Clin Oral Implants Res. 2021 Oct 19. doi: 10.1111/clr.13871. Online ahead of print.
ABSTRACT
OBJECTIVE: To analyze the clinical outcomes of all-ceramic single crowns (SCs) and fixed-dental-prostheses (FDPs) supported by ceramic implants.
MATERIALS AND METHODS: Based on a focused question and customized PICO-framework, electronic (Medline/EMBASE/Cochrane) and manual searches for studies reporting the clinical outcomes of all-ceramic SCs and FDPs supported by ceramic implants ≥ 12 months were performed. The primary outcomes were reconstruction survival as well as the chipping proportion. The secondary outcomes were implant survival, technical complications and patient-related-outcome-measurements. Meta-analyses were performed after 1, 2, and 5 years using random-effect meta-analyses.
RESULTS: Eight of the 1403 initially screened titles and 55 full-texts were included. Five reported on monolithic lithium-disilicate (LS2) SCs, one on veneered zirconia SCs, and two on veneered zirconia SCs and FDPs, which reported all on cement-retained reconstructions (mean observation: 12.0-61.0 months). Meta-analyses estimated a 5-year survival rate of 94% (95% confidence interval [CI]: 82%-100%) for overall implant survival. Reconstruction survival proportions after 5 years were: monolithic LS2, 100% (95%CI: 95%-100%); veneered zirconia SCs, 89% (95%CI: 62%-100%); and veneered zirconia FDPs 94% (95%CI: 81%-100%). The chipping proportion after 5 years was: monolithic LS2, 2% (95%CI: 0%-11%); veneered zirconia SCs, 38% (95%CI: 24%-54%); and veneered zirconia FDPs, 57% (95%CI: 38%-76%). Further outcomes were summarized descriptively.
CONCLUSIONS: Due to the limited data available, only tendencies could be identified. All-ceramic reconstructions supported by ceramic implants demonstrated promising survival rates after mid-term observation. However, high chipping proportions of veneered zirconia SCs and, particularly, FDPs diminished the overall outcome. Monolithic LS2 demonstrated fewer clinical complications. Monolithic reconstructions could be a valid treatment option for ceramic implants.
PMID:34665900 | DOI:10.1111/clr.13871
