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Meta-Analysis
. 2022 Jan;33(1):1-20.
doi: 10.1111/clr.13871. Epub 2021 Nov 5.

Clinical outcomes of all-ceramic single crowns and fixed dental prostheses supported by ceramic implants: A systematic review and meta-analyses

Frank Akito Spitznagel  1 , Marc Balmer  2 , Daniel B Wiedemeier  3 , Ronald Ernst Jung  2 , Petra Christine Gierthmuehlen  1
Affiliations
Meta-Analysis

Clinical outcomes of all-ceramic single crowns and fixed dental prostheses supported by ceramic implants: A systematic review and meta-analyses

Frank Akito Spitznagel et al. Clin Oral Implants Res. 2022 Jan.

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 and 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 1,403 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.

Keywords: ceramics; dental implants; implant-supported dental prosthesis; meta-analysis; survival analysis; systematic review; treatment outcome; zirconia.

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Conflict of interest statement

The authors declare no potential conflicts of interest regarding the authorship and/or publication of this manuscript.

Figures

FIGURE 1
FIGURE 1
Flowchart of the search strategy
FIGURE 2
FIGURE 2
(a) Forest plots demonstrating the implant survival rate after 1 year, proportions, and 95% confidence interval [CI] (SC =single crown, FDP =fixed dental prosthesis). (b) Forest plots demonstrating the implant survival rate after 2 years, proportions, and 95% CI. (c) Forest plots demonstrating the implant survival rate after 5 years, proportions, and 95% CI
FIGURE 3
FIGURE 3
(a) Forest plots demonstrating the reconstruction survival rate after 1 year, proportions, 95% confidence interval [CI], and overall weighted survival (SC =single crown, FDP =fixed dental prosthesis). (b) Forest plots demonstrating the reconstruction survival rate after 2 years, proportions, 95% CI, and overall weighted survival. (c) Forest plots demonstrating the reconstruction survival rate after 5 years, proportions, 95% CI, and overall weighted survival
FIGURE 4
FIGURE 4
(a) Forest plots demonstrating the chipping rate after 1 year, proportions, and a 95% confidence interval [CI] (SC =single crown, FDP =fixed dental prosthesis). (b) Forest plots demonstrating the chipping rate after 2 years, proportions, and 95% CI. (c) Forest plots demonstrating the chipping rate after 5 years, proportions, and 95% CI
See this image and copyright information in PMC

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