Clinical outcomes and complications of posterior three-unit porcelain-fused-to-metal restoration combined with tooth-implant-supported prosthesis: A meta-analysis

Background/purpose: The three-unit bridge that combines a natural tooth and an implant provides extended treatment possibilities for partially edentulous patients. We conducted a systematic review and meta-analysis of clinical trials to evaluate three-unit porcelain-fused-to-metal (PFM) tooth-implant-supported prosthesis (TISP) compared with implant-supported-prosthesis (ISP) reconstruction outcomes and complications. Materials and methods: The PubMed, Embase, and Cochrane library databases were searched for articles published before February 2021. The meta-analysis used a random-effects model to calculate overall effect size. The study was registered with PROSPERO (number: CRD 42021232606). Results: Seven articles published between 2004 and 2015, with sample sizes ranging from 10 to 250 patients were included. No significant difference in the prosthesis failure rate, implant failure rate, prosthesis technical complication rate, implant technical complication rate, and marginal bone level change was observed between the TISP group and the ISP group. In TISP group, natural tooth failure rate was reported to range from 0% to 4.3%, biological complication related to the natural tooth was reported to range from 0% to 26.9%, and no trial reported natural tooth intrusion. Conclusion: The three-unit short-span TISP is a potentially reliable treatment option for patients with missing posterior teeth.