A systematic review of the survival and complication rates of implant‐supported fixed dental prostheses (FDP s) after a mean observation period of at least 5 years

Abstract

Objectives: The objective of this systematic review was to assess the 5‐ and 10‐year survival of implant‐supported fixed dental prostheses (FDP s) and to describe the incidence of biological and technical complications. Methods: An electronic M edline search complemented by manual searching was conducted to identify prospective and retrospective cohort studies and case series on FDP s with a mean follow‐up time of at least 5 years. Patients had to have been examined clinically at the follow‐up visit. Failure and complication rates were analyzed using standard and random‐effects P oisson regression models to obtain summary estimates of 5‐year and 10‐year survival and complication rates. Results: The updated search provided 979 titles and 257 abstracts. Full‐text analysis was performed for 90 articles resulting in a total 32 studies that met the inclusion criteria. Meta‐analysis of these studies indicated an estimated survival of implants supporting FDP s of 95.6% after 5 years and 93.1% after 10 years. When machined surface implants were excluded from the analysis and only rough surface implants included, the survival rate increased to 97.2% after 5 years. The survival rate of implant‐supported FDP s was 95.4% after 5 years and 80.1% after 10 years of function. When the analysis was done exclusively for metal–ceramic FDP s, hence the old gold–acrylic FDP s were excluded, the survival rate increased significantly. The survival rate of metal–ceramic implant‐supported FDP s was 96.4% after 5 years and 93.9% after 10 years. Only 66.4% of the patients were free of any complications after 5 years. The most frequent complications over the 5‐year observation period were fractures of the veneering material (13.5%), peri‐implantitis and soft tissue complications (8.5%), loss of access hole restoration (5.4%), abutment or screw loosening (5.3%), and loss of retention of cemented FDP s (4.7%). Conclusion: It may be concluded that implant‐supported fixed dental prostheses (FDP s) are a safe and predictable treatment method with high survival rates. However, biological and technical complications were frequent (33.6%). To minimize the incidence of complications, dental professionals should make great effort in choosing reliable components and materials for implant‐supported FDP s and the patients should be placed in well‐structured maintenance system after treatment.