Abstract

Fixed full-arch implant-supported prostheses (FA-ISP), such as the "All-on-4" concept, have become a mainstream treatment for edentulous patients. The aim of this umbrella review was to synthesize evidence from published systematic reviews (SRs) on the outcomes and complications of these rehabilitations.

Methods: An electronic search was conducted in PubMed and Web of Science from January 2015 to September 2025. No language restrictions were applied. Studies were included if they were SRs with or without meta-analyses focusing on outcomes and complications of fixed FA-ISP in human adults. Follow-up durations varied across reviews and were not an inclusion criterion. Methodological quality was assessed using AMSTAR 2.

Results: Ten SRs were included. Implant survival was consistently high across all concepts (e.g., 94.8%–99.8% for All-on-4). Five reviews reported on biological complications; peri-implantitis prevalence ranged widely (1.5%–29.7%), primarily due to inconsistent diagnostic definitions. Technical complications (e.g., screw loosening, acrylic fracture) were reported in five reviews and were highly prevalent. AMSTAR 2 assessment revealed that seven SRs were of moderate quality, one was low, and two were critically low.

Conclusions: Fixed FA-ISP demonstrates high long-term survival. However, technical complications are frequent and necessitate ongoing maintenance, while biological risks such as peri-implantitis require lifelong professional monitoring. The variable quality of available SRs highlights the need for more rigorous, standardized research.

Author Note

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Authors & Affiliations

References

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