title: A systematic review of the survival and complication rates of implant supported fixed dental prostheses with cantilever extensions after an observation period of at least 5 years.
abstract: OBJECTIVE
  The aim of this systematic review was to assess the survival rates of short-span implant-supported cantilever fixed dental prostheses (ICFDPs) and the incidence of technical and biological complications after an observation period of at least 5 years.
  
  
  METHODS
  An electronic MEDLINE search supplemented by manual searching was conducted to identify prospective or retrospective cohort studies reporting data of at least 5 years on ICFDPs. Five- and 10-year estimates for failure and complication rates were calculated using standard or random-effect Poisson regression analysis.
  
  
  RESULTS
  The five studies eligible for the meta-analysis yielded an estimated 5- and 10-year ICFDP cumulative survival rate of 94.3% [95 percent confidence interval (95% CI): 84.1-98%] and 88.9% (95% CI: 70.8-96.1%), respectively. Five-year estimates for peri-implantitis were 5.4% (95% CI: 2-14.2%) and 9.4% (95% CI: 3.3-25.4%) at implant and prosthesis levels, respectively. Veneer fracture (5-year estimate: 10.3%; 95% CI: 3.9-26.6%) and screw loosening (5-year estimate: 8.2%; 95% CI: 3.9-17%) represented the most common complications, followed by loss of retention (5-year estimate: 5.7%; 95% CI: 1.9-16.5%) and abutment/screw fracture (5-year estimate: 2.1%; 95% CI: 0.9-5.1%). Implant fracture was rare (5-year estimate: 1.3%; 95% CI: 0.2-8.3%); no framework fracture was reported. Radiographic bone level changes did not yield statistically significant differences either at the prosthesis or at the implant levels when comparing ICFDPs with short-span implant-supported end-abutment fixed dental prostheses.
  
  
  CONCLUSIONS
  ICFDPs represent a valid treatment modality; no detrimental effects can be expected on bone levels due to the presence of a cantilever extension per se.
authors.affiliation: University of Bern, School of Dental Medicine, Bern CH-3010, Switzerland.
authors.forename: Marco
authors.initials: M
authors.lastname: Aglietta
authors.forename: Vincenzo Iorio
authors.initials: VI
authors.lastname: Siciliano
authors.forename: Marcel
authors.initials: M
authors.lastname: Zwahlen
authors.forename: Urs
authors.initials: U
authors.lastname: Brägger
authors.forename: Bjarni E
authors.initials: BE
authors.lastname: Pjetursson
authors.forename: Niklaus P
authors.initials: NP
authors.lastname: Lang
authors.forename: Giovanni E
authors.initials: GE
authors.lastname: Salvi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003758:Dental Implantation, Endosseous / Q000009:adverse effects; D015921:Dental Implants / Q000009:adverse effects*; D019094:Dental Prosthesis, Implant-Supported / Q000009:adverse effects; D003779:Denture Design; D003781:Denture Retention / Q000295:instrumentation*; D003830:Denture, Partial, Fixed / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult
chemical_list: D015921:Dental Implants