Purpose: To systematically review clinical studies on prosthodontic complication rates of implant fixed dental prostheses in edentulous patients after an observation period of at least 5 years. Materials and Methods: A literature search was conducted using different electronic databases. Specific terms were used for the database search, which spanned the years 1990 to 2008. The search was augmented by using the option of "related articles" as well as by hand searching of references and relevant journals. Relevant studies were selected according to predetermined inclusion and exclusion criteria. Agreement between reviewers was determined by using Cohen kappa coefficients. Results: The initial database search yielded 8,216 relevant titles. Following the filtering process, 19 studies were finally selected. No study directly compared the incidence of prosthodontic complications of complete implant-supported metal-ceramic versus metal-acrylic resin fixed prostheses in the completely edentulous patient. Studies of metal-ceramic prostheses were scarce and short term. Conclusion: Metal-acrylic resin complete implant fixed prostheses presented with various prosthodontic complications after long-term function. The most frequent complications were veneer fracture and material wear. Keywords: edentulous arch, implant fixed prosthesis, meta-analysis, prosthodontic complications, screw, veneer