MODERN APPROACHES TO THE USE OF DENTAL IMPLANTS IN PROSTHETICS WITH NON-REMOVABLE ORTHOPEDIC CONSTRUCTIONS (LITERATURE REVIEW)
DOI:
https://doi.org/10.35220/2523-420X/2025.3.18Keywords:
dental implants, fixed dental prostheses, All-on-4, CAD/CAM, zirconia implants, peri-implantitisAbstract
Purpose of the study. To systematize and critically analyze current approaches to the use of dental implants in fixed prosthodontic rehabilitation, considering clinical, biological, and technological aspects, as well as to evaluate long-term outcomes and complications based on recent scientific evidence from the last decade.Research methods. A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science databases covering 2015-2025. Keywords included «dental implants»,” «fixed dental prostheses», «implant- supported prostheses», «All-on-4», «All-on-6», «CAD/ CAM», «zirconia implants», «peri-implantitis». In total, 41 relevant publications were reviewed, selected based on publication recency (≤10 years), high citation index, and presence in leading peer-reviewed dental journals.Scientific novelty. This study provides a multifactorial overview of the current literature on implant-supported fixed prostheses, emphasizing both clinical success and complication patterns. It was confirmed that long-term implant survival rates exceed 94-95 % in most studies.Special focus was given to digital workflows (CAD/CAM, intraoral scanning), which ensure greater clinical accuracy and reduced treatment time. The review also highlights the emerging use of zirconia implants and monolithic ceramic prostheses, demonstrating superior esthetics and biocompatibility, while long-term predictability remains under investigation. Risk factors for peri-implantitis were summarized, and the importance of preventive strategies and supportive therapy for maintaining implant longevity was substantiated. Conclusions. Dental implants in combination with fixed prosthodontic restorations demonstrate high long-term clinical predictability and functional success. Nevertheless, biological complications, particularly peri-implantitis, remain a significant challenge.The All-on-4 and All-on-6 treatment concepts have expanded rehabilitation options for edentulous patients, enabling predictable outcomes while reducing the need for invasive bone grafting. Digital technologies are redefining clinical standards by enhancing precision, shortening treatment times, and minimizing technical complications.
References
Buser D., Sennerby L., De Bruyn H. Modern implant dentistry based on osseointegration: 50 years of progress and open questions. Periodontology 2000. 2017. Vol. 73, № 1. Р. 7–21. https://doi.org/10.1111/prd.12185
Pjetursson B. E., Thoma D., Jung R., Zwahlen M., Zembic A. A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clinical oral implants research. 2012. Suppl 23, № 6. Р. 22–38. https://doi.org/10.1111/j.1600-0501.2012.02546.x
Maló P., de Araújo Nobre M., Lopes A., Ferro A., Nunes M. The All-on-4 concept for full-arch rehabilitation of the edentulous maxillae: A longitudinal study with 5-13 years of follow-up. Clinical implant dentistry and related research. 2019. Vol. 21 № 4. Р. 538–549. https://doi.org/10.1111/cid.12771
Galindo-Moreno P., Nilsson P., King P., Worsaae N., Schramm A., Padial-Molina M., Maiorana C. Clinical and radiographic evaluation of early loaded narrow-diameter implants: 5-year follow-up of a multicenter prospective clinical study. Clinical oral implants research. 2017. Vol. 28, № 12. Р. 1584–1591. https://doi.org/10.1111/clr.13029
de Araújo Nobre M., Lopes A., Antunes E. The 10 Year Outcomes of Implants Inserted with Dehiscence or Fenestrations in the Rehabilitation of Completely Edentulous Jaws with the All-on-4 Concept. Journal of clinical medicine. 2022. Vol. 11, № 7. Р. 1939. https://doi. org/10.3390/jcm11071939
Gibello U., Lanzetti J., Crupi A., Longhi B., Molinero-Mourelle P., Roccuzzo A., Pera F. (2025). Clinical outcomes of full-arch fixed implant-supported prostheses in patients lacking supportive peri-implant care: A cross-sectional study. International journal of oral implantology. 2025. Vol 18, № 2. Р. 147–157.
