title: A systematic review of the survival and complication rates of resin-bonded fixed dental prostheses after a mean observation period of at least 5 years.
abstract: OBJECTIVE
  The objective of this systematic review was to assess the 5-year and 10-year survival of resin-bonded fixed dental prostheses (RBBs) and to describe the incidence of technical and biological complications.
  
  
  METHODS
  An electronic MEDLINE search complemented by manual searching was conducted to identify prospective and retrospective cohort studies and case series on RBBs 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 extraction were performed independently by two reviewers. Failure and complication rates were analyzed using robust Poisson regression models to obtain summary estimates of 5- and 10-year proportions.
  
  
  RESULTS
  The search provided 367 titles and 87 abstracts. Full-text analysis was performed for 22 articles resulting in seven studies that met the inclusion criteria. Five articles were found through manual search, and 17 studies were provided from (Pjetursson et al. 2008, Clinical Oral Implants Research, 19, 131), resulting in an overall number of included studies of 29. Meta-analysis of these studies reporting on 2300 RBBs indicated an estimated survival of resin-bonded bridges of 91.4% (95 percent confidence interval [95% CI]: 86.7-94.4%) after 5 years and 82.9% (95% CI: 73.2-89.3%) after 10 years. A significantly higher survival rate was reported for RBBs with zirconia framework compared with RBBs from other materials. RBBs with one retainer had a significantly higher survival rate (P < 0.0001) and a lower de-bonding rate (P = 0.001) compared with RBBs retained by two or more retainers. Moreover, the survival rate was higher for RBBs inserted in the anterior area of the oral cavity compared with posterior RBBs. The most frequent complications were de-bonding (loss of retention), which occurred in 15% (95% CI: 10.9-20.6%) and chipping of the veneering material that was reported for 4.1% (95% CI: 1.8-9.5%) of the RBBs over an observation period of 5 years.
  
  
  CONCLUSIONS
  Despite the high survival rate of RBBs after 5 and 10 years, technical complications like de-bonding and minor chipping were frequent. RBBs with zirconia framework and RBBs with one retainer tooth showed the highest survival rate.
authors.affiliation: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
authors.forename: Daniel S
authors.identifier: http://orcid.org/0000-0002-1764-7447
authors.initials: DS
authors.lastname: Thoma
authors.affiliation: Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Irena
authors.initials: I
authors.lastname: Sailer
authors.affiliation: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
authors.forename: Alexis
authors.identifier: http://orcid.org/0000-0002-2110-3645
authors.initials: A
authors.lastname: Ioannidis
authors.affiliation: Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Marcel
authors.initials: M
authors.lastname: Zwahlen
authors.affiliation: Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland.|Private Practice, Moscow, Russia.
authors.forename: Nikolay
authors.identifier: http://orcid.org/0000-0003-1543-1738
authors.initials: N
authors.lastname: Makarov
authors.affiliation: Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland.|Division of Reconstructive Dentistry, Faculty of Odontology, University of Iceland, Reykjavik, Iceland.
authors.forename: Bjarni E
authors.initials: BE
authors.lastname: Pjetursson
mesh_terms: D019232:Dental Restoration Failure / Q000706:statistics & numerical data; D016379:Denture, Partial, Fixed, Resin-Bonded / Q000009:adverse effects; D006801:Humans; D012117:Resins, Synthetic / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D012117:Resins, Synthetic
keywords: Resin-bonded bridges; biological complications; complication rates; de-bonding; failures; fiber-reinforced composite; fixed dental prostheses; longitudinal; success; survival; systematic review; technical complications