Abstract
Statement of problem
Whether placing implants to replace each missing tooth or using implant-supported
fixed partial dentures provides better outcomes is unclear.
Purpose
The purpose of this systematic review and meta-analysis was to assess the success
and survival rates of implants supporting single-unit and multiunit fixed prostheses
by using conventional protocols for placement and loading in short- and long-term
follow-ups.
Material and methods
An electronic search was conducted in PubMed, Scopus, and Web of Science for studies
published up to March 17, 2022. Comparative studies that reported the success or survival
rates of both single-unit and splinted multiunit prostheses were considered for qualitative
and quantitative analyses.
Results
A total of 68 publications comprising 11 271 implants were included. Compared with
the single prostheses, the splinted multiunit group showed no significant differences
in implant success rates in the short-term (risk difference=−0.004; 95% confidence
interval (CI)=−0.033 to 0.025; P=.780) and long-term (risk difference=0.003; 95% confidence interval (CI)=−0.029 to
0.034; P=.874) follow-ups. Significant statistical differences were also not found in terms
of the survival rates of the 2 groups (short-term risk difference=−0.004; 95% CI=−0.031
to 0.023; P=.779, long-term risk difference=−0.002; 95% CI=−0.029 to 0.025; P=.887).
Conclusions
Implants supporting single-unit or splinted multiunit prostheses seem to be a predictable
treatment in terms of survival and success over short and long periods. Nonetheless,
it seems that cantilever and nonsplinted multiunit prostheses should be used with
more caution.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Prosthetic DentistryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Interventions for replacing missing teeth: different times for loading dental implants.Cochrane Database Syst Rev. 2013; 3: CD003878
- Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man.Acta Orthop Scand. 1981; 52: 155-170
- Dental implants: a review.Morphologie. 2016; 100: 189-198
- Long-term implant survival and success: a 10–16-year follow-up of non-submerged dental implants.Clin Oral Implants Res. 2010; 21: 772-777
- Factors affecting the survival rate of dental implants: a retrospective study.J Int Soc Prev Community Dent. 2017; 7: 351-355
- Pathogenesis of implant failures.Periodontol 2000. 1994; 4: 127-138
- Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs).Clin Oral Implants Res. 2007; 18: 97-113
- In patients requiring single-tooth replacement, what are the outcomes of implant- as compared to tooth-supported restorations?.Int J Oral Maxillofac Implants. 2007; 22: 71-95
- 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.Int J Oral Maxillofac Implants. 2015; 30: 851-861
- Success rate of implants placed in autogenous bone blocks versus allogenic bone blocks: a systematic literature review.Ann Maxillofac Surg. 2016; 6: 78-90
- Success rate of dental implants inserted in autologous bone graft regenerated areas: a systematic review.Oral Implantol (Rome). 2011; 4: 3-10
- Success rates and complications associated with single immediate implants: a systematic review.Dentistry Journal. 2022; 10: 31
- Long-term outcomes of maxillary single-tooth implants in relation to timing protocols of implant placement and loading: systematic review and meta-analysis.Clin Oral Implants Res. 2021; 32: 56-66
- Implant placement and loading protocols in partially edentulous patients: a systematic review.Clin Oral Implants Res. 2018; 29: 106-134
- Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review.Int J Oral Maxillofac Surg. 2015; 44: 377-388
- Long-term (10-year) dental implant survival: a systematic review and sensitivity meta-analysis.J Dent. 2019; 84: 9-21
- Survival and complication rates of tooth-implant versus freestanding implant supporting fixed partial prosthesis: a systematic review and meta-analysis.J Prosthodont Res. 2021; 65: 1-10
