Three-year clinical outcomes of additively manufactured hybrid composite implant-supported restorations fabricated through tilting stereolithography: a retrospective clinical study

OBJECTIVES: To evaluate the 3-year clinical performance of additively manufactured (AM) hybrid composite short-span implant-supported restorations fabricated through tilting stereolithography (TSLA) within a fully digital workflow. METHODS: This retrospective clinical study included 218 patients rehabilitated with 278 implant-supported restorations fabricated from a ceramic-filled hybrid composite material using TSLA technology. The restorations comprised 207 single crowns (SCs) and 71 fixed partial dentures (FPDs), supported by 360 implants. All rehabilitations were produced through a complete digital workflow. Primary outcomes included marginal adaptation, occlusal and interproximal contact quality, and chromatic integration, assessed at delivery by two independent evaluators using a 5-point scoring system. Secondary outcomes included restoration survival and restoration success during follow-up. Kaplan-Meier survival analysis was performed. RESULTS: At delivery, both evaluators assigned predominantly excellent or satisfactory scores for marginal adaptation, occlusal contacts, interproximal contacts and chromatic integration, with no significant differences between restoration types (p > 0.05). During follow-up, 3 biological complications (1.1%) and 19 prosthetic complications (6.8%) were recorded, including 7 cases of abutment screw loosening, 6 decementations and 6 restoration fractures. Two implants failed during early healing, while three patients were lost to follow-up during the third year. Kaplan-Meier analysis revealed a cumulative restoration survival rate of 97.8% and an overall restoration success rate of 92.0% after 3 years. CONCLUSIONS: Within the limitations of this short-term study, TSLA-manufactured hybrid composite restorations demonstrated favourable clinical accuracy, high survival rates and acceptable short-term clinical performance. CLINICAL RELEVANCE: Hybrid composite restorations fabricated through TSLA may represent a promising option for definitive short-span implant-supported rehabilitations within contemporary digital prosthodontic workflows.