title: Clinical performance of anterior resin-bonded fixed dental prostheses with different framework designs: A systematic review and meta-analysis.
abstract: OBJECTIVE
  To systematically review the failure rate and complications of different framework designs of resin-bonded fixed dental prostheses (RBFDPs) in the anterior region.
  
  
  METHODS
  A systematic search for clinical studies on RBFDPs published prior to December 2014 in Medline/PubMed, EMBASE, and Cochrane Library databases was conducted and complemented by a manual search. Randomized controlled trials (RCTs) as well as prospective and retrospective cohort studies that compared at least two RBFDP framework designs with a minimum of 2 years follow up were included in this review. The quality of the included studies were assessed using the Newcastle-Ottawa scale for cohort studies and Cochrane Handbook for RCT. Prostheses-based data on reported failure rate/survival rate, debonding, and fractures were analyzed by meta-analysis.
  
  
  RESULTS
  Of 1010 screened articles, one RCT and 4 cohort studies fit the inclusion criteria and were included in the meta-analysis. All included articles have a high risk of bias. Failure rates of single-retainer cantilever RBFDPs were lower than two-retainer fixed-fixed RBFDPs (OR 0.42, 95% CI 0.19-0.94, P=0.04). Metal-ceramic RBFDPs showed no difference of failure rates between cantilever RBFDPs and two-retainer fixed-fixed RBFDPs (OR 0.93, 95% CI 0.33-2.63, P=0.89). Debonding was not significantly different between cantilever RBFDPs and two-retainer fixed-fixed RBFDPs (OR 0.61, 95% CI 0.23-1.60, P=0.32). Metal-ceramic RBFDPs showed no difference of debonding between cantilever RBFDPs and two-retainer fixed-fixed RBFDPs (OR 0.81, 95% CI 0.28-2.34, P=0.70,).
  
  
  CONCLUSIONS
  Within the limitations of the present study, cantilever RBFDPs demonstrate lower clinical failure than two-retainer RBFDPs in the anterior region. The failure of metal-ceramic RBFDPs is independent of the framework design, while the failure of all-ceramic RBFDPs with different designs has not been clear yet.
  
  
  CONCLUSIONS
  Based on the principle of minimally invasive treatment, less number of retainers is recommended for RBFDPs.
authors.affiliation: Department of Prosthodontics, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
authors.forename: Ya-Ru
authors.initials: YR
authors.lastname: Wei
authors.affiliation: Department of Prosthodontics, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Wang
authors.affiliation: Department of Prosthodontics, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Prosthodontics, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
authors.forename: Xiang-Xia
authors.initials: XX
authors.lastname: Li
authors.affiliation: Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, United States.
authors.forename: Markus B
authors.initials: MB
authors.lastname: Blatz
authors.affiliation: Institute of Stomatological Research, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
authors.forename: Yu-Tao
authors.initials: YT
authors.lastname: Jian
authors.affiliation: Department of Prosthodontics, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China. Electronic address: zhaoke@mail.sysu.edu.cn.
authors.forename: Ke
authors.initials: K
authors.lastname: Zhao
mesh_terms: D001840:Dental Bonding; D017267:Dental Prosthesis Design; D019232:Dental Restoration Failure; D003781:Denture Retention; D016379:Denture, Partial, Fixed, Resin-Bonded; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D019279:Resin Cements; D016896:Treatment Outcome
chemical_list: D019279:Resin Cements
keywords: Denture; Meta-analysis; Resin-bonded; Systematic review