- The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.BMJ. 2021; 372: n71
- RoB 2: a revised tool for assessing risk of bias in randomised trials.BMJ. 2019; 366: l4898
- Methodological index for non-randomized studies (minors): development and validation of a new instrument.ANZ J Surg. 2003; 73: 712-716
- Measuring inconsistency in meta-analyses.BMJ. 2003; 327: 557-560
- Bias in meta-analysis detected by a simple, graphical test.BMJ. 1997; 315: 629-634
- Osseointegrated implants for single-tooth replacement: a prospective 5-year multicenter study.Int J Oral Maxillofac Implants. 1996; 11: 450-455
- A 5-year multicenter study on implant-supported single crown restorations.Int J Oral Maxillofac Implants. 1998; 13: 212-218
- Guided bone regeneration with barrier membranes--a clinical and radiographic follow-up study after 24 months.Clin Oral Implants Res. 1999; 10: 16-23
- A 3 to 4 year study of single tooth hydroxylapatite coated endosseous dental implants.BDJ Open. 1999; 187: 90-94
- Sinus augmentation for single-tooth replacement in the posterior maxilla: a 3-year follow-up clinical report.Int J Oral Maxillofac Implants. 1999; 14: 55-60
- Brånemark System Wide Platform implants for single molar replacement: clinical evaluation of prospective and retrospective materials.Clin Implant Dent Relat Res. 2000; 2: 61-69
- Preliminary 3-dimensional surface texture measurement and early loading results with a microtextured implant surface.Int J Oral Maxillofac Implants. 2003; 18: 729-738
- Early loading of nonsubmerged titanium implants with a sandblasted and acid-etched (SLA) surface: 3-year results of a prospective study in partially edentulous patients.Int J Oral Maxillofac Implants. 2003; 18: 659-666
- A 3-year prospective clinical and radiologic analysis of early loaded maxillary dental implants supporting single-tooth crowns.Int J Prosthodont. 2006; 19: 389-390
- A 5-year follow-up study on one-stage implants inserted concomitantly with localized alveolar ridge augmentation.J Oral Rehabil. 2007; 34: 781-789
- Vertical guided bone regeneration with bioabsorbable barriers.J Periodontol. 2007; 78: 2036-2042
- Single-tooth Morse taper connection implants after 1 year of functional loading: a multicentre study on 302 patients.Eur J Oral Implantol. 2008; 1: 305-315
- Early implant placement with simultaneous guided bone regeneration following single-tooth extraction in the esthetic zone: 12-month results of a prospective study with 20 consecutive patients.J Periodontol. 2009; 80: 152-162
- Prospective clinical evaluation of 307 single-tooth morse taper-connection implants: a multicenter study.Int J Oral Maxillofac Implants. 2010; 25: 394-400
- Implant-prosthodontic rehabilitation of anterior partial edentulism: a clinical review.Int J Oral Maxillofac Implants. 2011; 26: 1043-1050
- Survival rate of one-piece dental implants placed with a flapless or flap protocol--a randomized, controlled study: 12-month results.Int J Periodontics Restorative Dent. 2011; 31: 591-601
- Efficacy of injectable demineralized bone matrix as graft material during sinus elevation surgery with simultaneous implant placement in the posterior maxilla: clinical evaluation of 49 sinuses.J Oral Maxillofac Surg. 2011; 69: 134-141
- Short threaded implants with an oxidized surface to restore posterior teeth: 1- to 3-year results of a prospective study.Int J Oral Maxillofac Implants. 2011; 26: 393-403
- Clinical outcome and bone preservation of single TiUnite™ implants installed with flapless or flap surgery.Clin Implant Dent Relat Res. 2011; 13: 175-183
- Preliminary 2-year report on treatment outcomes for 6-mm-long implants in posterior atrophic mandibles.Int J Prosthodont. 2012; 25: 279-289
- Clinical and radiographic evaluation of single-tooth dental implants placed in grafted extraction sites: a one-year report.J Int Acad Periodontol. 2013; 15: 113-124
- Comparative clinical study of three-unit fixed partial prostheses supported by two or three implants.Int J Oral Maxillofac Implants. 2013; 28: 1110-1115
