Long-term Outcomes of Tooth-implant Supported Prostheses - A Systematic Review and Meta-analysis

Area of Science:

• Dental prosthetics
• Biomaterials science
• Clinical dentistry

Background:

• Tooth-implant supported prostheses (TISP) integrate natural teeth and implants for function restoration.
• Biomechanical performance of TISP is debated due to differing tooth and implant mobility.

Purpose of the Study:

• Evaluate long-term survival, success, and complication rates of TISP.
• Assess the impact of connector design, framework material, and patient factors on TISP outcomes.

Main Methods:

• Systematic literature search of major databases (PubMed, Scopus, Embase, Web of Science) up to July 2024.
• Inclusion of clinical studies with ≥12-month follow-up on fixed TISP.
• Data extraction and bias assessment by two independent reviewers, followed by random-effects meta-analysis.

Main Results:

• Pooled survival rate for TISP was 91.7% with low heterogeneity.
• Non-rigid connectors (NRCs) demonstrated fewer mechanical complications and slightly higher survival rates.
• Zirconia frameworks offered aesthetic advantages with survival comparable to metal-ceramic options; however, mechanical and biological complications remain frequent.

Conclusions:

• TISP represents a conservative and reliable long-term restorative option when extensive implant treatment is not viable.
• Non-rigid connectors and monolithic zirconia frameworks appear to enhance biomechanical performance.
• Further large-scale controlled trials are necessary to confirm these findings and improve TISP treatment protocols.