ABSTRACT
PURPOSE: The aim of this systematic review with meta-analysis was to compare the survival rate of single crowns supported by extra-short implants (≤ 6 mm) to those supported by conventional implants, with or without previous maxillary sinus augmentation. The proportion of failures was described according to the type of complication and follow-up periods. MATERIALS AND METHODS: Randomized and prospective clinical trials were selected from six databases and gray literature. The risk of bias was evaluated by Joanna Briggs Institute Critical Appraisal Checklist, and the certainty of the evidence was analyzed with Grading of Recommendations Assessment, Development, and Evaluation. Meta-analyses were processed with RevMan and MedCalc Statistical Software. RESULTS: Single crowns supported by extra-short implants had a similar risk of failure to those supported by conventional implants, regardless of previous maxillary sinus augmentation (P > .05). Overall failure proportion of extra-short implants was 5.19%, but it varied according to follow-up (1.18% before loading, 1.56% at 12 months, 1.20% at 24 months, 2.10% at 48 months). Biologic failure complications were 37.90% for bleeding on probing, 22.45% for peri-implantitis, and 11.29% for infection. Prosthodontics failure complications were 14.88% for abutment failures and 14.73% for prosthetic screw loosening. Considering the risk of bias, most studies were classified at moderate risk. CONCLUSION: The risk of failure of single crowns supported by extra-short implants is similar to those supported by conventional implants, regardless of previous maxillary sinus augmentation or follow-up period. The most frequent biologic and prosthetic complications were bleeding on probing and abutment failures, respectively.
Subject(s)
Dental Implantation, Endosseous , Dental Implants , Crowns , Dental Implants/adverse effects , Dental Prosthesis Design , Dental Prosthesis, Implant-Supported , Dental Restoration Failure , Humans , Prospective StudiesABSTRACT
STATEMENT OF PROBLEM: Ceramic restorations are popular because of their excellent optical properties. However, failures are still a major concern, and dentists are confronted with the following question: is sleep bruxism (SB) associated with an increased frequency of ceramic restoration failures? PURPOSE: The purpose of this systematic review and meta-analysis was to assess whether the presence of SB is associated with increased ceramic restoration failure. MATERIAL AND METHODS: Observational studies and clinical trials that evaluated the short- and long-term survival rate of ceramic restorations in SB participants were selected. Sleep bruxism diagnostic criteria must have included at least 1 of the following: questionnaire, clinical evaluation, or polysomnography. Seven databases, in addition to 3 nonpeer-reviewed literature databases, were searched. The risk of bias was assessed by using the meta-analysis of statistics assessment and review instrument (MAStARI) checklist. RESULTS: Eight studies were included for qualitative synthesis, but only 5 for the meta-analysis. Three studies were categorized as moderate risk and 5 as high risk of bias. Clinical and methodological heterogeneity across studies were considered high. Increased hazard ratio (HR=7.74; 95% confidence interval [CI]=2.50 to 23.95) and odds ratio (OR=2.52; 95% CI=1.24 to 5.12) were observed considering only anterior ceramic veneers. Nevertheless, limited data from the meta-analysis and from the restricted number of included studies suggested that differences in the overall odds of failure concerning SB and other types of ceramic restorations did not favor or disfavor any association (OR=1.10; 95% CI=0.43 to 2.8). The overall quality of evidence was considered very low according to the GRADE criteria. CONCLUSIONS: Within the limitations of this systematic review, the overall result from the meta-analysis did not favor any association between SB and increased odds of failure for ceramic restorations.