- Tilted implants for the restoration of posterior mandibles with horizontal atrophy: an alternative treatment.J Oral Maxillofac Surg. 2013; 71: 856-864
- Effect of flapless surgery on single-tooth implants in the esthetic zone: a randomized clinical trial.J Periodontol. 2013; 84: 1747-1754
- Success and survival rates of narrow diameter implants made of titanium-zirconium alloy in the posterior region of the jaws - results from a 1-year follow-up.Clin Oral Implants Res. 2014; 25: 137-141
- Platform switch versus platform match in the posterior mandible - 1-year results of a multicentre randomized clinical trial.J Clin Periodontol. 2014; 41: 521-529
- Piezoelectric vs. conventional drilling in implant site preparation: pilot controlled randomized clinical trial with crossover design.Clin Oral Implants Res. 2014; 25: 1336-1343
- Clinical and radiographic evaluation of narrow-diameter titanium-zirconium implants in unilateral atrophic mandibular distal extensions: a 1-year pilot study.J Contemp Dent Pract. 2014; 15: 417-422
- Short implants in maxillary and mandibular rehabilitations: interim results (6 to 42 months) of a prospective study.J Oral Implantol. 2015; 41: 50-55
- A Two-Year evaluation of a sloped marginal contour implant system placed in healed sites.Int J Oral Maxillofac Implants. 2016; 31: 1423-1428
- 3D Printing/Additive Manufacturing Single Titanium Dental Implants: a Prospective Multicenter Study with 3 Years of Follow-Up.Int J Dent. 2016; 2016: 8590971
- One-year follow-up of titanium/zirconium alloy X commercially pure titanium narrow-diameter implants placed in the molar region of the mandible: a randomized controlled trial.Clin Oral Implants Res. 2016; 27: 393-398
- Success of 6-mm implants with single-tooth restorations: a 3-year randomized controlled clinical trial.J Dent Res. 2016; 95: 623-628
- Patient-related outcome measures with implant therapy after 5 years.Clin Oral Implants Res. 2017; 28: 683-688
- Comparison of clinical and radiographic status around immediately loaded versus conventional loaded implants placed in patients with type 2 diabetes: 12- and 24-month follow-up results.J Oral Rehabil. 2017; 44: 220-228
- Evaluation of ultrashort and longer implants with microrough surfaces: results of a 24-to 36-month prospective study.Int J Oral Maxillofac Implants. 2017; 32: 171-179
- Clinical outcomes of implants placed in ridge-preserved versus nonpreserved sites: a 4-year randomized clinical trial.Clin Implant Dent Relat Res. 2018; 20: 906-914
- Narrow- and regular-diameter implants in the posterior region of the jaws to support single crowns: a 3-year split-mouth randomized clinical trial.Clin Oral Implants Res. 2018; 29: 100-107
- Digital versus analog procedures for the prosthetic restoration of single implants: a Randomized controlled trial with 1 Year of follow-Up.Biomed Res Int. 2018; 2018: 5325032
- Implant site preparation using ultrasonic technique vs. Conventional drilling: three-year follow-up of a split-mouth study.J Biol Regul Homeost Agents. 2019; 33: 49-58
- Clinical and esthetic outcomes of two different prosthetic workflows for implant-supported all-ceramic single crowns-3 year results of a randomized multicenter clinical trial.Clin Oral Implants Res. 2020; 31: 495-505
- Clinical and volumetric outcomes after vertical ridge augmentation using computer-aided-design/computer-aided manufacturing (CAD/CAM) customized titanium meshes: a pilot study.BMC Oral Health. 2020; 20: 219
- Prognosis of single tooth implants following alveolar ridge preservation with two recombinant human bone morphogenetic protein-2 delivery systems.BMC Oral Health. 2021; 21: 201
- Clinical and radiographic performance of self-locking conical connection implants in the posterior mandible: five-year results of a two-centre prospective study.Clin Oral Implants Res. 2021; 32: 998-1007
- Implant reconstruction in the posterior mandible: a long-term retrospective study.J Prosthet Dent. 1997; 78: 34-42
