title: Short-term complications of implant-supported and combined tooth-implant-supported fixed dental prostheses.
abstract: OBJECTIVE
  The objective of this clinical study was to evaluate survival and incidence of complications for metal-ceramic and all-ceramic implant-supported fixed dental prostheses (FDPs) and tooth-implant-supported FDPs.
  
  
  METHODS
  One-hundred and sixty-six FDPs placed in 132 patients from a prospective study were selected for this retrospective analysis. Included were 91 conventional implant-supported FDPs with implant support on both extremities, 27 implant-supported cantilever FDPs, and 48 tooth-implant-supported FDPs. All restorations were veneered with ceramic. Twenty-six FDPs had a zirconia framework and 140 had a metal framework. Kaplan-Meier analysis was performed to estimate FDP success defined as complication-free survival and the Cox regression model was used to isolate risk factors for the most frequent complications.
  
  
  RESULTS
  Within a median follow-up of 1 year and 2 months, three failures were caused by a failed implant (n = 2) and by extended chipping of the veneer (n = 1). In contrast with this low incidence of failure was a high incidence of complications including chipping (n = 29), loss of retention (n = 35), and abutment fractures (n = 2). Multivariate survival analysis revealed a significantly greater incidence of chipping for males and a tendency to increased incidence of chipping for zirconia-based FDPs. The incidence of loss of retention tended to be less for tooth-implant-supported FDPs, for which semi-permanent cement was the only significant risk factor, with a hazard ratio of almost 5.
  
  
  CONCLUSIONS
  As chipping of the ceramic veneer was the most frequent complication leading to substantial aftercare, improvements of ceramic veneers are desirable for zirconia-based and metal-based FDPs.
authors.affiliation: Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. peter_rammelsberg@med.uni-heidelberg.de
authors.forename: Peter
authors.initials: P
authors.lastname: Rammelsberg
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schwarz
authors.forename: Christin
authors.initials: C
authors.lastname: Schroeder
authors.forename: Justo L
authors.initials: JL
authors.lastname: Bermejo
authors.forename: Olaf
authors.initials: O
authors.lastname: Gabbert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002516:Ceramics / Q000737:chemistry; D003738:Dental Cements / Q000737:chemistry; D015921:Dental Implants / Q000009:adverse effects*; D003764:Dental Materials / Q000737:chemistry; D019094:Dental Prosthesis, Implant-Supported / Q000009:adverse effects*; D019232:Dental Restoration Failure / Q000706:statistics & numerical data; D003801:Dental Veneers; D003779:Denture Design; D003781:Denture Retention / Q000706:statistics & numerical data; D003830:Denture, Partial, Fixed / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016876:Metal Ceramic Alloys / Q000737:chemistry; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D013499:Surface Properties; D016019:Survival Analysis; D014070:Tooth / Q000502:physiology*; D055815:Young Adult; D015040:Zirconium / Q000737:chemistry
chemical_list: D003738:Dental Cements; D015921:Dental Implants; D003764:Dental Materials; D016876:Metal Ceramic Alloys; D015040:Zirconium; C028541:zirconium oxide