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A systematic review of the survival and complication rates of zirconia‐ceramic and metal‐ceramic multiple‐unit fixed dental prostheses

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dc.contributor Háskóli Íslands (HÍ)
dc.contributor University of Iceland (UI)
dc.contributor.author Sailer, Irena
dc.contributor.author Strasding, Malin
dc.contributor.author Valente, Nicola Alberto
dc.contributor.author Zwahlen, Marcel
dc.contributor.author Liu, Shiming
dc.contributor.author Pjetursson, Bjarni Elvar
dc.date.accessioned 2020-01-03T10:25:47Z
dc.date.available 2020-01-03T10:25:47Z
dc.date.issued 2018-10
dc.identifier.citation Sailer I, Strasding M, Valente NA, Zwahlen M, Liu S, Pjetursson BE. A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic multiple-unit fixed dental prostheses. Clin Oral Impl Res. 2018;29(Suppl. 16):184–198. https://doi.org/10.1111/clr.13277
dc.identifier.issn 0905-7161
dc.identifier.issn 1600-0501 (eISSN)
dc.identifier.uri https://hdl.handle.net/20.500.11815/1430
dc.description Publisher's version (útgefin grein)
dc.description.abstract Objectives: The aim of the present review was to compare the outcomes, that is, survival and complication rates of zirconia-ceramic and/or monolithic zirconia implant-supported fixed dental prostheses (FDPs) with metal-ceramic FDPs. Materials and Methods: An electronic MEDLINE search complemented by manual searching was conducted to identify randomized controlled clinical trials, prospective cohort studies and retrospective case series on implant-supported FDPs with a mean follow-up of at least 3 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data extraction was performed independently by two reviewers. Failure and complication rates were analyzed using robust Poisson regression models to obtain summary estimates of 5-year proportions. Results: The search provided 5,263 titles and 455 abstracts. Full-text analysis was performed for 240 articles resulting in 19 studies on implant FDPs that met the inclusion criteria. The studies reported on 932 metal-ceramic and 175 zirconia-ceramic FDPs. Meta-analysis revealed an estimated 5-year survival rate of 98.7% (95% CI: 96.8%–99.5%) for metal-ceramic implant-supported FDPs, and of 93.0% (95% CI: 90.6%–94.8%) for zirconia-ceramic implant-supported FDPs (p < 0.001). Thirteen studies including 781 metal-ceramic implant-supported FDPs estimated a 5-year rate of ceramic fractures and chippings to be 11.6% compared with a significantly higher (p < 0.001) complication rate for zirconia implant-supported FDPs of 50%, reported in a small study with 13 zirconia implant-supported FDPs. Significantly (p = 0.001) more, that is, 4.1%, of the zirconia-ceramic implant-supported FDPs were lost due to ceramic fractures compared to only 0.2% of the metal-ceramic implant-supported FDPs. Detailed analysis of factors like number of units of the FDPs or location in the jaws was not possible due to heterogeneity of reporting. No studies on monolithic zirconia implant-supported FDPs fulfilled the inclusion criteria of the present review. Furthermore, no conclusive results were found for the aesthetic outcomes of both FDP-types. Conclusion: For implant-supported FDPs, conventionally veneered zirconia should not be considered as material selection of first priority, as pronounced risk for framework fractures and chipping of the zirconia veneering ceramic was observed. Monolithic zirconia may be an interesting alternative, but its clinical medium- to long-term outcomes have not been evaluated yet. Hence, metal ceramics seems to stay the golden standard for implant-supported multiple-unit FDPs.
dc.format.extent 184-198
dc.language.iso en
dc.publisher Wiley
dc.relation.ispartofseries Clinical Oral Implants Research;29(S16)
dc.rights info:eu-repo/semantics/openAccess
dc.subject Biological
dc.subject Complications
dc.subject Fixed dental prostheses
dc.subject Implant bridge
dc.subject Meta-analysis
dc.subject Metal-ceramics
dc.subject Survival
dc.subject Systematic review
dc.subject Technical
dc.subject Zirconia framework
dc.subject Tannlækningar
dc.subject Tannfyllingarefni
dc.title A systematic review of the survival and complication rates of zirconia‐ceramic and metal‐ceramic multiple‐unit fixed dental prostheses
dc.type info:eu-repo/semantics/article
dcterms.license This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2018 The Authors. Clinical Oral Implants Research Published by John Wiley & Sons Ltd.
dc.description.version Peer Reviewed
dc.identifier.journal Clinical Oral Implants Research
dc.identifier.doi 10.1111/clr.13277
dc.contributor.department Tannlæknadeild (HÍ)
dc.contributor.department Faculty of Odontology (UI)
dc.contributor.school Heilbrigðisvísindasvið (HÍ)
dc.contributor.school School of Health Sciences (UI)

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