Abstract
Background: The treatment plan of prosthetic restorations supported by dental implants requires comprehensive scientific knowledge to deliver prostheses with good prognosis, even before the implant insertion. This review aims to analyze the main prosthetic determinants of the prognosis of implant-supported prostheses. Methods: A comprehensive review of the literature was conducted with a PICO (Patient Intervention Comparison Outcomes) question: “For partially or complete edentulous subjects treated with implant-supported prostheses, which prosthetic factors could affect clinical outcomes?”. A literature search was performed electronically in PubMed (MEDLINE), Scopus and Cochrane Library with the following equation [PROGNOS * OR RISK] FACTOR IMPLANT DENTAL, and by hand search in relevant journals and throughout the selected papers. Results: This revision was carried out based on 50 papers focused on several prosthodontics-related risk factors that were grouped as follows: implant-connection, loading protocol, transmucosal abutments, prosthetic fit, provisionalization, type of retention, impression technique, fabrication technique, and occlusion. More than a half of the studies were systematic reviews (30%), meta-analysis (16%), or prospective evaluations of prosthesis with various kinds of events (18%). However, narrative reviews of literature (14%) and in vitro/animal studies (16%) were also found. Conclusions: The current literature provides insufficient evidence for most of the investigated topics. However, based on the accumulated data, it seems reasonable to defend that the best treatment approach is the use of morse taper implants with transmucosal abutments, recorded by means of rigidly splinted copings through the pick-up technique, and screwed by milled prosthesis occlusally adjusted to minimize functional overloading.
Highlights
Edentulism continues to be an oral health challenge with a growing interest, especially due to the increase in life expectancy in industrialized countries; in the last decades, implant prosthetics have become exponentially popular in both adult and elderly populations.This growth in demand has forced prosthodontics, as a dental specialty, to be systematically challenged by the incessant changes in the conception and therapeutic approach of dental implants, as well as by the abundance of materials and manufacturing methods available today for the replacement of lost tissues in the stomatological area
Prosthodontic treatment on dental implants has continuously evolved over the last decades and is currently a routine option for clinicians and patients
Most of the reported prognostic factors of dental implants are focused on evaluating those variables that impinge on the primary osseointegration [14,15,16]
Summary
Edentulism continues to be an oral health challenge with a growing interest, especially due to the increase in life expectancy in industrialized countries; in the last decades, implant prosthetics have become exponentially popular in both adult and elderly populations This growth in demand has forced prosthodontics, as a dental specialty, to be systematically challenged by the incessant changes in the conception and therapeutic approach of dental implants, as well as by the abundance of materials and manufacturing methods available today for the replacement of lost tissues in the stomatological area. Methods: A comprehensive review of the literature was conducted with a PICO (Patient Intervention Comparison Outcomes) question: “For partially or complete edentulous subjects treated with implant-supported prostheses, which prosthetic factors could affect clinical outcomes?”. Based on the accumulated data, it seems reasonable to defend that the best treatment approach is the use of morse taper implants with transmucosal abutments, recorded by means of rigidly splinted copings through the pick-up technique, and screwed by milled prosthesis occlusally adjusted to minimize functional overloading
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