A systematic review and meta-analysis of survival and complication rates of monolithic lithium disilicate implant-supported single crowns

Although monolithic implant-supported restorations have been increasingly adopted in clinical practice, clear and specific data on the performance of monolithic lithium disilicate (MLD) implant-supported single crowns (ISSCs) are still lacking. This systematic review and meta-analysis aimed to evaluate the clinical performance of MLD ISSCs, focusing on survival and complication rates, and to assess whether design and procedural factors influence outcomes. A comprehensive electronic search of PubMed/MEDLINE, Scopus, and EMBASE databases up to June 2025 was conducted by two independent reviewers. Eligible studies included randomized controlled trials and prospective clinical investigations. Study quality and risk of bias were evaluated using the Newcastle-Ottawa Scale and the RoB-2 tool. Meta-analysis was performed using R software. From 689 records, 12 studies were included, encompassing 1492.6 crown-years of follow-up. The pooled annual failure rate was 0.93% [95% confidence interval (CI), 0.53–1.62%], with an estimated crown survival of 99.1%, 98.2%, and 97.2% at 1, 2, and 3 years, respectively. Annual complication incidence was 1.45% (95% CI, 0.80–2.65%), corresponding to complication-free survival rates of 98.6%, 97.1%, and 95.7%. Subgroup analyses revealed no meaningful differences based on crown manufacturing method, abutment type, fixation system, or impression technique. MLD ISSCs demonstrate outstanding short- to mid-term clinical success, with low annual failure and complication rates. The consistency of results across varied clinical workflows underscores their reliability. Nevertheless, robust long-term trials are needed to confirm longevity and optimize clinical guidelines.