Influence of Prosthetic Material Type on the Survival of Tooth-Supported Fixed Dental Prostheses: A Systematic Review of the Literature.

PURPOSE: To evaluate the influence of prosthetic material type on the survival of tooth-supported fixed dental prostheses by comparing metal-ceramic, all-ceramic, and zirconia restorations, as well as the associated technical and biological complications. MATERIALS AND METHODS: A systematic review of the literature was conducted using PubMed, ScienceDirect, and Wiley Online Library databases for the period 2015-2026. The search strategy was based on keywords related to fixed dental prostheses. Seventeen studies were included after applying inclusion and exclusion criteria. Qualitative analysis of the data was performed owing to the methodological heterogeneity of the included studies. RESULTS: Seventeen studies were included in this systematic review. Metal-ceramic restorations showed high survival rates, reaching 100% at 5 and 10 years in some studies. All-ceramic restorations demonstrated survival rates ranging from 88% to 100%, with excellent esthetic performance but mechanical variability depending on the material. Zirconia restorations showed variable survival rates, ranging from 71% to over 100%, depending on the study and follow-up duration, with a higher frequency of technical complications, particularly chipping of the veneering ceramic in layered restorations. CONCLUSION: Metal-ceramic restorations are a benchmark for clinical reliability. All-ceramic and zirconia restorations are effective alternatives, particularly when high esthetic demands are involved. Material selection should be individualized and based on biomechanical constraints, esthetic requirements, and patient-specific characteristics to optimize the long-term clinical outcomes.