Clinical Outcomes of Metal-Ceramic vs Metal–Acrylic Resin Implant-Supported Fixed Complete Dental Prostheses: A Systematic Review and Meta-analysis

Purpose: To compare the clinical outcomes of metal-ceramic vs metal–acrylic resin implant-supported fixed complete denture prostheses (IFCDPs). Materials and Methods: An electronic literature database search was conducted in the CINAHL, EMBASE, PubMed, and Web of Science databases. A manual search of the literature was also performed. Studies conducted in edentulous human subjects comparing clinical outcomes of metal-acrylic IFCDPs to metal-ceramic IFCDPs were included if quantitative outcomes for the following variables were reported: implant failure, prosthetic failure, incidence of peri-implantitis, incidence of peri-implant mucositis, incidence of peri-implant mucosal recession, prosthetic complications, and/or patient-centered outcomes. Data from included studies were pooled to estimate effect size. Results: Five studies met the inclusion criteria. A quantitative analysis was possible for risk of implant failure, prosthetic failure, and incidence of peri-implantitis. Meta-analysis showed no statistically significant differences in the risk of implant and prosthetic failure between the two groups. However, a meta-analysis showed a significantly greater risk of developing peri-implantitis at the implant level in the metal-acrylic group when compared to the metal-ceramic group (risk difference = 0.069; 95% CI = 0.028 to 0.06; P = .001; fixed-effects model). Furthermore, descriptive analysis of the literature indicated a higher incidence of other biologic complications (such as peri-implant mucositis and peri-implant mucosal recession) and prosthetic complications (such as abrasion and veneer fracture) in metal-acrylic IFCDPs compared to metal-ceramic IFCDPs. Conclusion: The available evidence suggests that higher incidence of biologic and prosthetic complications, including a higher risk of peri-implantitis, present with metal-acrylic IFCDPs compared to metal-ceramic IFCDPs.