Derks J., Tomasi C. Peri-implant health and disease: A systematic review of current epidemiology. Journal of Clinical Periodontology. 2015. Vol. 42, № 16. Р. 158–171. https://doi.org/10.1111/jcpe.12334
Mangano F. G., Luongo F., Picciocchi G., Mortellaro C., Park K. B., Mangano C. Soft Tissue Stability around Single Implants Inserted to Replace Maxillary Lateral Incisors: A 3D Evaluation. International journal of dentistry. 2016, е.9393219. https://doi.org/10.1155/2016/9393219
Sanz M., Chapple I. L. Working Group 4 of the VIII European Workshop on Periodontology. Clinical research on peri-implant diseases: consensus report of Working Group 4. Journal of clinical periodontology. 2012. Vol. 39, № 12. Р. 202–206. https://doi.org/10.1111/j.1600-051X.2011.01837.x
Raco A., Di Murro B., Passarelli P. C., D’Addona A., Pilloni A., Marini L., Papi P. Long-Term Clinical and Radiographic Analysis of Platform Matching and Platform Switching Implants in the Esthetic Zone: A Retrospective Cohort Study. Applied Sciences. 2023. Vol. 13, № 1. Р. 661. https://doi.org/10.3390/app13010661
Rodriguez Martrus A. M., Sánchez C. A., Kassis E. N. CAD-CAM system in dental implants: a systematic review. MedNEXT Journal of Medical and Health Sciences. 2022. Vol. 3, № 1. https://doi.org/10.54448/mdnt22S103
Mohseni P., Soufi A., Chrcanovic B.R. Clinical outcomes of zirconia implants: a systematic review and meta-analysis. Clin Oral Invest. 2024. Vol. 28, № 15. https://doi.org/10.1007/s00784-023-05401-8
Degidi M., Nardi D., Gianluca S., Piattelli A. The Conometric Concept: A 5-Year Follow-up of Fixed Partial Monolithic Zirconia Restorations Supported by Cone-in-Cone Abutments. The International journal of periodontics & restorative dentistry. 2018. Vol. 38, № 3. Р. 363–371. https://doi.org/10.11607/prd.3130
Pjetursson B. E., Sailer I., Makarov N. A., Zwahlen M., Thoma D. All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part II: Multiple-unit FDPs. Dental materials: official publication of the Academy of Dental Materials. 2015. Vol. 31, № 6. Р. 624–639. https://doi.org/10.1016/j.dental.2015.02.013
Araújo M. G., Buser D. Clinical relevance of dimensional bone and soft tissue alterations post-extraction in esthetic sites. Periodontology 2000. 2016. Vol. 77, № 1. Р. 73–83. https://doi.org/10.1111/prd.12167
Chrcanovic B. R., Albrektsson T., Wennerberg A. Diabetes and oral implant failure: a systematic review. Journal of dental research. 2014. Vol. 93, № 9. P. 859–867. https://doi.org/10.1177/0022034514538820
Papaspyridakos P., Bordin T. B., Kim Y. J., et.al. Technical Complications and Prosthesis Survival Rates with Implant-Supported Fixed Complete Dental Prostheses: A Retrospective Study with 1- to 12-Year Follow-Up. Journal of prosthodontics: official journal of the American College of Prosthodontists. 2020. Vol. 29, № 1. Р. 3–11. https://doi.org/10.1111/jopr.13119
French D., Ofec R., Levin L. Long term clinical performance of 10 871 dental implants with up to 22 years of follow-up: A cohort study in 4247 patients. Clinical implant dentistry and related research. 2021. Vol. 23, № 3. Р. 289–297. https://doi.org/10.1111/cid.12994
Lee D. Jae., Son J., Ahn K. M. Evaluation of criteria for dental implant success: a systematic literature review. Journal of implantology and applied sciences. 2024. Р. 123–133 https://doi.org/10.32542/implantology.2024013
Abdunabi A., Morris M., Nader S. A., Souza R. F. Impact of immediately loaded implant-supported maxillary full-arch dental prostheses: a systematic review. Journal of applied oral science: revista FOB. 27. 2019. e20180600. https://doi.org/10.1590/1678-7757-2018-0600
Mancini L., Strauss F. J., Lim H. C., Tavelli L., Jung R. E., Naenni N. Impact of keratinized mucosa on implant-health related parameters: A 10-year prospective re-analysis study. Clinical implant dentistry and related research. 2024. Vol. 26, № 3. Р. 554–563. https://doi.org/10.1111/cid.13314
Diaz P., Gonzalo E., Villagra J. G., Miegimolle B., Suarez, M. J. What is the prevalence of peri-implantitis? A systematic review and meta-analysis. BMC oral health. Vol. 22, № 1. 2022. P. 449. https://doi.org/10.1186/s12903-022-02493-8
Derks J., Schaller D., Håkansson J., Wennström J.L., Tomasi C., Berglundh T. Effectiveness of Implant Therapy Analyzed in a Swedish Population: Prevalence of Periimplantitis. Journal of Dental Research. 2015. Vol. 95, № 1. Р. 43–49. doi:10.1177/0022034515608832
Wang H. L., Avila-Ortiz G., Monje A., et. al. AO/ AAP consensus on prevention and management of peri- implant diseases and conditions: Summary report. Journal of periodontology. 2025. Vol. 96, № 6. Р. 519–541. https:// doi.org/10.1002/JPER.25-0270
