A systematic review of the survival and complication rates of implant supported fixed dental prostheses with cantilever extensions after an observation period of at least 5 years

Abstract

AbstractObjective: The aim of this systematic review was to assess the survival rates of short‐span implant‐supported cantilever fixed dental prostheses (ICFDPs) and the incidence of technical and biological complications after an observation period of at least 5 years.Material and methods: An electronic MEDLINE search supplemented by manual searching was conducted to identify prospective or retrospective cohort studies reporting data of at least 5 years on ICFDPs. Five‐ and 10‐year estimates for failure and complication rates were calculated using standard or random‐effect Poisson regression analysis.Results: The five studies eligible for the meta‐analysis yielded an estimated 5‐ and 10‐year ICFDP cumulative survival rate of 94.3% [95 percent confidence interval (95% CI): 84.1–98%] and 88.9% (95% CI: 70.8–96.1%), respectively. Five‐year estimates for peri‐implantitis were 5.4% (95% CI: 2–14.2%) and 9.4% (95% CI: 3.3–25.4%) at implant and prosthesis levels, respectively. Veneer fracture (5‐year estimate: 10.3%; 95% CI: 3.9–26.6%) and screw loosening (5‐year estimate: 8.2%; 95% CI: 3.9–17%) represented the most common complications, followed by loss of retention (5‐year estimate: 5.7%; 95% CI: 1.9–16.5%) and abutment/screw fracture (5‐year estimate: 2.1%; 95% CI: 0.9–5.1%). Implant fracture was rare (5‐year estimate: 1.3%; 95% CI: 0.2–8.3%); no framework fracture was reported. Radiographic bone level changes did not yield statistically significant differences either at the prosthesis or at the implant levels when comparing ICFDPs with short‐span implant‐supported end‐abutment fixed dental prostheses.Conclusions: ICFDPs represent a valid treatment modality; no detrimental effects can be expected on bone levels due to the presence of a cantilever extension per se.