Implant-supported prostheses have considerable biomechanical advantages in partially edentulous patients when compared to other prosthetic options. Given the steady drop in the frequency of patients reporting with complete edentulism, it is not unusual to see situations where teeth and implants can be splinted to provide support for fixed prostheses. A tooth implant prosthesis differs majorly from an implant-supported prosthesis in terms of force dissipation and design. The aim of this systematic review was to compare the survival rates of tooth-implant-supported prostheses with fully implant-supported and fully tooth-supported prostheses. Using the appropriate search terms, PubMed, Google Scholar, and other indexed journals were used to search the English-language literature. According to the review protocols and the PICOS inclusion criteria, the pertinent studies were chosen. The screening of appropriate studies, evaluation of study quality, and data extraction were carried out independently by two reviewers. The pooling of survival data by prostheses failure, implant failure, and marginal bone loss was used in the meta-analysis. The cumulative data of all included studies indicated that tooth-implant-supported prostheses showed a 5-year survival rate of 77%-84% and a 10-year survival rate of 72%. The pooled risk ratio for prostheses failure and implant failure was 0.99 and 1.76, respectively. These results were not statistically significant (P > 0.05). The pooled standard mean difference for marginal bone loss was 0.59, and the results were statistically significant (P < 0.05). A tooth-implant-supported fixed partial denture (FPD) has a similar survival rate when compared to implant-supported FPD or T-FPD.

OBJECTIVE: This systematic review investigates the effectiveness of implant-supported fixed partial denture (IS-FPD) in patients with history of periodontitis (HP) vs. patients with no history of periodontitis (NHP).
METHODS: A literature search was performed on different databases on May 2020. Prospective and retrospective studies assessing survival (primary outcome), success and biological/mechanical complications of IS-FPDs in HP vs. NHP patients at ≥1 year after implant loading were evaluated. Meta-analyses were conducted by estimating hazard ratio (HR), risk ratio (RR) and standardized mean differences (SMD) with 95% confidence intervals (CI) using random effect models.
RESULTS: Of the initially identified 4096 articles, 349 underwent a full-text evaluation. Finally, 17 were included. Pooled data analyses showed that overall implant survival was significantly higher in the NHP than the HP group (HR = 2.06; 95% CI = 1.37-3.09; I2  = 0%). This difference was noted when follow-up ≥5 years. The risk of peri-implantitis was higher in HP than NHP patients (RR = 3.3; 95% CI = 1.31-8.3; I2  = 0%), whereas the mean marginal bone level change over time was not different between the groups (SMD = -0.16 mm; 95% CI = -1.04-0.73; I2  = 98%).
CONCLUSIONS: In partially edentulous patients receiving IS-FPDs, a history of periodontitis is associated with poorer survival rate and higher risk of peri-implantitis during a 5-10 years period after implant loading.

Although CAD/CAM ceramics present a promising alternative to metal-ceramic fixed dental prostheses, little is known about their mid- and long-term clinical performance. This systematic review aims to estimate the survival and success rates and describes the underlying complication characteristics for CAD/CAM tooth-supported zirconia- and lithium disilicate-based fixed dental prostheses (FDPs). We systematically searched MEDLINE and Web of Science to find relevant prospective studies with a follow-up of at least one year. We estimated pooled 1-, 5-, and 10-year survival and success rates by combining the collected data in a Poisson regression model. Descriptive statistics were conducted to evaluate the distribution of failures and complications in the included studies. Risk of bias for the included studies was assessed with an adapted checklist for single-arm trials. Pooled estimated 1-, 5-, and 10-year survival rates ranged from 93.80% to 94.66%, 89.67% to 91.1%, and 79.33% to 82.20%, respectively. The corresponding success rates excluding failures, but including any other types of intervention were 94.53% to 96.77%, 90.89% to 94.62%, and 81.78% to 89.25%. Secondary caries was the most frequent cause of failure, followed by chipping of the veneering. The most common cause of complication excluding failures but requiring intervention was chipping of the veneering. Risk of bias was generally acceptable for the included studies, with seven studies associated with low risk of bias, eight studies with a moderate risk of bias, and three studies with serious risk of bias. The current meta-analysis on CAD/CAM-supported FDPs revealed satisfying survival and success rates for up to 10 years of exposure. More prospective studies focusing on long-term performance are needed to strengthen the evidence currently available in the literature.

