Duygu Karasan

Objective The objectives of the study were to assess the survival, failure, and technical complication rates of implant‐supported fixed dental prosthesis (iFDPs) with pontic or splinted crown (iS p C) designs in the posterior area and compare the influence of prosthetic materials and prosthetic design on the outcomes. Methods Electronic and manual searches were performed to identify randomized‐, prospective‐, and retrospective clinical trials with follow‐up time of ≥12 months, evaluating the clinical outcomes of posterior iFDPs with pontic or iS p Cs. Survival and complication rates were analyzed using robust Poisson's regression models. Results Thirty‐two studies reporting on 42 study arms were included in the present systematic review. The meta‐analysis of the included studies indicated estimated 3‐year survival rates of 98.3% (95%CI: 95.6–99.3%) for porcelain‐fused‐to‐metal (PFM) iFDPs, 97.5% (95%CI: 95.5–98.7%) for veneered zirconia (Zr) iFDPs with pontic, 98.9% (95%CI: 96.8–99.6%) for monolithic or micro‐veneered zirconia iFDPs with pontic, and 97.0% (95%CI: 84.8–99.9%) for lithium disilicate iFDPs with pontics. The survival rates for different material combination showed no statistically significant differences. Veneered restorations, overall, showed significantly ( p < .01) higher ceramic fracture and chipping rates compared with monolithic restorations. Furthermore, there was no significant difference in survival rates (98.3% [95%CI: 95.6–99.3%] vs. 99.1% [95%CI: 97.6–99.7%]) and overall complication rates between PFM iFDPs with pontic and PFM iS p Cs. Conclusions Based on the data identified by this systematic review, PFM, veneered Zr, and monolithic Zr iFDPs with pontic and iS p Cs showed similarly high short‐term survival rates in the posterior area. Veneered restorations exhibit ceramic chipping more often than monolithic restorations, with the highest fracture rate reported for veneered Zr iFDPs.

Objectives To evaluate the association between different vertical levels of the abutment margin and residual cement prevalence in cement‐retained implant restorations with customized abutments. Methods One hundred and nine single‐unit cement‐retained implant restorations with a screw‐access channel were included. The crowns were intraorally cemented on the abutments, and excess cement was removed. The abutment–crown complex was unscrewed, and the abutment–crown complex and peri‐implant tissue were photographed. Residual cement presence was recorded by dividing the abutment–crown complex and peri‐implant tissue into four quadrants: mesial, distal, buccal, and lingual. The prevalence of residual cement was compared according to the height of the custom abutment margin of the corresponding quadrant. A multilevel model was used for statistical analysis ( α = .05). Results Cement remnants were discovered on 72.48% of the dental implants. When the restoration quadrants were compared, cement remnants were present on 51.38%, 39.45%, 20.18%, and 17.43% of the mesial, distal, buccal, and lingual surfaces, respectively ( p < .01). Regarding the abutment margin level, cement residues were found in 60.22% and 61.4% of the 0.5 mm subgingival and ≥1 mm subgingival margin groups, respectively, which were significantly more than those in the supragingival (23.65%) and equigingival (26.59%) margin groups ( p < .01). After adjustment for confounding factors, the adjusted odds ratio (with 95% confidence interval) for residual cement in the subgingival margin groups was 3.664 (1.71, 7.852) when compared to the supragingival and equigingival margin groups. Conclusions The risk of residual cement occurrence was 3.66‐fold higher with a subgingival abutment margin than with supragingival and equigingival abutment margins.