Coroas monolíticas implantossuportadas apresenta similaridade clínica às coroas metalocerâmicas? Uma revisão sistemática e meta-análise

Abstract

This study aimed to evaluate the evidence on the survival rate, complications and marginal bone loss of monolithic implant crowns compared to implant-supported metal-ceramic crowns. The review protocol was registered in PROSPERO (CRD42017078568). Randomized controlled trials (RCTs) comparing monolithic and metal-ceramic crowns on dental implants were eligible. In this systematic review and meta-analysis, five studies were included. Quantitative analysis revealed that monolithic zirconia crowns presented significantly fewer technical complications compared to metal-ceramic crowns (P = 0.008; RR: 0.33; CI: 0.14–0.74). No significant heterogeneity was observed in the analysis (P = 0.23; I2 = 28%). Regarding survival rates, there was no statistically significant influence of the restorative material between monolithic and metal-ceramic crowns (P = 0.36; RR: 1.66; CI: 0.56 to 4.94). Likewise, no influence of the restorative material of implant-supported single crowns could be observed in relation to marginal bone loss values (P = 0.71; MD: -0.02; CI: -0.10 to 0.07). Although an increase in heterogeneity values was observed, it was also not significant (P = 0.17; I2 = 40%). The assessment of the risk of bias of the studies showed that three presented low risk, adequately reporting all the domains analyzed, while two did not provide essential information about the sample randomization process. Thus, given the limitations of this review, it is concluded that implantsupported monolithic crowns demonstrate survival and bone stability rates similar to metal-ceramic crowns. Furthermore, the use of monolithic crowns may reduce technical complications such as screw loosening and fracture of the restorative material. However, long-term studies are needed to evaluate their durability and clinical performance over time.