Three-dimensional (3D) printing technologies have been widely used to manufacture crowns and frameworks for fixed dental prostheses. This systematic review and meta-analysis aimed to assess the reliability of the marginal fit of 3D-printed cobalt-chromium-based fixed dental prostheses in comparison to conventional casting methods. Articles published until 25 June 2020, reporting the marginal fit of fixed prostheses fabricated with metal 3D printing, were searched using electronic literature databases. After the screening and quality assessment, 21 eligible peer-reviewed articles were selected. Meta-analysis revealed that the marginal gap of the prostheses manufactured using 3D printing was significantly smaller compared to that manufactured using casting methods (standard mean difference (95% CI): -0.92 (-1.45, -0.38); Z = -3.37; p = 0.0008). The estimated difference between the single and multi-unit types did not differ significantly (p = 0.3573). In the subgroup analysis for the measurement methods, the tendency of marginal discrepancy between the 3D printing and casting groups was significantly different between articles that used direct observation and those that used the silicone replica technique (p < 0.001). Metal 3D printing technologies appear reliable as an alternative to casting methods in terms of the fit of the fixed dental prostheses. In order to analyze the factors influencing manufacturing and confirm the results of this review, further controlled laboratory and clinical studies are required.

UNASSIGNED: The aim of this systematic review was to investigate the marginal adaptation of three or four unit fixed dental prosthesis (FDP) fabricated with digital impression techniques to those fabricated using any other impression technique.
UNASSIGNED: Database/electronic searches were conducted till August 2019 in PUBMED-MEDLINE, SCOPUS, and Cochrane library. To identify published articles, multiple keywords were used to develop a search strategy in various combinations. Manual searching of articles was also done. Clinicaltrials.gov.in WHOICTRP and CTRI websites were also searched. Two independent reviewers (TP and VK) assessed eligibility for inclusion, extracted data, and assessed quality using the Cochrane risk of bias tool.
UNASSIGNED: Database search identified 497 citations and four citations through manual search. After removing duplicates and going through abstracts, 23 articles were perused for full-text screening. Two articles met the inclusion criteria; characteristics were described qualitatively, with two studies having overall low risk of bias.
UNASSIGNED: Marginal adaptation of FDPs fabricated using the digital and conventional impressions method was within the clinically acceptable limits. However, more robust clinical trials need to be conducted with large sample size to validate the conclusions.

Purpose: To compare the fit and assess the accuracy of tooth-supported single and multi-unit FDPs in cobalt chromium fabricated using different manufacturing techniques. Materials and methods: A systematic search was performed in three databases; PubMed, Scopus, and Web of Science, using clearly specified search terms and inclusion criteria. The search yielded 1071 articles and included 18 articles in the analysis. Data regarding the fit analyses and the methods of manufacturing were extracted and the accuracy was defined as the fit result minus the pre-set cement spacer. Internal gap (IntG) was the mean of all the internal measuring points and total gap (TotG) was the mean of all measuring points (marginal, cervical, chamfer, axial, occlusal). Results: The total gap results for fit and accuracy irrespective of manufacturing technique were 96 μm and 54 μm for single crowns, 107 μm and 54 μm for multi-unit FDPs, and 98 μm and 54 μm for both single crowns and multi-unit FDPs combined. For total gap of single crowns soft milling had the highest accuracy, for multi-unit FDPs additive manufactured restorations had the highest accuracy. With the results grouped by impression technique, the accuracy for total gap was highest for digital impressions and lower for conventional impressions. Conclusions: Due to the inherent limitations of this systematic review, it still remains unclear what effect the manufacturing technique has on the fit of FDPs. However, the descriptive results suggest that the marginal fit of cobalt chromium FDPs is not negatively affected by the manufacturing technique.

