Clinical outcomes of implant-supported monolithic zirconia crowns and fixed partial dentures: A systematic review

Purpose To determine the survival rates of implant-supported monolithic zirconia crowns and fixed partial dentures (FPD). Material and methods An electronic search for articles in the English language literature published from January 1, 2001 to September 17, 2021 was performed using PubMed, Scopus, and CENTRAL search engines. After applying predetermined inclusion and exclusion criteria, the definitive list of selected articles was used for calculating the interval survival rate (ISR) and cumulative survival rate (CSR). Restoration failure in this study was defined as the fracture or compromise of any part of the ceramic restoration that required the removal or remake of the implant-supported restoration. Results The electronic search resulted in 457 titles. The systematic application of inclusion and exclusion criteria resulted in 14 clinical studies that addressed the clinical outcomes of implant-supported monolithic zirconia crowns and fixed partial dentures. Of these, 3 were randomized controlled trials, 5 were prospective studies, and 6 were retrospective studies. Follow-up periods ranged from 1 to 5 years. Of the 644 implant-supported monolithic zirconia restorations computed in this systematic review, there was only 1 reported failure of the monolithic zirconia restorative material over a follow-up period of up to 5 years, for a cumulative survival rate of 99.84%. At the maximum follow-up interval of 5 years, the cumulative survival rate for monolithic zirconia single crowns was 100% and the cumulative survival rate for monolithic zirconia fixed partial dentures was 99.60%. Conclusions Implant-supported monolithic zirconia single crowns and fixed partial dentures have excellent short-term (<5 years) survival rates but the evidence for medium-term survival (>5 years) and beyond is lacking.