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

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‐FDPs after 5 years. However, chipping of the veneering ceramic was frequent, resulting in estimated 5‐year complication rates of 22.8% (P‐FDPs) and 34.8% (FA‐FDPs). Five‐year survival estimates of implants supporting P‐FDPs and FA‐FDPs of 98.5% and 99.4% were calculated, respectively. Including a total of 540 FDPs, 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‐FDPs 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.