Monje A., Catena A., Borgnakke W. S. Association between diabetes mellitus/hyperglycemia and peri-implant diseases: Systematic review and meta-analysis. Journal of Clinical Periodontology. 2017. Vol. 44, № 6. Р. 636–648. https://doi.org/10.1111/jcpe.12724
Schimmel M., Müller F., Suter V., Buser D. Implants for elderly patients. Periodontol 2000. 2017. № 73. 228–240. https://doi.org/10.1111/prd.12166
Chrcanovic B. R., Kisch J., Larsson C. Analysis of technical complications and risk factors for failure of combined tooth-implant-supported fixed dental prostheses. Clinical implant dentistry and related research. 2020. Vol. 22, № 4. Р. 523–532. https://doi.org/10.1111/cid.12927
Halim F. C., Pesce P., De Angelis N., Benedicenti S., Menini M. Comparison of the Clinical Outcomes of Titanium and Zirconia Implant Abutments: A Systematic Review of Systematic Reviews. Journal of clinical medicine. 2022. Vol. 11, № 17. Р. 5052. https://doi.org/10.3390/jcm11175052
Padhye N. M., Calciolari E., Zuercher A. N., Tagliaferri S., Donos N. Survival and success of zirconia compared with titanium implants: a systematic review and meta-analysis. Clinical oral investigations. 2023. Vol. 27, № 11. Р. 6279–6290. https://doi.org/10.1007/s00784-023-05242-5
Abu Al-Faraj T. M., Alsubhi B. M., Almarhoon A. N., et. al. Comparison of Peri-Implant Soft Tissue Around Zirconia and Titanium Abutments in the Aesthetic Zone: A Narrative Review. Cureus. 2024. Vol. 16, № 7. e65782. https://doi.org/10.7759/cureus.65782
Hao C. P., Cao N. J., Zhu Y. H., Wang, W. The osseointegration and stability of dental implants with different surface treatments in animal models: a network meta-analysis. Scientific reports. 2021. Vol. 11, № 1. е13849. https://doi.org/10.1038/s41598-021-93307-4
Gallucci, G. O., Benic, G. I., Eckert, S. E., Papaspyridakos, P., Schimmel, M., Schrott, A., & Weber, H. P. Consensus statements and clinical recommendations for implant loading protocols. The International journal of oral & maxillofacial implants. 2014. Suppl. 29, P. 287–290. https://doi.org/10.11607/jomi.2013.g4
Goker F., Mali Rai P., De Santis D., et. al. Outcomes of Dental Implants in Routine Clinical Practice: A Retrospective Multicenter Study. International journal of dentistry. 2025. e9930477. https://doi.org/10.1155/ijod/9930477
Slot W., Raghoebar G. M., Cune M. S., Vissink A., Meijer J. A. Maxillary overdentures supported by four or six implants in the anterior region: 10-year randomized controlled trial results. Journal of clinical periodontology. 2023. Vol. 50, № 1. Р. 36–44. https://doi.org/10.1111/jcpe.13726
Wang J., Wang B., Liu Y. Y., Luo Y. L., Wu Y. Y., Xiang L., Yang X. M., Qu Y. L., Tian T. R., Man Y. Recent Advances in Digital Technology in Implant Dentistry. Journal of dental research. 2024. Vol. 103, № 8. Р. 787–799. https://doi.org/10.1177/00220345241253794
Yilmaz B., Guo X., Schimmel M., Abou- Ayash S. Effect of industrial scanner and framework material interaction on the marginal gaps of CAD-CAM complete arch implant frameworks. The Journal of prosthetic dentistry. 2023. Vol. 130, № 5. Р. 723–730. https://doi.org/10.1016/j.prosdent.2021.10.013
Monje A., Aranda L,. Diaz K.T., et al. Impact of Maintenance Therapy for the Prevention of Peri-implant Diseases: A Systematic Review and Meta-analysis. Journal of Dental Research. 2015. Vol. 95, № 4. Р. 372–379. doi:10.1177/0022034515622432
Lin G. H., Lee E., Barootchi S., et al. The influence of prosthetic designs on peri-implant bone loss: An AO/ AAP systematic review and meta-analysis. J Periodontol. 2025. № 96. P. 634–651. https://doi.org/10.1002/JPER.24-0144
ArRejaie A. S., Al-Hamdan R. S., Basunbul G. I., Abduljabbar T., Al-Aali K. A., Labban N. Clinical performance of one-piece zirconia dental implants: A systematic review. Journal of investigative and clinical dentistry. 2019. Vol. 10, № 2. e12384. https://doi.org/10.1111/jicd.12384
Altuna P., Lucas-Taulé E., Gargallo-Albiol J., Figueras-Álvarez O., Hernández-Alfaro F., Nart J. Clinical evidence on titanium-zirconium dental implants: a systematic review and meta-analysis. International journal of oral and maxillofacial surgery. 2016. Vol. 45, № 7. P. 842–850. https://doi.org/10.1016/j.ijom.2016.01.004
Cappare P., Ferrini F., Mariani G., Nagni M., Cattoni F. Implant rehabilitation of edentulous jaws with predominantly monolithic zirconia compared to metal-acrylic prostheses: a 2-year retrospective clinical study. Journal of biological regulators and homeostatic agents. 2021. Vol. 35, № 1. Р. 99–112. https://doi.org/10.23812/21-4supp1-9
