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Survival and complication rates of fixed partial dentures supported by a combination of teeth and implants
Hans-Peter Weber1, Yvette Zimering
1Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA. hpweber@hsdm.harvard.edu
Selection Criteria:
The authors searched for all English-language articles in MEDLINE through 2004. The electronic search yielded 3844 titles, from which 151 studies were ultimately selected. The authors also conducted a manual search that included searching 8 specialty dental journals that published articles on implant-related research during 2001 to 2004. The manual search yielded 25 additional studies. Overall, no randomized controlled trials (RCTs) were found. Inclusion criteria required studies to have patients clinically examined at follow-up and to have reported on the characteristics of the fixed partial dentures (FPD) structure. The meta-analysis included 13 of 176 studies in which patients with 5 or 10 years of follow-up in a prospective or retrospective study design were evaluated clinically at the end of the follow-up period.
Key Study Factor:
The primary exposure was tooth-implant-supported fixed partial dentures compared with implant-only supported FPDs.
Main Outcome Measure:
The main outcome measure was the failure rate of implants in tooth-implant-supported FPDs after 5 or 10 years of follow-up. Secondary outcome measures included the failure rate of the FPD itself or biological or technical complications.
Main Results:
The meta-analysis included 555 patients ranging in age from 17 to 83 years who received 1002 implants that supported 538 FPDs. Survival of implants in combined tooth-implant-supported FPDs was 90.1% (95% confidence interval [CI]: 82.4%-94.5%) after 5 years and 82.1% (95% CI: 55.8%-93.6%) after 10 years. Survival of FPDs was 94.1% after 5 years and 77.8% after 10 years. There was no difference in the failure rates of implant abutments (3.4%) or tooth abutments (3.2%) for the FPDs after 5 years. Biological complications were reported in only 2 of 13 studies after 5 years, and the cumulative rate was 11.7%.
Conclusions:
The authors concluded that survival rates for implants and FPDs in combined tooth-implant-supported FPDs were lower than found in a similar meta-analysis of implant-only-supported FPDs. The worse survival data for FPDs after 10 years for combined tooth-implant support (77.8%) compared with implant-only support (86.7%) is based on data in only 60 FPDs.