OBJECTIVE: To evaluate the biological and mechanical complications of angulated abutments on full-arch and partial jaw rehabilitations with a follow-up for at least 1 year.
METHODS: Electronic search was carried out in MEDLINE, EMBASE and Web of Science. Studies published between January 2000 and January 2019 were included. The quality of the included studies was assessed. The data extraction was focused on implant loss, marginal bone loss and mechanical complications, and meta-analyses were performed for marginal bone loss, mechanical complications and implant failure.
RESULTS: Nine studies, three prospective and six retrospective cohort studies were included. They reported on 797 patients that received 4127 implants. The total number of abutments was 4079 of which 1673 were angulated, and 2406 were straight. All abutments were prefabricated. Angulated abutments were associated with increased implant failure rates (two studies; RR = 7.30; 95% CI = 2.79-19.08) and an effect that was both statistically significant (P < .001) and clinically relevant. Three studies reported differentiated data for mechanical and technical complications at 1 year of follow-up, being mostly related to the retention screw while screw fracture. Angulated abutments were associated with a statistically significant increase in MBL 1 year after insertion compared to straight abutments (three studies; MD = 0.08 mm; 95% CI = 0.01-0.14 mm; P = .02), which might be, however, clinically negligible.
CONCLUSIONS: The prosthetic complications such as screw loosening and abutment loosening were frequent. After 1 year of follow-up, implants supporting angulated abutments yielded significantly more marginal bone loss than those supporting straight abutments.

Various materials have been used over time in prosthetic dentistry. However, due to the evolution of science and knowledge, new materials are being brought to the forefront. Polyether ether ketone (PEEK) is a polymer with many potential applications in dentistry. The use of PEEK has become increasingly more common in dental practice; its favorable properties have made it a compelling alternative biomaterial in restorative dentistry. The current trend is moving towards the use of metal-free restorations and biomaterials which exhibit advanced properties in the complex oral environment. This review paper presents and summarizes clinical applications of PEEK in contemporary dentistry.

OBJECTIVE: To evaluate the implant failure, marginal bone loss (MBL), and other biological or technical complications of restorations supported by tilted and straight implants after at least 3 years in function.
METHODS: Electronic and manual searches were performed in MEDLINE, Embase, Web of Science, and OpenGrey to identify clinical studies published up to December 2017. After duplicate study selection and data extraction, the risk of bias was assessed with the ROBINS-I tool. Random-effects meta-analyses of relative risks (RRs) or mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by subgroup/sensitivity analyses and application of the GRADE approach.
RESULTS: A total of 17 nonrandomized studies (eight prospective/nine retrospective) were included. The number of implants of the overall systematic review was 7,568 implants placed in 1,849 patients supporting either full-arch or partial implant prostheses. No difference in the failure of tilted and straight implants was seen (eight studies; 4,436 implants; RR = 0.95; 95% CI = 0.70 to 1.28; p = 0.74), with the quality of evidence being very low due to bias and imprecision. Likewise, no difference in MBL was seen between tilted and straight implants (16 studies; 5,293 implants; MD = 0.03 mm; 95% CI = -0.03 to 0.10 mm; p = 0.32), with the quality of evidence being very low due to bias and inconsistency. Contradictory results regarding implant survival were found from prospective and retrospective studies, which could indicate bias from the latter.
CONCLUSIONS: Within the limitations of the present systematic review, no effect of implant inclination on implant survival or peri-implant bone loss was found.

OBJECTIVE: The purpose of this study was to methodically review the literature concerning the success and survival rates of zirconia fixed dental prostheses (FDPs).
METHODS: A systematic search was conducted of MEDLINE, Elsevier and the Cochrane Library to identify relevant articles about zirconia FDPs. In order to obtain suitable articles, rigorous criteria were applied. The minimum follow-up period was five years.
RESULTS: From a total of 986 articles identified in the first electronic search, only 10 matched the inclusion criteria. A total of 368 patients with 430 zirconia FDPs were included in this systematic review. The survival rate was 89.43% ± 10.01% and chipping of the veneering ceramic occurred in 16.97% of the cases.
CONCLUSIONS: Zirconia-based fixed dental prostheses perform reasonably well and can serve as an alternative to metal-ceramic fixed dental prostheses.