The influence of age on tooth supported fixed prosthetic restoration longevity. A systematic review

Objective: The purpose of this study was to investigate the possible influence of age on the longevity of tooth supported fixed prosthetic restorations, using a systematic review process. Data sources: To identify relevant papers an electronic search was made using various databases (MEDLINE via Pubmed, EMBASE, The Cochrane Register of RCTs, the database of abstracts of Reviews of Effects-DARE), augmented by hand searching of key prosthodontic journals (International Journal of Prosthodontics, Journal of Prosthetic Dentistry and journal of Prosthodontics) and reference cross-check. Study selection: Assessment and selection of studies identified were conducted in a two phase procedure, by two independent reviewers utilizing specific inclusion and exclusion criteria. The minimum mean follow-up time was set at 5 years. Results: The initial database search yielded 513 relevant titles. After the subsequent filtering process, 22 articles were selected for full-text analysis, finally resulting in 11 studies that met the inclusion criteria. All studies were classified as category C according to the strength of evidence. Meta-analysis was not possible due to the non-uniformity of the data available. The final studies were presented with conflicting results. The majority of the final studies did not report a statistically significant effect of age on fixed prostheses survival, whilst only one study reported poorer prognosis for elderly patients, and two studies reported poorer prognosis for middle-aged patients. Conclusions: The results of this systematic review showed that increased age of patients should not be considered as a risk factor for the survival of fixed prostheses. Although the majority of studies did not show any effect of age on the survival of fixed prostheses, there was some evidence that middle-aged patients may present with higher failure rates. (c) 2009 Elsevier Ltd. All rights reserved.