Objective: To assess the clinical performance of tooth implant-supported removable partial dentures in terms of abutment survival in relation to the attachment system used.

Methods: An electronic search in MEDLINE/PubMed Web of Science and Cochrane Central Register of Controlled Trials databases was performed. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale. Survival rates after 3 years and 5 years, loss, and complication rates per 100 years were estimated by Poisson regression.

Results: A total of twelve studies were included; eleven studies were used for the meta-analysis. Survival analysis for mixed attachments showed an estimated survival rate of 100% after 3 years and 5 years. For uniform attachments, the estimated survival rate was 99.3% after 3 years and 98.8% after 5 years. Tooth abutment survival analysis for mixed attachments estimated a survival rate of 95% after 3 years and 91.7% after 5 years: Uniform attachments reached a survival rate of 97.2% after 3 years and 95.4% after 5 years. The prosthetic survival rate was 100% for mixed and uniform abutments after 3 years and 5 years of function.

Conclusions: Tooth implant-supported removable partial dentures can be considered as a reliable option with excellent prosthetic and implant survival rates and favorable rates for the abutments after 3-year and 5-year follow-ups. Complications may be reduced when 5 or more abutments are used.

Clinical relevance: Tooth implant-supported removable partial dentures are a favorable and potential alternative to restore a partially edentulous arch by optimizing the number and distribution of abutments.