Clinical outcomes of partial and full‐arch all‐ceramic implant‐supported fixed dental prostheses. A systematic review and meta‐analysis

Abstract Objective To assess the survival and technical complication rate of partial and full‐arch all‐ceramic implant‐supported fixed dental prostheses (P‐ FDP / FA ‐ FDP ) and supporting implants. Materials and methods An electronic search through three databases ( MEDLINE /Pubmed, Cochrane Library, Embase) was conducted to identify relevant clinical studies with an observation period of at least 12 months, including ≥15 patients. Reconstruction and implant survival rates, technical complications and confounding variables such as processed/installed materials, retention mode and location in the mouth were obtained. Failure and complication rates were analyzed using standard Poisson regression models to calculate 5‐year survival and complication estimates. Results A total of five studies for the P‐ FDP group and seven studies for the FA ‐ FDP group were included, throughout evaluating veneered zirconia reconstructions. In the P‐ FDP group, reconstructions were located in posterior regions. Meta‐analysis indicated survival estimates on the reconstruction level of 98.3% and 97.7% for P‐ and FA ‐ FDP s after 5 years. However, chipping of the veneering ceramic was frequent, resulting in estimated 5‐year complication rates of 22.8% (P‐ FDP s) and 34.8% ( FA ‐ FDP s). Five‐year survival estimates of implants supporting P‐ FDP s and FA ‐ FDP s of 98.5% and 99.4% were calculated, respectively. Including a total of 540 FDP s, one screw‐loosening and 11 de‐cementations were reported. Confounding variables were not found to have a significant influence on survival and complication rates. Conclusions All‐ceramic implant‐supported P‐ and FA ‐ FDP s comprising veneered zirconia frameworks showed high survival but clinically inacceptable fracture rates of the veneering ceramic. Their suitability with regard to this indication and a successful long‐term outcome needs to be further evaluated.