Survival and complications of tooth- and implant-supported ceramic restorations: A systematic review and meta-analysis.

STATEMENT OF PROBLEM During oral rehabilitation, clinicians manage various substrates including natural teeth and implants. Biomechanical differences might influence stress distribution within ceramic materials.

Purpose

This systematic review compared the frequency of failures and fracture-related complications of tooth- and implant-supported ceramic restorations. MATERIAL AND

Methods

A search was conducted in MEDLINE/PubMed, Scopus, Web of Science, Embase, and LILACS databases to identify studies meeting the inclusion criteria. The PICOS question included: Population-multiple or single-unit, monolithic or bilayered, ceramic restorations; Intervention-implant-supported restorations; Comparison-tooth-supported restorations; Outcome-number of failures and number of complications; Study design-clinical trials or observational studies. Risk of bias was assessed with the Newcastle-Ottawa Scale and the confidence of the cumulative evidence was evaluated with GRADEpro. Meta-analyses were conducted separately for lithium disilicate, alumina, and zirconia ceramics comparing the outcomes of failures, technical failures, and complications associated with repairable fractures.

Results

The search yielded 2073 records. Of these, 38 studies were selected for full-text reading, and 25 were included in this review (17 quantitatively and 8 qualitatively analyzed). In all analyses, the heterogeneity among studies was low, and no significant differences were found between tooth- and implant-supported substrates. Risk of bias was mostly low, and confidence of evidence was considered low to moderate by GRADE assessment.

Conclusions

No significant differences were found in the frequency of failures, technical failures, or repairable fracture-related complications between ceramic restorations supported by teeth or implants, regardless of the ceramic material evaluated.