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Meta-Analysis
. 2021 Oct;32 Suppl 21(Suppl 21):254-288.
doi: 10.1111/clr.13863.

A systematic review and meta-analysis evaluating the survival, the failure, and the complication rates of veneered and monolithic all-ceramic implant-supported single crowns

Bjarni Elvar Pjetursson  1   2 , Irena Sailer  2 , Andrey Latyshev  2   3 , Kerstin Rabel  4 , Ralf-Joachim Kohal  4 , Duygu Karasan  2
Affiliations
Meta-Analysis

A systematic review and meta-analysis evaluating the survival, the failure, and the complication rates of veneered and monolithic all-ceramic implant-supported single crowns

Bjarni Elvar Pjetursson et al. Clin Oral Implants Res. 2021 Oct.

Erratum in

  •  .
    [No authors listed] [No authors listed] Clin Oral Implants Res. 2021 Dec;32(12):1507. doi: 10.1111/clr.13877. Clin Oral Implants Res. 2021. PMID: 34881821 Free PMC article. No abstract available.

Abstract

Objective: To assess the survival, failure, and complication rates of veneered and monolithic all-ceramic implant-supported single crowns (SCs).

Methods: Literature search was conducted in Medline (PubMed), Embase, and Cochrane Central Register of Controlled Trials until September 2020 for randomized, prospective, and retrospective clinical trials with follow-up time of at least 1 year, evaluating the outcome of veneered and/or monolithic all-ceramic SCs supported by titanium dental implants. Survival and complication rates were analyzed using robust Poisson's regression models.

Results: Forty-nine RCTs and prospective studies reporting on 57 material cohorts were included. Meta-analysis of the included studies indicated an estimated 3-year survival rate of veneered-reinforced glass-ceramic implant-supported SCs of 97.6% (95% CI: 87.0%-99.6%). The estimated 3-year survival rates were 97.0% (95% CI: 94.0%-98.5%) for monolithic-reinforced glass-ceramic implant SCs, 96.9% (95% CI: 93.4%-98.6%) for veneered densely sintered alumina SCs, 96.3% (95% CI: 93.9%-97.7%) for veneered zirconia SCs, 96.1% (95% CI: 93.4%-97.8%) for monolithic zirconia SCs and only 36.3% (95% CI: 0.04%-87.7%) for resin-matrix-ceramic (RMC) SCs. With the exception of RMC SCs (p < 0.0001), the differences in survival rates between the materials did not reach statistical significance. Veneered SCs showed significantly (p = 0.017) higher annual ceramic chipping rates (1.65%) compared with monolithic SCs (0.39%). The location of the SCs, anterior vs. posterior, did not influence survival and chipping rates.

Conclusions: With the exception of RMC SCs, veneered and monolithic implant-supported ceramic SCs showed favorable short-term survival and complication rates. Significantly higher rates for ceramic chipping, however, were reported for veneered compared with monolithic ceramic SCs.

Keywords: biological; complications; fixed dental prostheses; implant crown; meta-analysis; monolithic; success; survival; systematic review; technical; veneered; zirconia framework.

PubMed Disclaimer

Conflict of interest statement

The authors have no specific conflict of interest related to the present systematic review.

Figures

FIGURE 1
FIGURE 1
Summary of the search terms that were used for two independent electronic literature searches. The blocks are addressing the restoration type, the restoration support and the restoration material
FIGURE 2
FIGURE 2
Search strategy—For summary of the excluded full‐text articles see Table S1
FIGURE 3
FIGURE 3
Forrest plot for the annual failure rate of veneered‐reinforced glass‐ceramic implant‐supported SCs
FIGURE 4
FIGURE 4
Forrest plot for the annual failure rate of monolithic‐reinforced glass‐ceramic implant‐supported SCs
FIGURE 5
FIGURE 5
Forrest plot for the annual failure rate of veneered densely sintered alumina implant‐supported SCs
FIGURE 6
FIGURE 6
Forrest plot for the annual failure rate of veneered zirconia implant‐supported SCs
FIGURE 7
FIGURE 7
Forrest plot for the annual failure rate of monolithic zirconia implant‐supported SCs
FIGURE 8
FIGURE 8
Funnel plot for the annual failure rate of resin‐matrix ceramic implant‐supported SCs
See this image and copyright information in PMC

References

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References of excluded studies

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    1. Alayan, J. , & Ivanovski, S. (2019). Biological and technical outcomes of restored implants after maxillary sinus augmentation‐Results at 1‐year loading. Clinical Oral Implants Research, 30(9), 849–860. 10.1111/clr.13489. - DOI - PubMed
    1. Anitua, E. , Saracho, J. , Almeida, G. Z. , Duran‐Cantolla, J. , & Alkhraisat, M. H. (2017). Frequency of prosthetic complications related to implant‐borne prosthesis in a sleep disorder unit. Journal of Oral Implantology, 43(1), 19–23. 10.1563/aaid-joi-D-16-00100. - DOI - PubMed
    1. Balmer, M. , Spies, B. C. , Kohal, R. J. , Hämmerle, C. H. , Vach, K. , & Jung, R. E. (2020). Zirconia implants restored with single crowns or fixed dental prostheses: 5‐year results of a prospective cohort investigation. Clinical Oral Implants Research, 31(5), 452–462. 10.1111/clr.13581. - DOI - PubMed
    1. Balmer, M. , Spies, B. C. , Vach, K. , Kohal, R. J. , Hämmerle, C. H. F. , & Jung, R. E. (2018). Three‐year analysis of zirconia implants used for single‐tooth replacement and three‐unit fixed dental prostheses: A prospective multicenter study. Clinical Oral Implants Research, 29(3), 290–299. 10.1111/clr.13115. - DOI - PubMed

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