open and unrestricted title search, avoiding limitations and filters in order to be as inclusive as possible on the title level. Additionally, meticulous hand‐searching of all reference lists of previous reviews and all included full‐text papers of the present systematic review helped locating the included studies of the present and a parallel review addressing multi‐unit implant supported fixed dental prostheses (Sailer et al., ; ITI CC SR).…”

“…In the final article selection phase, data were divided into implant‐supported SCs, for the present systematic review and fixed dental prostheses (FDPs) for the review by Sailer et al. (). Both reviews were prepared in the context of the ITI Consensus Conference 2018.…”

Ceramic Materials and Technologies Applied to Digital Works in Implant-Supported Restorative Dentistry

“…There have been few papers reporting the long-term clinical results of fixed implant-supported monolithic Y-TZP restorations for periods of over five years [57][58][59][60][61][62][63][64]. The five-year survival rate is estimated to be over 90% in complete-arch fixed implant-supported monolithic Y-TZP prostheses [57,64].…”

“…The five-year survival rate is estimated to be over 90% in complete-arch fixed implant-supported monolithic Y-TZP prostheses [57,64]. There appear to be no studies on single or multiple-unit fixed implant-supported monolithic Y-TZP dental prostheses with a mean follow-up period of at least 3 years [62,63]. As SM-based monolithic Y-TZP restorations are being used in clinics globally, randomized controlled trials and other prospective clinical studies will be reported and published in the near future.…”