Survival and complication rates of tooth-implant versus freestanding implant supporting fixed partial prosthesis: A systematic review and meta-analysis

Purpose: This systematic review was performed to compare tooth, implant and prosthesis failures and biological and technical complications in tooth-implant vs freestanding implant supported fixed partial prostheses, in order to evaluate the effectiveness and predictability in combining teeth and implants in the same fixed partial prosthesis. Study selection: A comprehensive and systematic literature research was conducted, according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, to identify human trials, with a minimum sample size of 10 patients, comparing tooth-implant to freestanding implant supported fixed partial prostheses. Four groups of meta-analyses were performed based on the patients treated with tooth-implant vs freestanding implantsupported fixed partial prostheses: abutment failures, biological and mechanical complications, prosthesis failures, and prosthetic (technical) complications. Results: The search yielded 749 records, after removal of duplicates. Based on the title assessment, the abstracts reading and the full-texts evaluation, 8 articles, published between 1999 and 2013, fulfilled the inclusion criteria and were included in the meta-analysis. The studies included were: 4 controlled clinical trials, 2 prospective and 2 retrospective cohort studies. The meta-analysis revealed no significant difference between tooth-implant and implant-implant supported fixed in the number of abutment (implant or tooth) failures, biological complications, prosthesis lost, and prosthetic complications. Conclusions: Within the limitations of the present systematic review, although the freestanding implant supported fixed partial prosthesis remains the first choice, joining teeth and implants to support fixed prosthesis in partially edentulous patients becomes a valid alternative with an acceptable success rate.