- Biologic and mechanical stability of single-tooth implants: 4- to 7-year follow-up.Clin Implant Dent Relat Res. 2001; 3: 214-220
- Long-term evaluation of osseointegrated implants inserted at the time or after vertical ridge augmentation. A retrospective study on 123 implants with 1-5 year follow-up.Clin Oral Implants Res. 2001; 12: 35-45
- Bioabsorbable materials for guided bone regeneration prior to implant placement and 7-year follow-up: report of 14 cases.J Periodontol. 2001; 72: 257-264
- Tilted implants as an alternative to maxillary sinus grafting: a clinical, radiologic, and periotest study.Clin Implant Dent Relat Res. 2001; 3: 39-49
- Long-term clinical effectiveness of oral implants in the treatment of partial edentulism. Seven-year life table analysis of a prospective study with ITI dental implants system used for single-tooth restorations.Clin Oral Implants Res. 2002; 13: 133-143
- Implant-supported fixed cantilever prostheses in partially edentulous arches. A seven-year prospective study.Clin Oral Implants Res. 2003; 14: 303-311
- Long-term survival and success of oral implants in the treatment of full and partial arches: a 7-year prospective study with the ITI dental implant system.Int J Oral Maxillofac Implants. 2004; 19: 247-259
- The use of short, wide implants in posterior areas with reduced bone height: a retrospective investigation.J Prosthet Dent. 2004; 92: 139-144
- Success and failure rates of 9 mm or shorter implants in the replacement of missing maxillary molars when restored with individual crowns: preliminary results 0 to 84 months in function. A retrospective study.J Periodontol. 2004; 75: 327-332
- Single implants in the anterior maxilla after 15 years of follow-up: comparison with central implants in the edentulous maxilla.Int J Prosthodont. 2008; 21: 400-408
- Use of sintered porous-surfaced dental implants to restore single teeth in the maxilla: a 7- to 9-year follow-up.Int J Periodontics Restorative Dent. 2009; 29: 191-199
- Implant-supported fixed cantilever prosthesis in partially edentulous jaws: a cohort prospective study.Clin Oral Implants Res. 2009; 20: 1278-1285
- Crown-to-implant ratios of short-length implants.J Oral Implantol. 2010; 36: 425-433
- Immediate, early, and late implant placement in first-molar sites: a retrospective case series.Int J Oral Maxillofac Implants. 2011; 26: 1108-1122
- Cemented versus screw-retained implant-supported single-tooth crowns: A 10-year randomised controlled trial.Eur J Oral Implantol. 2012; 5: 355-364
- The impact of cantilevers on biological and technical success outcomes of implant-supported fixed partial dentures. A retrospective cohort study.Clin Oral Implants Res. 2014; 25: 175-184
- Short (8-mm) locking-taper implants supporting single crowns in posterior region: a prospective clinical study with 1-to 10-years of follow-up.Clin Oral Implants Res. 2014; 25: 933
- Evaluation of Hi-Tec implant restoration in mandibular first molar region- A prospective clinical study.J Clin Diagn Res. 2015; 9: ZC75-ZC79
- Survival rates and bone and soft tissue level changes around one-piece dental implants placed with a Flapless or Flap Protocol: 8.5-Year Results.Int J Periodontics Restorative Dent. 2017; 37: 327-337
- Effect of prosthetic restoration on implant survival and success.Clin Oral Implants Res. 2017; 28: 1296-1302
- A retro-prospective long-term follow-up of Brånemark single implants in the anterior maxilla in young adults. Part 1: clinical and radiographic parameters.Clin Implant Dent Relat Res. 2018; 20: 937-944
- Survival rates of 8-mm or shorter tissue-level implants in function for Up to 228 Months.Int J Oral Maxillofac Implants. 2020; 35: 1239-1247
- Influence of crown-implant ratio on implant success rate of ultra-short dental implants: results of a 8-to 10-year retrospective study.Clin Oral Investig. 2020; 24: 3213-3222
- Osseointegrated dental implants.Dent Clin North Am. 1986; 30: 151-174
- State of the art in oral implants.J Clin Periodontol. 1991; 18: 474-481
- Current interpretations of the osseointegrated response: clinical significance.Int J Prosthodont. 1993; 6: 95-105
