Implants versus short-span fixed bridges: survival, complications, patients' benefits. A systematic review on economic aspects

Aim To systematically evaluate the existing evidence to answer the focused question: For a patient with a single tooth to be replaced, is the implant crown, based on economic considerations, preferred to a conventional fixed partial denture? Material and methods PubMed MEDLINE, Cochrane-Central and Embase databases were searched using an extended list of search terms related to economics, which were then combined with the terms prosthodontics and dental implant. Results The combined search for the economic terms and prosthodontics revealed 904 titles. The combination with dental implants revealed 2039 titles. Based on the abstracts, 73 full text publications were evaluated and data comparing outcomes with FDPs and implant crowns were retrieved from 26 publications. Initial costs for single implant crowns and FDPs on teeth were similar, but varied between tariff systems. The conditions of neighboring teeth and of the alveolar ridge defined the complexity (costs) of the treatment. Failure rates reported with single implant crowns and FDPs on teeth were similar. The long-term financial economic comparison showed a similar outcome for single implant crowns and FDPs. Conclusion Other factors than costs and survival rates such as patient or provider reported factors may be more decisive when choosing between implant crowns and FDPs on teeth. The utility for the patient to keep healthy adjacent teeth unprepared makes the implant crown more economic.