For a single missing tooth, the survival numbers are close. In a 2007 review that pooled outcomes for each option under one statistical model, implant-supported single crowns had a five-year estimate of 94.5% and a ten-year estimate of 89.4%, and conventional tooth-supported bridges 93.8% and 89.2%.1
What separates them is not survival but what happens to the teeth beside the gap. A conventional bridge requires the dentist to file down at least one healthy tooth on each side to carry it.2 An implant leaves them untouched.
The options, side by side
The most complete set of estimates comes from a single 2007 review that pooled outcome data for five bridge and crown designs, each drawn from its own set of studies and run through the same statistical model. That shared method makes the pooled numbers below comparable in form, but it is not a trial that followed the same patients through all five designs, so the table reports what each pooled estimate was rather than a head-to-head result.1 One of the five, the implant-supported bridge, is a multi-unit design spanning more than one abutment. It is not an ordinary way to close a single gap, and it appears here only because the review reports it alongside the others.
| Option | 5-year survival | 10-year survival |
|---|---|---|
| Implant-supported single crown | 94.5% | 89.4% |
| Conventional tooth-supported bridge | 93.8% | 89.2% |
| Implant-supported bridge | 95.2% | 86.7% |
| Cantilever bridge | 91.4% | 80.3% |
| Tooth-and-implant combined support | 95.5% | 77.8% |
The review's authors ranked the five. A conventional tooth-supported bridge, an implant-supported bridge, and an implant-supported single crown were their first choices. For one missing tooth, though, the practical first choices are the conventional bridge and the implant crown, since the implant-supported bridge is built for a wider span. A cantilever bridge and a design that combines a natural tooth and an implant as supports came second, kept for cases where anatomy or a patient's preference rules out the first three.1
In short
- All five options sit within 4.1 percentage points of each other at five years.
- The review's first choices are the conventional bridge, the implant-supported bridge, and the implant single crown. The implant-supported bridge is a multi-unit design, though, not a routine option for one gap alone.
- 38.7% of implant-supported bridge patients had some complication over five years, whether or not the bridge itself survived, compared with 15.7% for conventional bridges and 20.6% for cantilever bridges.1
What the numbers do not cover
Survival is not the only difference between these options, and it may not be the one that matters most to the teeth next door. A conventional bridge is not glued across the gap. It is anchored on the teeth to either side, and building that anchor means grinding down at least one healthy tooth on each side to accept a crown.2 A tooth that has been cut down for a crown does not grow that structure back.
An implant changes nothing about the neighboring teeth. The fixture is set into the bone at the site of the missing tooth itself, so the teeth on either side stay exactly as they were.
A resin-bonded bridge sits between the two. Instead of full crowns on the neighboring teeth, a thin wing is bonded to the back of one or both of them, removing almost no tooth structure. The review behind these numbers covers both designs, and bonding to just one tooth held up better and detached less often than bonding to both.4 Pooled across every design, survival was 91.4% at five years and roughly 83% at ten, below both the conventional bridge and the implant crown, with debonding and small chips reported fairly often. For a patient who wants to keep drilling to a minimum and can accept a shorter working life in exchange, it is a reasonable middle option.
If you choose the implant
Table 1 above is the most complete set of pooled estimates for weighing an implant against the alternatives, even though each design's estimate is drawn from a different set of studies rather than a single trial. It is not, however, the most current picture of the implant crown on its own. A separate 2018 review, built on a different and larger set of studies, looked only at implant-supported single crowns and the material they are made from.3
Across 4,363 metal-ceramic implant crowns, five-year survival was 98.3%, and across a smaller group of 912 veneered zirconia-ceramic crowns it was 97.6%. The review found no studies on newer monolithic zirconia crowns that met its inclusion criteria, so these figures describe veneered zirconia-ceramic and do not extend to monolithic zirconia. Complication-free rates come from separate, smaller subsets. In a subset of 1,300 metal-ceramic crowns, the estimated five-year rate free of any biological or technical complication was 86.7%. In a subset of 76 veneered zirconia-ceramic crowns, it was 83.8%. Veneered zirconia had fewer esthetic problems but significantly more material fractures, a trade-off the reviewers stated outright.3
These figures come from a different study population than the 2007 comparison above. They are not evidence that implant survival rose between 2007 and 2018, and they should not be read that way. They answer a narrower question: once an implant has been chosen, how does the implant crown perform on current evidence?
Questions patients ask
Which option should I actually pick?
Based on the 2007 comparison, the authors' first choices were a conventional tooth-supported bridge, an implant-supported bridge, and an implant-supported single crown. The implant-supported bridge is a multi-unit design, though, and not an ordinary way to close a single gap, so for one missing tooth the practical first choices are the conventional bridge and the implant crown. A cantilever bridge or a tooth-and-implant combined design comes second, used where the anatomy of the gap or a patient's own preference rules the first three out.
Which material looks the most natural on an implant crown?
Veneered zirconia-ceramic had fewer esthetic complications than metal-ceramic in the 2018 review, but it also had significantly more material fracture failures; the review did not include monolithic zirconia. Metal-ceramic remains the more thoroughly tested option, with a larger set of crowns behind its survival figure.
How often do these options run into problems even when they survive?
Surviving and being trouble-free are not the same thing. Over five years, 38.7% of implant-supported bridge patients had some complication, compared with 15.7% for conventional bridges and 20.6% for cantilever bridges, and resin-bonded bridges debond or chip fairly often without failing outright.
What if I want to avoid touching the teeth next to the gap?
A conventional bridge requires grinding down a healthy tooth on each side. A cantilever bridge only needs one, since it is anchored from a single side rather than both. An implant does not touch either neighboring tooth at all. A resin-bonded bridge removes only a thin layer from the back of a neighboring tooth rather than a full crown's worth, and can be bonded to just one side instead of two.
References
- Pjetursson BE, Brägger U, Lang NP, Zwahlen M. Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs). Clinical Oral Implants Research. 2007;18(Suppl 3):97–113. doi:10.1111/j.1600-0501.2007.01439.x
- Dental Implants. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/10903-dental-implants. Accessed 16 September 2026.
- Pjetursson BE, Valente NA, Strasding M, Zwahlen M, Liu S, Sailer I. A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic single crowns. Clinical Oral Implants Research. 2018;29(Suppl 16):199–214. doi:10.1111/clr.13306
- Thoma DS, Sailer I, Ioannidis A, Zwahlen M, Makarov N, Pjetursson BE. A systematic review of the survival and complication rates of resin-bonded fixed dental prostheses after a mean observation period of at least 5 years. Clinical Oral Implants Research. 2017;28(11):1421–1432. doi:10.1111/clr.13007. PMID: 28191679.
This page describes published clinical practice. It is not a treatment plan, and it does not replace an examination.