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Survival and complication rates of implant‐supported fixed partial dentures with cantilevers: a systematic review

2009; Wiley; Volume: 20; Issue: s4 Linguagem: Inglês

10.1111/j.1600-0501.2009.01773.x

1600-0501

José Javier Marín Zurdo, Cristina Romão, Jan L. Wennström,

Orthopaedic implants and arthroplasty

Abstract Objective: The objective of the present systematic review was to analyze the potential effect of incorporation of cantilever extensions on the survival rate of implant‐supported fixed partial dental prostheses (FPDPs) and the incidence of technical and biological complications, as reported in longitudinal studies with at least 5 years of follow‐up. Methods: A MEDLINE search was conducted up to and including November 2008 for longitudinal studies with a mean follow‐up period of at least 5 years. Two reviewers performed screening and data abstraction independently. Prosthesis‐based data on survival/failure rate, technical complications (prosthesis‐related problems, implant loss) and biological complications (marginal bone loss) were analyzed. Results: The search provided 103 titles with abstract. Full‐text analysis was performed of 12 articles, out of which three were finally included. Two of the studies had a prospective or retrospective case–control design, whereas the third was a prospective cohort study. The 5‐year survival rate of cantilever FPDPs varied between 89.9% and 92.7% (weighted mean 91.9%), with implant fracture as the main cause for failures. The corresponding survival rate for FPDPs without cantilever extensions was 96.3–96.2% (weighted mean 95.8%). Technical complications related to the supra‐constructions in the three included studies were reported to occur at a frequency of 13–26% (weighted mean 20.3%) for cantilever FPDPs compared with 0–12% (9.7%) for non‐cantilever FPDPs. The most common complications were minor porcelain fractures and bridge‐screw loosening. For cantilever FPDPs, the 5‐year event‐free survival rate varied between 66.7% and 79.2% (weighted mean 71.7%) and between 83.1% and 96.3% (weighted mean 85.9%) for non‐cantilever FPDPs. No statistically significant differences were reported with regard to peri‐implant bone‐level change between the two prosthetic groups, either at the prosthesis or at the implant level. Conclusion: Data on implant‐supported FPDPs with cantilever extensions are limited and therefore survival and complication rates should be interpreted with caution. The incorporation of cantilevers into implant‐borne prostheses may be associated with a higher incidence of minor technical complications.