Meng-Long Hu1, Hong Lin2, You-Dong Zhang1, Jian-Min Han3. 1. Graduate student, Dental Medical Devices Testing Center, Dental Materials Laboratory, Peking University School and Hospital of Stomatology, Peking University, Beijing, PR China. 2. Research fellow, Dental Medical Devices Testing Center, Dental Materials Laboratory, Peking University School and Hospital of Stomatology, Peking University, Beijing, PR China. 3. Associate research fellow, Dental Medical Devices Testing Center, Dental Materials Laboratory, Peking University School and Hospital of Stomatology, Peking University, Beijing, PR China. Electronic address: dentalhan@126.com.
Abstract
STATEMENT OF PROBLEM: Differences between ceramic and metal-ceramic implant-supported fixed dental prostheses are unclear. PURPOSE: The purpose of this systematic review and meta-analysis was to compare the technical, biological, and esthetic complication rates of implant-supported ceramic and metal-ceramic restorations. MATERIAL AND METHODS: Six databases were searched to identify randomized controlled clinical trials (RCTs) and prospective and retrospective cohort studies of implant-supported fixed dental prostheses. The survival rate, marginal adaptation, marginal bone loss, pocket probing depth, crown color match, and mucosal discoloration of ceramic and metal-ceramic single crowns were assessed. For implant-supported fixed partial dental prostheses (FPDPs), only the survival rate was assessed. The risk of bias was assessed for individual studies and across studies by using the Cochrane guidelines, Newcastle-Ottawa scale, and funnel plots. RESULTS: Twenty studies were included in this meta-analysis. Ceramic and metal-ceramic implant-supported single crowns were compared in terms of the survival rate (OR=0.84 [0.32, 2.23], P=.730), marginal adaptation (mean difference [MD]=0.33 [0.19, 0.47], P<.001), marginal bone loss (MD=-0.03 [-0.07, 0.02], P=.260), pocket probing depth (MD=-0.07 [-0.14, 0.00], P=.060), crown color match (MD=-0.15 [-0.29, 0.00], P=.040), and mucosal discoloration (standardized mean difference [SMD]=-0.14 [-0.86, 0.58], P=.710). The survival rate of ceramic and metal-ceramic implant-supported FPDPs was also compared (odds ratio [OR]=1.92 [1.26, 2.94], P=.003). CONCLUSIONS: No significant difference was observed between ceramic and metal-ceramic implant-supported single crowns in terms of the survival rate, marginal bone loss, pocket probing depth, or mucosal discoloration. However, metal-ceramic single crowns had better marginal adaptation and poorer crown color match than did ceramic single crowns. In addition, current evidence indicates that metal-ceramic implant-supported FPDPs might have a higher survival rate than ceramic FPDPs.
STATEMENT OF PROBLEM: Differences between ceramic and metal-ceramic implant-supported fixed dental prostheses are unclear. PURPOSE: The purpose of this systematic review and meta-analysis was to compare the technical, biological, and esthetic complication rates of implant-supported ceramic and metal-ceramic restorations. MATERIAL AND METHODS: Six databases were searched to identify randomized controlled clinical trials (RCTs) and prospective and retrospective cohort studies of implant-supported fixed dental prostheses. The survival rate, marginal adaptation, marginal bone loss, pocket probing depth, crown color match, and mucosal discoloration of ceramic and metal-ceramic single crowns were assessed. For implant-supported fixed partial dental prostheses (FPDPs), only the survival rate was assessed. The risk of bias was assessed for individual studies and across studies by using the Cochrane guidelines, Newcastle-Ottawa scale, and funnel plots. RESULTS: Twenty studies were included in this meta-analysis. Ceramic and metal-ceramic implant-supported single crowns were compared in terms of the survival rate (OR=0.84 [0.32, 2.23], P=.730), marginal adaptation (mean difference [MD]=0.33 [0.19, 0.47], P<.001), marginal bone loss (MD=-0.03 [-0.07, 0.02], P=.260), pocket probing depth (MD=-0.07 [-0.14, 0.00], P=.060), crown color match (MD=-0.15 [-0.29, 0.00], P=.040), and mucosal discoloration (standardized mean difference [SMD]=-0.14 [-0.86, 0.58], P=.710). The survival rate of ceramic and metal-ceramic implant-supported FPDPs was also compared (odds ratio [OR]=1.92 [1.26, 2.94], P=.003). CONCLUSIONS: No significant difference was observed between ceramic and metal-ceramic implant-supported single crowns in terms of the survival rate, marginal bone loss, pocket probing depth, or mucosal discoloration. However, metal-ceramic single crowns had better marginal adaptation and poorer crown color match than did ceramic single crowns. In addition, current evidence indicates that metal-ceramic implant-supported FPDPs might have a higher survival rate than ceramic FPDPs.