Survival and Complication Rates of Tooth‐Supported Veneered Zirconia Fixed Partial Dentures: A Systematic Review and Metaanalysis
Arul Kumar Sengottaiyan, Vincent Bennani, Arthi VeerasamyStatement of Problem
The long‐term survival and complication rates of tooth‐supported veneered zirconia fixed partial dentures (FPDs) remain unclear due to heterogeneous and fragmented clinical evidence. Therefore, a systematic review and metaanalysis were conducted to synthesize the available clinical data.
Purpose
The purpose of this systematic review and metaanalysis was to evaluate the survival rates and the incidence of technical and biological complications associated with tooth‐supported veneered zirconia FPDs.
Materials and Methods
Electronic searches were conducted in MEDLINE/Embase, PubMed, Scopus, Web of Science, and Google Scholar databases up to August 2026 according to preferred reporting Items for systematic reviews and metaanalyses (PRISMA) guidelines. Clinical studies evaluating tooth‐supported veneered zirconia FPDs with a minimum follow‐up of 5 years were included. Randomized clinical trials and prospective or retrospective observational studies reporting survival or complication outcomes were considered. Risk of bias was assessed using the ROBINS‐I tool for cohort studies and the Joanna Briggs Institute (JBI) case series checklist for single‐arm studies. Metaanalysis was performed using R software (ggplot and meta package) with a random‐effects model.
Results
The database search identified 2220 records. After removal of 1815 duplicates, 405 records were screened by title and abstract. A total of 180 full‐text articles were assessed for eligibility, and 17 studies met the inclusion criteria and were included in the quantitative synthesis. The pooled survival rate for veneered zirconia was 92% (95% CI: 90%–94%) at 5 years, 86% (95% CI: 81%–89%) at 7 years, and 83% (95% CI: 71%–91%) at 10 years. Veneered zirconia prostheses demonstrated higher technical complications, particularly veneering porcelain chipping.
Conclusion
Tooth‐supported veneered zirconia fixed dental prostheses demonstrated acceptable survival rates over 5–13 years, with most studies reporting survival above 85%. The most frequent complications were chipping of the veneering porcelain.
Clinical Implication
Understanding the survival and complication patterns of tooth‐supported veneered zirconia FPDs provides valuable insights for clinicians in selecting suitable restorative materials and prosthesis designs.