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    2012 Implant-Supported Single Crowns Predictably

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    2012 Implant-Supported Single Crowns Predictably

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    2012 Implant-Supported Single Crowns Predictably

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    Previously Published

    Review analysis & evaluation

    Implant-Supported Single Crowns Predictably


    Survive to Five Years with Limited Complications

    SUMMARY
    Article Title and
    Bibliographic Information Selection Criteria
    A systematic review of the 5-year
    survival and complication rates of An electronic MEDLINE search was conducted to identify cohort studies, prospec-
    implant-supported single crowns. Jung tive or retrospective, describing clinical performance of implant-supported single
    RE, Pjetursson BE, Glauser R, Zembic A, crowns. Manual searches of bibliographies from full-text articles and related re-
    Zwahlen M, Lnag NP.
    Clin Oral Implants Res 2008;19(2):119-30. views were conducted using numerous scientific journals. Studies were included
    if the mean follow-up time was at least 5 years, if articles were published in the
    Reviewer English or German language, if pa­tients were physically examined, and if study de-
    Thomas Salinas, DDS,
    Steven Eckert, DDS, MS tails were sufficient for data extraction. Of the initial 3601 studies identified, only
    26 were selected. No randomized control trials were identified.
    Purpose/Question
    The purpose of this study was to Key Study Factor
    evaluate the 5-year survival of implant-
    supported crowns and to identify the The 5-year survival and complications of implant-supported single crowns.
    incidence of biologic and mechanical
    complications. Main Outcome Measures
    Source of Funding The primary outcome measure in this study was survival of endosseous implants
    Information not available. when used to support single crowns. In addition, the clinical per­formance of soft tis-
    Type of Study Design
    sue (peri-implantitis) and hard tissue (bone level) was documented. Clinical compli-
    Systematic review with metaanalysis cations of a biomechanical nature were re­corded relative to fracture of restorative
    of data. materials. Poisson’s regression models were used to estimate failure and complica-
    Level of Evidence
    tion rates at 5 years.
    Limited-quality, patient-
    level 2
    oriented evidence
    Main results
    A systematic review of the scientific literature identified 26 studies from which
    Strength of
    Recommendation Grade
    data were extracted (1558 placed implants). Meta-analysis identified survival of im-
    plants used to support and retain single crowns at 96.8% (95% confidence interval
    B Limited quality patient oriented [CI]: 95.9%-97.6% after 5 years). The survival rate of the single crown restorations
    evidence
    documented in 13 studies was 94.5% (95% 92.5%-95.9%) with a significantly higher
    survival rate when metal ce­ramic crowns were used in comparison with all ceramic
    Reviewer:Thomas Salinas, DDS,
    Associate Professor in Dentistry, College of crowns (95.4% 93.6%-96.7%; 91.2% CI: 86.8%-94.2%). Soft tissue complications, in­
    Medicine, Mayo Clinic cluding peri-implantitis, were observed in 9.7% of the single crowns, whereas bone
    Rochester, MN 55905
    E-mail: Salinas.thomas@mayo.edu
    loss exceeding 2 mm was identified on 6.3% of the implants over the 5-year study.
    Reviewer: Steven Eckert, DDS, MS, Prosthetic or abutment screw loosening was observed in 12.7% of the restoration
    Professor in Dentistry, College of Medicine, and screw fracture occurred in 0.35%. Although only 7 of the 26 studies reported
    Mayo Clinic
    Rochester, MN 55905 esthetic complications, the cumulative effects of esthetic complications approached
    E-mail: seeckert@mayo.edu 9% at 5 years.
    Originally Published in:
    J Evid Base Dent Pract 2010;10:56-57
    1532-3382/$36.00 Conclusions
    © 2010 Elsevier Inc. All rights reserved. From the presented data it may be concluded that 5-year survival of im­plant-
    doi: 10.1016/j.jebdp.2009.11.017
    supported single crowns is high, although biologic and mechanical complications
    are anticipated.

    213 September 2012


    Journal of evidence-based dental practice Special Issue—Periodontal and Implant Treatment

    COMMENTARY AND ANALYSIS differentiated between complications and maintenance, the


    Theresearchers in this systematic review provideda careful reader’s impression of the results could differ from those ex-
    analysis demonstrating mean survival of 5 years.1 Overall pressed by the au­thors. This method of identifying all events
    implant survival of 96.8% was seen in 26 studies, whereas as complica­tions has been used previously.2 Reference to
    the 13 studies that differentiated survival of single im­plant- ceramic chipping on all-ceramic restorations was described
    supported crowns demonstrated a mean survival of 94.5%. as occurring rarely, whereas others have identified this as a
    The included articles were representative of cohort studies more common event when implant-supported restora­tions
    and included individuals aged 13 to 94 years with a total of are in direct opposition.3
    1558 implants placed. Although the overall im­plant survival Overall the survival of implants used to support single-crown
    rate was high, greater than 96% complica­tions were observed. restorations is high but the clinician must under­stand that
    Material fracture, a biomechanical and technical failure, was mechanical and biologic complications are observed and
    significantly more common with all-ceramic restorations than maintenance issues are anticipated.
    with metal-ceramic res­torations. Soft tissue inflammation, de-
    scribed as peri-im­plantitis, was the most common adverse
    biologic event, whereas bone loss of greater than 2 mm oc- REFERENCES
    curred less frequently. 1. Jung RE, Pjetursson BE, Glauser R, Zembic A, Zwahlen M, Lang NP. A
    systematic review of the 5-year survival and complication rates of im-
    Management of the mechanical and biologic complica­tions plant-supported single crowns. Clin Oral Implants Res 2008;19:119-30.
    was not discussed in detail. The authors describe complica- 2. Pjetursson BE, Bragger U, Lang NP, Zwahlen M. Comparison of sur­vival
    tions in a broad sense, appearing to pool data from all types and complication rates of tooth-supported fixed dental prosthe­ses
    of complications, whereas some may differ­entiate the study (FDPs) and implant-supported FDPs and single crowns (SCs) [Erratum
    appears in Clin Oral Implants Res 2008;19(3):326–8.]. Clin Oral Im-
    concerns into ‘‘complications’’ or ‘‘main­tenance’’ issues. When
    plants Res 2007;18(Suppl 3):97-113.
    clinicians use provisional cement or screw retention to al-
    low retrieval of a prosthesis, it is ev­ident that these materials 3. Kinsel RP, Lin D. Retrospective analysis of porcelain failures of metal ce-
    ramic crowns and fixed partial dentures supported by 729 implants in
    will loosen over time. When this occurs, simple maintenance 152 patients: patient-specific and implant-specific predictors of ceramic
    procedures will compensate for the event. Had the authors failure. J Prosthet Dent 2009;101:388-94.

    Volume 12, Supplement 1 214

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