Outcomes and Complication Rates of the Tooth-Implant-Supported Fixed Prosthesis: A Systematic Review and Meta-Analysis.

Abstract

To evaluate the implant and prosthetic outcomes and biologic and technical complications of tooth-implant- supported fixed dental prostheses (TISFDPs) in comparison with implant-supported fixed dental prostheses (ISFDPs). A comprehensive electronic search was performed by two independent reviewers up to February 2019. A hand search in relevant dental journals was also performed. The search identified a total of 175 citations, and 160 were excluded. Of the remaining 15 articles, seven were included in the review. The implant failure rate was between 0% and 9% for the TISFDPs and between 0% and 13% for the ISFDPs, and the prosthesis failure rate was between 0% and 13% for the TISFDPs and between 0% and 17% for the ISFDPs; no significant differences were observed within 24 to 120 months of follow-up. Less peri-implant marginal bone loss was observed in the TISFDPs (MD: -0.29; 95% CI: -0.58, 0.00; P = .05), but the difference was marginally significant. Abutment tooth intrusion rate was 3%, while abutment tooth fracture rate was between 0% and 4%. No significant differences in the technical complications were observed, although the TISFDPs had higher failure rates in framework fracture and abutment/prosthesis screw loosening, while ISFDPs had a higher failure rate in porcelain fracture. The TISFDPs could be an alternative treatment option to ISFDPs for the partially edentulous patient with both treatments achieving comparable implant, prosthetic, biologic, and technical outcomes.