Abstract
Statement of problem
Monolithic ceramic implant-supported restorations have been used to rehabilitate partially
edentulous patients. However, knowledge of the survival and prosthetic complications
of single crowns (SCs) and fixed partial dentures (FPDs) is limited.
Purpose
The purpose of this systematic review with meta-analysis was to evaluate the clinical
performance of monolithic ceramic implant-supported SCs and FPDs in terms of survival
and prosthetic complication rates.
Material and methods
The systematic review was registered on the prospective register of systematic reviews
(PROSPERO) (CRD42017078568). Five electronic databases were independently searched
by 2 authors for articles published until May 2022. In addition, a hand search was
performed in the nonpeer-reviewed literature, specific journals, and reference lists
of included articles. A single-arm meta-analysis was performed by using the R program.
The risk of bias and quality were assessed using the Cochrane risk of bias tools and
the Newcastle-Ottawa scale.
Results
Twenty-eight studies were included in the quantitative synthesis. A total of 1298
monolithic ceramic implant-supported restorations (1116 SCs and 182 FPDs) were evaluated
in 1193 participants, with a median observation time of 24 months (range: 12 to 72
months). Meta-analysis indicated the proportion of failures and prosthetic complication
rates of 2% (95% confidence interval [CI]: 1% to 4%) for SCs. No difference was observed
for monolithic zirconia and lithium disilicate SCs. In the FPDs, only monolithic zirconia
was considered, with 1 failure reported totaling the proportion of failures of 0%
(0% to 1%) and complication rates of 4% (0% to 12%). The most complications reported
for both types of restorations were screw loosening, debonding, and minor chipping
and were considered repairable. The included studies showed a low risk of bias and
good quality.
Conclusions
The use of monolithic ceramic implant-supported SCs, independent of ceramic material,
and monolithic zirconia implant-supported FPDs should be considered an effective and
safe treatment option because of favorable short-term survival and low prosthetic
complications. However, additional well-conducted studies with a longer-term follow-up
and direct comparison between veneered restorations are recommended to reassess clinical
performance.
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Article info
Publication history
Published online: December 21, 2022
Publication stage
In Press Corrected ProofFootnotes
Funding: Supported by the scholarship of São Paulo State Research Foundation - FAPESP: #2015/24442-8.
Identification
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© 2022 by the Editorial Council for the Journal of Prosthetic Dentistry.