- Consensus report of session IV.in: Lang N.P. Karring T. Proceedings of the 1st European Workshop on Periodontology. Quintessence, London1994: 365-369
- Criteria for success and failure of an implant system. Consensus report.in: Lang N.P. Karring T. Proceedings of the First European Workshop on Peridontology. Quintessence, Chicago1994: 243-244
- Determinants of correct clinical reporting.Int J Prosthodont. 1998; 11: 517-521
- Consensus report: towards optimized treatment outcomes for dental implants.J Prosthet Dent. 1998; 80: 641
- Tissue integration of non-submerged implants. l-year results of a prospective study with 100 ITI hollow-cylinder and hollow-screw implants.Clin Oral Implants Res. 1990; 1: 33-40
- Tissue integration of one-stage implants: three-year results of a prospective longitudinal study with hollow cylinder and hollow screw implants.Quintessence Int. 1994; 25: 679-686
- Clinical experience with one-stage, non-submerged dental implants.Adv Dent Res. 1999; 13: 153-161
- Long-term stability of osseointegrated implants in augmented bone: a 5-year prospective study in partially edentulous patients.Int J Periodontics Restorative Dent. 2002; 22: 109-117
- A 15-year study of osseointegrated implants in the treatment of the edentulous jaw.Int J Oral Surg. 1981; 10: 387-416
- The longitudinal clinical efficacy of osseointegrated dental implants: a 3-year report.Int J Oral Maxillofac Implants. 1987; 2: 91-100
- Criteria for success of osseointegrated endosseous implants.J Prosthet Dent. 1989; 62: 567-572
- Success statistics.in: Rateitschak K.H. Wolf H.F. Color atlas of dental medicine - Implan-ology. Thieme medical publishers, New York1995: 353
- A 10-year follow-up study of IMZ and TPS implants in the edentulous mandible using bar-retained overdentures.Int J Oral Maxillofac Implants. 1995; 10: 231-243
- Immediate placement of implants into extraction sockets: implant survival.Int J Oral Maxillofac Implants. 1996; 11: 205-209
- Outcomes and their measurement in clinical trials of endosseous oral implants.Ann Periodontol. 1997; 2: 291-298
- A qualitative and quantitative method for evaluating implant success: a 5-year retrospective analysis of the Brånemark implant.Int J Oral Maxillofac Implants. 1997; 12: 504-514
- Long-term results after placement of dental implants: longitudinal study of 1,964 implants over 16 years.Int J Oral Maxillofac Implants. 1999; 14: 748-755
- Long-term implant prognosis in patients with and without a history of chronic periodontitis: A 10-year prospective cohort study of the ITI Dental Implant System.Clin Oral Implants Res. 2003; 14: 329-339
- Effect of implant design on survival and success rates of titanium oral implants: A 10-year prospective cohort study of the ITI Dental Implant System.Clin Oral Implants Res. 2004 Feb; 15: 8-17
- Implant success, survival, and failure: the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference.Implant Dent. 2008; 17: 5-15
- Immediate and early loading of Straumann implants with a chemically modified surface (SLActive) in the posterior mandible and maxilla: 1-year results from a prospective multicenter study.Clin Oral Implants Res. 2008; 19: 1119-1128
- Implant Bio-mechanics for Successful Implant Therapy: a Systematic Review.J Int Soc Prev Community Dent. 2020; 10: 700-714
- Does the presence of a cantilever influence the survival and success of partial implant-supported dental Prostheses? Systematic Review and Meta-Analysis.Int J Oral Maxillofac Implants. 2018; 33: 815-823
- Bone level changes at implants supporting crowns or fixed partial dentures with or without cantilevers.Clin Oral Implants Res. 2008; 19: 983-990
Article info
Publication history
Published online: February 11, 2023
Publication stage
In Press Corrected ProofFootnotes
Funding: This study was funded by Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences.
Identification
Copyright
© 2023 by the Editorial Council for the Journal of Prosthetic Dentistry.
