Tooth-to-Implant-Supported Fixed Partial Denture: A Comprehensive Overview of Systematic Reviews.

OBJECTIVES: Tooth-to-implant-connected prostheses have been described as a possible treatment option for patients with long-span edentulous situations that were not conducive for placement of an adequate number of supporting implants. In this comprehensive overview of systematic reviews, the incidence of complications and the long-term survival rates of tooth-to-implant-supported fixed partial dentures (FPDs) were evaluated to determine whether it is a viable treatment. MATERIALS AND METHODS: A systematic search of 5 electronic databases was conducted for systematic reviews and meta-analyses of tooth-to-implant-supported FPDs up to January 2017. The articles were AMSTAR rated for methodological quality, and low-quality articles were eliminated. RESULTS: The initial search yielded 369 reviews in PubMed, 248 in Web of Science, 49 in EMBASE, 63 in Cochrane Library, and 27 in Google Scholar. After removal of duplicates and after full-text analysis, 5 were selected for the overview. CONCLUSIONS: Within the limitations of this overview, it was concluded that (1) the 10-year survival rates for tooth-to-implant FPDs were lower than the 5-year survival rates, (2) the tooth-to-implant FPDs' survival was lower than the individual abutment tooth or implant supporting it, (3) the biological and technical complications were more at 10 years compared with 5 years, and (4) the intrusion of the abutment teeth was more in the nonrigid connection FPDs than the rigid connection FPDs. Therefore, tooth-to-implant FPDs are a viable option but should be considered secondary to other available options with higher long-term survival rates and lower complications.

A meta-analysis on the effect of implant characteristics on the survival of the wide-diameter implant.

The purposes of the study are to study the implant survival of the wide-diameter implant and to analyze if the length, the implant surface, or the placement location has any effect on its survival. Electronic databases were searched from inception to Dec 2014. Studies included in the review had implants placed in areas of adequate bone width and had clear inclusion and exclusion criteria for patient selection. Immediately placed and immediately loaded implants were excluded. A meta-analysis was done using the "random effects" model on the included studies. And, a meta-regression was used to evaluate the effects of location, length, and surface on the implant survival. Of the six studies selected, three evaluated surface-treated implants and three machined implants. The overall pooled survival rate of the wide implant is 96.3 %. The meta-regression showed that when using a wide implant, neither its surface nor its length nor its position in the maxilla or mandible adversely affected its survival (P > 0.05). This meta-analysis concluded that the location, length, and surface of the wide-diameter implant did not affect its survival and therefore suggested that when the conditions of the implant site corresponded to the inclusion criteria of our meta-analysis, choosing a wide-diameter implant in the posterior mandible or maxilla, where implant length may be limited by the nerve or the sinus, the use of a short implant regardless of its surface would not affect its survival.