Clinical outcomes of implant‐supported monolithic zirconia crowns and fixed partial dentures: A systematic review

Abstract

To determine the survival rates of implant-supported monolithic zirconia crowns and fixed partial dentures (FPD). Material and methods: An electronic search for articles in the English language literature published from January 1, 2001 to September 17, 2021 was performed using PubMed, Scopus, and CENTRAL search engines. After applying predetermined inclusion and exclusion criteria, the definitive list of selected articles was used for calculating the interval survival rate (ISR) and cumulative survival rate (CSR). Restoration failure in this study was defined as the fracture or compromise of any part of the ceramic restoration that required the removal or remake of the implant-supported restoration. Results: The electronic search resulted in 457 titles. The systematic application of inclusion and exclusion criteria resulted in 14 clinical studies that addressed the clinical outcomes of implant-supported monolithic zirconia crowns and fixed partial dentures. Of these, 3 were randomized controlled trials, 5 were prospective studies, and 6 were retrospective studies. Follow-up periods ranged from 1 to 5 years. Of the 644 implantsupported monolithic zirconia restorations computed in this systematic review, there was only 1 reported failure of the monolithic zirconia restorative material over a followup period of up to 5 years, for a cumulative survival rate of 99.84%. At the maximum follow-up interval of 5 years, the cumulative survival rate for monolithic zirconia single crowns was 100% and the cumulative survival rate for monolithic zirconia fixed partial dentures was 99.60%. Conclusions: Implant-supported monolithic zirconia single crowns and fixed partial dentures have excellent short-term (<5 years) survival rates but the evidence for medium-term survival (>5 years) and beyond is lacking. K E Y W O R D Sfixed partial denture survival, implant restoration, monolithic zirconia, single crown survival Ceramic materials are widely used in prosthodontics to meet functional and esthetic needs of patients. Numerous ceramic systems have been developed for dental restorations, and zirconia-based ceramics, in particular, have become increasingly popular as a dental restorative material. 1,2 The relatively high strength of yttria-stabilized zirconia compared to other dental ceramics, and the ability to produce zirconia restorations via computer-aided design and computer-aided manufacturing (CAD-CAM) technologies, have contributed to its widespread use in implant dentistry. [2][3][4] The clinical performance and survival of zirconia restorations in the oral cavity have been previously studied. 1-3 A recent summary of systematic reviews investigating clinical performance of tooth-or implant-supported zirconia-based fixed prosthodontic restorations by Laumbacher et al 5 found that 5-year cumulative survival rates varied between 91.2% and 95.9% for tooth-supported single crowns (SC), 89.4% and 100% for tooth-supported multi-unit fixed partial dentures (FPD), 97.1% and 97.6% for implant-supported (IS) SCs and 93.0% and 100% for ...

Risk factors associated with loss of variable‐thread tapered implants: A retrospective observational study of 1–5 years

“…A 10-year cohort study focusing on implant-supported prostheses revealed slightly higher survival rates in FPDs than SCs (Bragger et al, 2005), and this was coincident with our results. However, recent studies suggested an equal level of survival and complication of these two treatments (Chandran et al, 2022;Kim et al, 2023). To our knowledge, only It is important and meaningful to notice the limitation of this retrospective analysis.…”

“…A 10‐year cohort study focusing on implant‐supported prostheses revealed slightly higher survival rates in FPDs than SCs (Bragger et al, 2005), and this was coincident with our results. However, recent studies suggested an equal level of survival and complication of these two treatments (Chandran et al, 2022; Kim et al, 2023). To our knowledge, only Boon et al (2020) have evaluated the clinical outcome of different prosthesis types on VTTIs (in the maxillary anterior region), so more well‐designed prospective research should be conducted to estimate the efficacy of VTTIs under different loading types in consideration of many other factors, such as prosthesis materials, abutment types, occlusal design, and masticatory habits.…”

Indirect restorative systems—A narrative review

“…When it comes to the third and multilayered generations, the scientific data evaluating them is scarce, mainly because the multilayer system is the latest release on the market. For predominantly second generation Y-TZP restorations, a recent systematic review has indicated that tooth and implant supported monolithic single crowns presented 96%-100%, and FDPs, 99.6% 3-5 years survival rates, 17,125 with small chippings being the most frequent complication (0.39%). 17 Moreover, monolithic zirconia has also shown to be a feasible alternative to the conventional metal framework for full arch implantsupported prosthesis, achieving 100% survival and success rates after short-term 2 years of follow-up.…”

Screw‐retained ceramic‐veneered/monolithic zirconia partial implant‐supported fixed dental prostheses: A 5 to 10‐year retrospective study on survival and complications

“…3,16 Recent studies have reported excellent short-term (<5 years) survival rates of monolithic zirconia ISFDP; 17,18 however, clinical evidence on the medium-(>5 years) and long-term survival of screw-retained monolithic zirconia ISFDP is still lacking. 19 Consequently, this retrospective study aimed to evaluate the clinical outcomes of screw-retained, ceramicveneered/monolithic zirconia ISFDPs in partially edentulous patients over 5-10 years. Additionally, this study attempted to assess implant-and prosthesis-related factors influencing treatment failure and complications.…”

“…The survival rate of PFM ISFDP after 5 years was 96.4%, and after 10 years was 93.9% 3,16 . Recent studies have reported excellent short‐term (<5 years) survival rates of monolithic zirconia ISFDP; 17,18 however, clinical evidence on the medium‐ (>5 years) and long‐term survival of screw‐retained monolithic zirconia ISFDP is still lacking 19 …”