Prosthesis wear and complications in various materials used for fixed implant-supported prostheses: A systematic review

Abstract

Statement of problem: Clinical evidence regarding the wear of prosthetic materials and antagonist dentition in fixed implant-supported prostheses (FIPs) remains limited, particularly for polymers such as polymethyl methacrylate (PMMA), polyoxymethylene (POM), and polyetheretherketone (PEEK).

Purpose: The purpose of this systematic review was to evaluate prosthesis wear in FIPs fabricated from different restorative materials, to identify associated patient- and treatment-related factors, and to assess their effect on antagonist teeth.

Material and methods: A systematic literature search was conducted in the PubMed, Scopus, Embase, and Web of Science databases for clinical studies with a minimum of 6 months follow-up evaluating FIPs published between January 2020 and June 2025. Extracted data included prosthesis wear, antagonist wear, prosthetic complications, and modifying clinical variables. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool for randomized clinical trials and the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool for observational studies.

Results: Ten clinical studies fulfilled the inclusion criteria. Evaluated materials included PMMA, POM, lithium disilicate, zirconia-ceramic, and metal frameworks veneered with ceramic or acrylic resin. Quantitative wear of the prosthesis material itself was reported only for PMMA, POM, and lithium disilicate restorations, whereas in other studies, prosthesis wear was recorded exclusively as a wear-related complication. Wear-related complications, including severe material wear, chipping, screw loosening, and framework fractures, were more frequently reported in metal-acrylic resin complete arch prostheses. Bruxism and the absence of a protective occlusal devices were frequently associated with higher complication rates. Antagonist wear was quantitatively assessed in only 1 study, which reported no significant differences between prosthetic materials and natural enamel.

Conclusions: Available clinical evidence indicates that prosthesis wear is material-dependent and influenced by patient-related factors. The short-term wear behavior of PMMA and POM appears comparable, whereas clinical data on antagonist wear and long-term outcomes remain scarce.