A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years.

OBJECTIVES The objective of this systematic review was to assess the survival of cantilever fixed partial dentures (FPDs) and the incidence of biological and technical complications. METHODS An electronic MEDLINE search supplemented 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 to obtain summary estimates of 10-year survival proportions. RESULTS From a yield of 3658 titles and 211 abstracts, 81 articles were selected for full-text analysis, finally resulting in 13 studies that met the inclusion criteria. Meta-analysis of these studies resulted in an estimated survival rate of cantilever FPDs of 81.8% (95 percent confidence interval (95% CI): 78.2-84.9%) and success rate (free of all complications) of 63% (95% CI: 54.7-70.2%) after 10 years. The most common biological complication was loss of pulp vitality (32.6%) followed by caries at abutment teeth (9.1%). After a 10-year observation period 2.6% of the FPDs were lost as a result of dental caries and 1% due to recurrent periodontitis. The most frequent technical complication was loss of retention (16.1%) followed by material fractures (5.9%). The cumulative incidence of fractures of abutment teeth was 2.9% and 2.4% of the FPDs were lost as a result of abutment tooth fracture after an observation period of 10 years. CONCLUSION This systematic review on cantilever fixed partial dentures indicated that survival and success rates of cantilever fixed partial dentures were lower than those of conventional end-abutment supported FPDs described in a review by Tan et al. (2004) and biological and technical complications were frequent.