title: A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years.
abstract: OBJECTIVE
  The objective of this systematic review was to assess the 5- and 10-year survival of implant supported fixed partial dentures (FPDs) and to describe the incidence of biological and technical complications.
  
  
  METHODS
  An electronic MEDLINE search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on FPDs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data abstraction was performed independently by two reviewers. Failure and complication rates were analyzed using random-effects Poisson regression models to obtain summary estimates of 5- and 10-year survival proportions.
  
  
  RESULTS
  The search provided 3844 titles and 560 abstracts. Full-text analysis was performed for 176 articles resulting in 21 studies that met the inclusion criteria. Meta-analysis of these studies indicated an estimated survival of implants in implant-supported FPDs of 95.4% (95 percent confidence interval (95% CI): 93.9-96.5%) after 5 and 92.8% (95% CI: 90-94.8%) after 10 years. The survival rate of FPDs supported by implants was 95% (95% CI: 92.2-96.8%) after 5 and 86.7% (95% CI: 82.8-89.8%) after 10 years of function. Only 61.3% (95% CI: 55.3-66.8%) of the patients were free of any complications after 5 years. Peri-implantitis and soft tissue complications occurred in 8.6% (95% CI: 5.1-14.1%) of FPDs after 5 years. Technical complications included implant fractures, connection-related and suprastructure-related complications. The cumulative incidence of implant fractures after 5 years was 0.4% (95% CI: 0.1-1.2%). After 5 years, the cumulative incidence of connection-related complications (screw loosening or fracture) was 7.3% and 14% for suprastructure-related complications (veneer and framework fracture).
  
  
  CONCLUSIONS
  Despite a high survival of FPDs, biological and technical complications are frequent. This, in turn, means that substantial amounts of chair time have to be accepted by the clinician following the incorporation of implant-supported FPDs. More studies with follow-up times of 10 and more years are needed as only few studies have described the long-term outcomes.
authors.affiliation: School of Dental Medicine, University of Berne, Berne, Switzerland. bjarni.pjetursson@zmk.unibe.ch
authors.forename: Bjarni E
authors.initials: BE
authors.lastname: Pjetursson
authors.forename: Ken
authors.initials: K
authors.lastname: Tan
authors.forename: Niklaus P
authors.initials: NP
authors.lastname: Lang
authors.forename: Urs
authors.initials: U
authors.lastname: Brägger
authors.forename: Matthias
authors.initials: M
authors.lastname: Egger
authors.forename: Marcel
authors.initials: M
authors.lastname: Zwahlen
mesh_terms: D000465:Algorithms; D019094:Dental Prosthesis, Implant-Supported / Q000009:adverse effects / Q000706:statistics & numerical data*; D019232:Dental Restoration Failure; D003830:Denture, Partial, Fixed / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D016012:Poisson Distribution; D013997:Time Factors