Systematic review of the survival rate and the biological, technical, and aesthetic complications of fixed dental prostheses with cantilevers on implants reported in longitudinal studies with a mean of 5 years follow‐up

Abstract Objective A systematic review was carried out to evaluate the success and survival rate of implants supporting cantilever prosthesis, as well as the incidence of technical and biological complications. Material and Methods A MEDLINE search was conducted up to December 2011 for studies with a mean follow‐up of 5 years or more. Two independent reviewers screened the retrieved articles and extracted the data independently. Data on survival, failure, mechanical/technical and biological complications were analyzed. Results One‐hundred and sixty articles were selected as abstract. Only 18 underwent a full‐text analysis and only six were included in the study. The estimated cumulative survival rate of implants supporting cantilevered prosthesis was 98.9% (95% CI : 97.4–99.5%), whereas ICFDP survival was estimated to be about 97.1% (95% CI : 90.1–99.2%). Implant failures before prosthetic delivery were not considered. Biological complications were estimated to be 5.7% (95% CI : 4.2–7.6%) at implant level after 5 years. Technical complications were analyzed: the most common complications were veneer fractures (5‐year estimate: 10.1%; 95% CI : 3.7–16.5%) and abutment screw fractures (5‐year estimate: 1.6%; 95% CI : 0.8–3.5%). Decementation and screw loosening were estimated to be at 5 years 5.9% (95% CI : 1.7–16.8%) and 7.9% (95% CI : 3.2–18.2%), respectively. Implant fracture was rare (5‐year estimate: 0.7%; 95% CI : 0.1–4.7%); no framework fracture was reported. Radiographic bone level changes did not yield statistically significant differences. No aesthetic outcome was reported. Conclusions ICFDPS can be considered a reliable treatment: the systematic review assessed that there is no increase in complication rate due to the presence of the cantilever.