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

• Published in: Clinical oral implants research 2021-10, Vol.32 (S21), p.254-288
• Main Authors: Pjetursson, Bjarni Elvar, Sailer, Irena, Latyshev, Andrey, Rabel, Kerstin, Kohal, Ralf‐Joachim, Karasan, Duygu
• Format: Article
• Language: English
• Subjects: Aluminum oxide; biological; Ceramics; Chipping; Clinical trials; complications; Dental implants; Dental materials; Dental prosthetics; Evaluation; Failure analysis; fixed dental prostheses; implant crown; Meta-analysis; monolithic; Regression analysis; Regression models; Review; Robustness (mathematics); Statistical analysis; success; Survival; systematic review; technical; The 6th EAO Consensus Conference 2021; Titanium; Transplants & implants; veneered; Zirconia; zirconia framework; Zirconium dioxide
• ISSN: 0905-7161; 1600-0501
• DOI: 10.1111/clr.13863

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.