An Up-to-15-Year Comparison of the Survival and Complication Burden of Three-Unit Tooth-Supported Fixed Dental Prostheses and Implant-Supported Single Crowns

Abstract

To assess and compare the outcomes and economic complication burden of three-unit toothsupported fixed dental prostheses (TFDPs) and implant-supported single crowns (ISCs) provided to a sequential cohort in a specialist prosthodontic practice over a 15-year period. Materials and Methods: Sequential patients requiring replacement of a single missing tooth between 1996 and 2010 with a metal-ceramic three-unit TFDP (n = 145 patients, n = 174 prostheses) or ISC (n = 174 patients, n = 220 prostheses) were included. Prostheses subjectively judged at insertion to have an unfavorable 10-year prognosis (17 TFDPs, 0 ISCs) were removed from statistical analyses. The estimated cumulative survival (ECS) was calculated with the life table actuarial method and standard errors calculated with the Greenwood formula. Differences in outcomes between all prostheses and those replacing only anterior or only posterior teeth were assessed with the log rank test. Complication incidence, severity, and economic burden, measured in time/cost accounting units (TAUs), were tallied and compared descriptively. Results: The 15-year ECS did not differ for 112 TFDPs (92.75% ± 3.28%) and 81 ISCs (95.95% ± 2.92%) replacing posterior teeth. However, the 15-year ECS was significantly greater for 139 ISCs (93.33% ± 6.44%) than for 45 TFDPs (82.82% ± 6.50%) replacing anterior teeth. The economic burden of nonterminal complications for both prostheses was low (mean = 0.3 and 0.2 TAUs per prosthesis for TFDPs and ISCs, respectively). This equated to 3 TAUs/100 years in clinical service and 4 TAUs/100 years in clinical service for the TFDPs and ISCs, respectively. Conclusion: The survival of three-unit TFDPs and ISCs over 15 years was not statistically different when replacing posterior teeth, but ISCs survived significantly better when replacing anterior teeth. The complication rates of the TFDPs and ISCs were similar, but the economic burden for the TFDPs was greater.

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

“…Until today, metal‐ceramics is the “golden standard” material of choice for the fabrication of multiple‐unit implant‐ or tooth‐borne FDPs (Creugers, Käyser, & van't Hof, ; Scurria, Bader, & Shuggars, ; Walton, , , ). More recently, zirconia‐based reconstructions have increasingly been used instead, in an attempt to provide patients with metal‐free reconstructions of higher aesthetics and lower price (Heintze & Rousson, ).…”

Clinical Evaluation of 762 Single-Tooth, Locking-Taper Implants: A Prospective Study with 1- to 12-Years of Follow-Up

“…Despite the high survival rates and predictability of rehabilitating patients with single-tooth restorations using dental implants, prosthetic complications (abutment screw loosening/fracture, chipping/fracture of veneering materials, need for recementation) still remain an issue; managing these complications can cause extra amount of chair-side time, additional costs and patient dissatisfaction [2,[5][6][7][8][9][10]. Abutment screw loosening was described already in 1996 as the most common complication affecting abutments tightened with a titanium screw [15].…”

A Retrospective Study of the AL Technology Implant System used for Single-Tooth Replacement

“…Dental implants represent the state-of-the-art treatment for replacing single missing teeth, as demonstrated by several longterm follow-up studies, with satisfactory high survival rates [1][2][3][4]. However, biological and prosthetic complications still affect single crowns (SCs) supported by dental implants [2,[5][6][7][8][9][10]. Biological complications include complications that affects only soft tissues (such as pain and swelling after surgery, or peri-implant mucositis) and complications that affect both soft and hard tissues (such as periimplantitis) [5,6,10].…”