Prosthetic complications with monolithic or micro‐veneered implant‐supported zirconia single‐unit, multiple‐unit, and complete‐arch prostheses on titanium base abutments: A single center retrospective study with mean follow‐up period of 72.35 months
Authors: Saponaro Paola C. , Karasan Duygu , Donmez Mustafa Borga , Johnston William Michael , Yilmaz Burak 
Published: November 2022

Background

The influence of prosthetic design on prosthetic complications when monolithic or micro‐veneered zirconia prostheses are supported with titanium base (ti‐base) abutments is not well‐known.

Purpose

The purpose of this single center, retrospective study was to assess the prevalence of prosthetic complications with monolithic or micro‐veneered single‐unit, multi‐unit, and complete‐arch zirconia prostheses supported with ti‐base abutments (implant level or multi‐unit abutment level).

Material and Methods

This study retrospectively evaluated the electronic health record (EHR) of participants who received either monolithic or micro‐veneered implant‐supported single‐unit, multi‐unit, and/or complete‐arch prostheses supported by ti‐base or zirconia‐ti‐base hybrid abutments delivered between the years 2010 and 2021. Data were analyzed by using logistic regression and Exact Mantel–Haenszel chi‐square test (α = 0.05) to assess the clinical performance of prostheses and complications including crown decementation, feldspathic porcelain chipping, prosthesis fracture, zirconia‐ti‐base hybrid abutment decementation, abutment screw loosening, screw fracture, abutment fracture, implant loss, and prosthesis remake.

Results

The study included 94 participants (50 female, 44 male) with a mean age of 59.5 years (range: 24–101 years of age). The retrospective EHR evaluation yielded 82 single‐unit, 51 multi‐unit, and 20 complete‐arch prostheses on 325 implants. Among 153 prostheses delivered, 108 were micro‐veneered (47 single‐unit, 41 multi‐unit, and 20 complete‐arch prostheses) and 45 were monolithic. The average duration was 72.35 months (6.02 years) with a follow‐up period of 5–132 months. From the time of insertion to the time of EHR review, of 153 prostheses, 78.43% did not exhibit any prosthetic complication. However, 33 prostheses (21.57%) from 29 participants (30.85%) had at least one prosthetic complication. Only four patients (4.25%) experienced two or more prosthetic complications. Prosthetic design affected the probability of having a complication (p = 0.005); complete‐arch prostheses had higher probability (p ≤ 0.028). Single‐unit prostheses had lower probability of complication than multi‐unit prostheses (p = 0.005). The most commonly observed complication was fracture of veneering material (5.88%) followed by prosthetic screw loosening (4.57%) and decementation between the zirconia and the ti‐base abutment (2.61%). Micro‐veneered complete‐arch prostheses had higher probability of having chipping than that of not having (p < 0.001), and other micro‐veneered prosthetic designs had similar probability of chipping with that of complete‐arch prostheses (p ≥ 0.082). Frequency of chipping was affected by veneering (p < 0.001). Monolithic prostheses had lower probability of chipping than micro‐veneered prostheses, regardless of the prosthetic design (p < 0.001).

Conclusions

The frequency of prosthetic complications varied depending on prosthetic design. Complete‐arch prostheses had the highest probability of complications while the single‐unit prostheses had the lowest. Micro‐veneered prostheses had higher probability for chipping than monolithic prostheses. Probability of chipping was similar for micro‐veneered single‐unit, multi‐unit, and complete‐arch zirconia prostheses.