Non-Cochrane · intervention · PM42434215
Prosthetic and Biological Complications of Metal-Zirconia versus Metal-Acrylic Implant-Supported Screw-Retained Complete-Arch Prostheses: A Systematic Review and Meta-Analysis.
Marinkovic Dusan, Gutiérrez Rodrigo, Frey Marcos, et al. · Journal of clinical and experimental dentistry · 2026 · PubMed · doi:10.4317/jced.63882
Findings
Population Patients rehabilitated with implant-supported screw-retained complete-arch prostheses
10 findings
| Metal-zirconia (monolithic zirconia on metal framework) screw-retained complete-arch prostheses | Metal-acrylic screw-retained complete-arch prostheses | Prosthesis survival Mean follow-up 5 years · Implant-supported full-arch rehabilitation | RR 1.05 [0.99, 1.11] 49 [-10, 107] per 1000 Moderate 8 studies · 396 participants |
| Metal-zirconia (monolithic zirconia on metal framework) screw-retained complete-arch prostheses | Metal-acrylic screw-retained complete-arch prostheses | Speech complications Mean follow-up 5 years · Implant-supported full-arch rehabilitation | RR 0.26 [0.04, 1.54] -59 [-77, 43] per 1000 Very low 2 studies · 118 participants |
| Metal-zirconia (monolithic zirconia on metal framework) screw-retained complete-arch prostheses | Metal-acrylic screw-retained complete-arch prostheses | Prosthetic wear Mean follow-up 5 years · Implant-supported full-arch rehabilitation | RR 0.29 [0.14, 0.59] -267 [-324, -154] per 1000 Moderate 8 studies · 401 participants |
| Metal-zirconia (monolithic zirconia on metal framework) screw-retained complete-arch prostheses | Metal-acrylic screw-retained complete-arch prostheses | Prosthetic tooth fracture Mean follow-up 5 years · Implant-supported full-arch rehabilitation | RR 0.78 [0.54, 1.12] -51 [-107, 28] per 1000 Moderate 8 studies · 401 participants |
| Metal-zirconia (monolithic zirconia on metal framework) screw-retained complete-arch prostheses | Metal-acrylic screw-retained complete-arch prostheses | Framework fracture Mean follow-up 5 years · Implant-supported full-arch rehabilitation | RR 0.76 [0.13, 4.33] -4 [-13, 49] per 1000 Low 8 studies · 401 participants |
| Metal-zirconia (monolithic zirconia on metal framework) screw-retained complete-arch prostheses | Metal-acrylic screw-retained complete-arch prostheses | Esthetic complications Mean follow-up 5 years · Implant-supported full-arch rehabilitation | RR 0.38 [0.07, 1.96] -25 [-37, 38] per 1000 Very low 2 studies · 118 participants |
| Metal-zirconia (monolithic zirconia on metal framework) screw-retained complete-arch prostheses | Metal-acrylic screw-retained complete-arch prostheses | Implant survival Mean follow-up 5 years · Implant-supported full-arch rehabilitation | RR 1.01 [1.00, 1.03] 10 [0, 30] per 1000 Low 7 studies · 1685 participants |
| Metal-zirconia (monolithic zirconia on metal framework) screw-retained complete-arch prostheses | Metal-acrylic screw-retained complete-arch prostheses | Marginal bone loss (mm) Mean follow-up 5 years · Implant-supported full-arch rehabilitation | SMD -0.36 [-0.71, 0.00] -0.36 [-0.71, 0] mm Moderate 4 studies · 130 participants |
| Metal-zirconia (monolithic zirconia on metal framework) screw-retained complete-arch prostheses | Metal-acrylic screw-retained complete-arch prostheses | Peri-implantitis Mean follow-up 5 years · Implant-supported full-arch rehabilitation | RR 0.67 [0.47, 0.96] -31 [-50, -4] per 1000 Low 6 studies · 1129 participants |
| Metal-zirconia (monolithic zirconia on metal framework) screw-retained complete-arch prostheses | Metal-acrylic screw-retained complete-arch prostheses | Prosthesis loss Mean follow-up 5 years · Implant-supported full-arch rehabilitation | RR 0.09 [0.02, 0.51] -23 [-25, -12] per 1000 Very low 8 studies · 396 participants |
Included primary studies 12
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Ayna 2018 A comparative study on 7-year results of "All-on-Four™" immediate-function concept for completely edentulous mandibles: metal-ceramic vs.… PMID:28321585 | 2018 | 1 other review | not stated | not extracted yet |
