Consensus Statement 1: Zirconia ceramic (veneered) implant supported FDPs exhibit significantly lower 5-year survival rates than metal ceramic implant supported FDPs

Zirconia ceramic (veneered) implant supported FDPs exhibit significantly lower 5-year survival rates than metal ceramic implant supported FDPs. This statement is based on 14 studies reporting on 932 implant-supported metal ceramic FDPs (9 Prospective, 5 Retrospective) and three studies (2 Prospective and 1 Retrospective) reporting on 175 veneered zirconia implant-supported FDPs.

Consensus Statement 2: There is a lack of information in current literature on the biological and technical outcomes of zirconia ceramic and metal ceramic implant supported FDPs

There is a lack of detailed information in the current literature to provide a statement on the biological and technical outcomes of the zirconia ceramic and metal ceramic implant supported FDPs. This statement is based on the systematic review scrutinizing the available literature on implant supported multiple unit FDPs.

Consensus Statement 3: Significantly more zirconia ceramic implant supported FDPs fail due to material fracture

Significantly more zirconia ceramic implant supported FDPs fail due to material fracture than metal ceramic implant supported FDPs. This statement is based on 18 clinical trials (11 Prospective and 7 Retrospective).

Consensus Statement 4: Chipping of veneering ceramic is a common technical complication

Chipping of the veneering ceramic is a common technical complication for both types of FDPs and may lead to a need for repair or replacement of the FDP. This statement is based on 14 clinical trials (8 Prospective and 6 Retrospective).

1) Zirconia ceramic implant supported FDPs cannot be recommended as a first treatment option

Zirconia ceramic (i.e., veneered) implant supported FDPs cannot be recommended as a first treatment option. If utilized, the patients need to be informed about the risks for fractures of the framework and chipping of the veneering ceramic.

2) Metal ceramic using high noble or noble alloys should be considered as the first option for implant supported FDPs

Metal ceramic, using high noble (noble metal content > or =60% and gold > or =40%) or noble (noble metal content > or =25%) alloys, should still be considered as the first option for implant supported FDPs.

3) Monolithic zirconia may be an interesting alternative considering the high costs of conventional metal ceramic FDPs and technical problems associated with the veneered FDPs

Due to the high costs of conventional metal ceramic FDPs and frequent technical problems associated with the veneered FDPs, monolithic zirconia may be an interesting alternative. However, clinical medium- to long-term outcomes have yet to be sufficiently analysed.