Survival and Complication Rates of Tooth-Supported Veneered Zirconia Fixed Partial Dentures: A Systematic Review and Metaanalysis
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Published on: December 20, 2024
Arul Kumar Sengottaiyan1, Vincent Bennani1, Arthi Veerasamy1
1Department of Oral Rehabilitation Faculty of Dentistry University of Otago Dunedin New Zealand otago.ac.nz.
Statement Of Problem:
The long-term survival and complication rates of tooth-supported veneered zirconia fixed partial dentures (FPDs) remain unclear due to heterogeneous and fragmented clinical evidence. Therefore, a systematic review and metaanalysis were conducted to synthesize the available clinical data.
Purpose:
The purpose of this systematic review and metaanalysis was to evaluate the survival rates and the incidence of technical and biological complications associated with tooth-supported veneered zirconia FPDs.
Materials And Methods:
Electronic searches were conducted in MEDLINE/Embase, PubMed, Scopus, Web of Science, and Google Scholar databases up to August 2026 according to preferred reporting Items for systematic reviews and metaanalyses (PRISMA) guidelines. Clinical studies evaluating tooth-supported veneered zirconia FPDs with a minimum follow-up of 5 years were included. Randomized clinical trials and prospective or retrospective observational studies reporting survival or complication outcomes were considered. Risk of bias was assessed using the ROBINS-I tool for cohort studies and the Joanna Briggs Institute (JBI) case series checklist for single-arm studies. Metaanalysis was performed using R software (ggplot and meta package) with a random-effects model.
Results:
The database search identified 2220 records. After removal of 1815 duplicates, 405 records were screened by title and abstract. A total of 180 full-text articles were assessed for eligibility, and 17 studies met the inclusion criteria and were included in the quantitative synthesis. The pooled survival rate for veneered zirconia was 92% (95% CI: 90%-94%) at 5 years, 86% (95% CI: 81%-89%) at 7 years, and 83% (95% CI: 71%-91%) at 10 years. Veneered zirconia prostheses demonstrated higher technical complications, particularly veneering porcelain chipping.
Conclusion:
Tooth-supported veneered zirconia fixed dental prostheses demonstrated acceptable survival rates over 5-13 years, with most studies reporting survival above 85%. The most frequent complications were chipping of the veneering porcelain.
Clinical Implication:
Understanding the survival and complication patterns of tooth-supported veneered zirconia FPDs provides valuable insights for clinicians in selecting suitable restorative materials and prosthesis designs.