| Ayna 2015 Comprehensive Comparison of the 5-Year Results of All-on-4 Mandibular Implant Systems With Acrylic and Ceramic Suprastructures. PMID:24712706 | 2015 | this review only | not stated | not extracted yet |
| Ayna 2021 Six-year clinical outcomes of implant-supported acrylic vs. ceramic superstructures according to the All-on-4 treatment concept for the… PMID:33837889 | 2021 | this review only | not stated | not extracted yet |
| Cercadillo-Ibarguren 2017 Immediately loaded implant-supported full-arches: Peri-implant status after 1-9years in a private practice. PMID:28962843 | 2017 | this review only | not stated | not extracted yet |
| Chochlidakis 2020 Survival rates and prosthetic complications of implant fixed complete dental prostheses: An up to 5-year retrospective study. PMID:31982146 | 2020 | this review only | not stated | not extracted yet |
| Chochlidakis 2022 Implant survival and biologic complications of implant fixed complete dental prostheses: An up to 5-year retrospective study. PMID:33618859 | 2022 | this review only | not stated | not extracted yet |
| Hjalmarsson 2011 Implant-level prostheses in the edentulous maxilla: a comparison with conventional abutment-level prostheses after 5 years of use. PMID:21479285 | 2011 | this review only | not stated | not extracted yet |
| Papaspyridakos 2018 Implant survival rates and biologic complications with implant-supported fixed complete dental prostheses: A retrospective study with up… PMID:30043456 | 2018 | this review only | not stated | not extracted yet |
| Papaspyridakos 2019 Double Full-Arch Fixed Implant-Supported Prostheses: Outcomes and Complications after a Mean Follow-Up of 5 Years. PMID:30806990 | 2019 | this review only | not stated | not extracted yet |
| Papaspyridakos 2020 Technical Complications and Prosthesis Survival Rates with Implant-Supported Fixed Complete Dental Prostheses: A Retrospective Study with… PMID:31650669 | 2020 | this review only | not stated | not extracted yet |
| Penarrocha 2013 Palatal positioning of implants in severely atrophic edentulous maxillae: five-year cross-sectional retrospective follow-up study. PMID:23869373 | 2013 | this review only | not stated | not extracted yet |
| Sanchez-Torres 2021 Mechanical complications of implant-supported complete-arch restorations and impact on patient quality of life: A retrospective cohort… PMID:32165011 | 2021 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Functional Outcomes of Prosthetic Rehabilitation in Older Adults With Tooth Loss: A Systematic Review and Meta-Analysis. (2026) | 1 | 0.03 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients rehabilitated with implant-supported screw-retained complete-arch prostheses; surgical and prosthetic phases completed; follow-up of at least 1 year | Adults over 50 with full-arch fixed implant-supported prostheses and confirmed osseointegration (n=12 studies) |
| Intervention | Monolithic zirconia IS-CAPs with a full-arch metallic bar-type substructure | Metal-zirconia screw-retained complete-arch prostheses (n=11 studies pooled) |
| Comparison | Conventional metal-acrylic IS-CAPs with a metallic substructure | Metal-acrylic screw-retained complete-arch prostheses |
| Outcomes | Prosthetic complications (framework fracture, decementation, wear, replacement of teeth or screws, acrylic or zirconia fractures) | Marginal bone loss; prosthetic tooth fracture; implant survival; prosthesis survival; peri-implantitis; framework fracture; esthetic complications; speech complications; prosthesis loss; prosthetic wear |
| Study designs | RCTs, non-randomized clinical trials, prospective or retrospective cohort studies | 12 non-randomized studies, mostly retrospective (11 in meta-analysis) |
| Timing | Minimum follow-up 1 year; publications from 2000 onward | Mean follow-up 5 years (3 to 7 years) |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: Yes · RCT: N/A | RCT: N/A · NRSI: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: No · RCT: N/A | RCT: N/A · NRSI: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |