Clinical performance and patient satisfaction obtained with tooth-supported ceramic crowns and fixed partial dentures

Up to 10 years clinical performance of zirconia ceramic and metal-ceramic fixed partial dentures: A retrospective study

STATEMENT OF PROBLEM

Completely veneered zirconia ceramic (ZC) fixed partial dentures (FPDs) have been reported to have a higher incidence of ceramic chipping than the standard metal-ceramic FPDs. However, data from comparative long-term studies are sparse.

PURPOSE

The purpose of this retrospective study was to compare the long-term survival, chipping-free survival, and success of ceramic-veneered high noble metal alloy (HN), base metal alloy (cobalt-chromium alloy) (CC), and ZC FPDs and to isolate risk factors for the incidence of failure, veneer chipping, and overall complications.

MATERIAL AND METHODS

Data from 289 study participants (58.7% women; mean age, 57.97 ±11.51 years) provided with a total of 400 FPDs comprising 197 (49.3%) HN FPDs, 121 (30.3%) CC FPDs, and 82 (20.5%) ZC FPDs fabricated from presintered 3 mol% yttria-stabilized zirconia (mean time of service, 6.85 ±3.25 years) were evaluated. Of these, 278 (69.5%) FPDs were provided by dentists and 122 (30.5%) by dental students. Five- and 10-year survival, chipping-free survival, and success rates were calculated using the Kaplan-Meier method and compared with the log-rank test. Risk factors were assessed using Cox regression analysis. The study was exploratory, so all P values were considered exploratory and descriptive.

RESULTS

The 5- and 10-year survival rates were 94.7% and 77.8% for HN, 93.7% and 81.2% for CC, and 92.9% and 53.3% for ZC FPDs, respectively, indicating no clear difference in survival among the framework materials. The 5- and 10-year chipping-free rates were 94.1% and 82.8% for HN, 96.1% and 78.9% for CC, and 82.6% and 62.2% for ZC FPDs, respectively, indicating a difference between HN and ZC, and CC and ZC restorations. The 5- and 10-year success rates were 83.7% and 55.3% for HN, 86.5% and 51.4% for CC, and 68.9% and 30.2% for ZC FPDs, respectively, indicating a difference between HN and ZC, and CC and ZC restorations. The Cox regression model indicated framework material as an influencing risk factor for success, and this influence persisted when chipping was investigated. Compared with zirconia, the use of a metal alloy reduced the risk of chipping or the occurrence of complications by up to one-third.

CONCLUSIONS

All FPDs showed high 5-year survival rates and acceptable 10-year survival rates with no strong differences among the materials. Higher success and chipping-free rates were observed for both HN and CC restorations compared with ZC restorations. Metal frameworks had a lower risk for complications or veneer chipping than zirconia frameworks.

Biomechanical behaviour of tilted abutment after fixed partial denture restoration of CAD/CAM materials

BACKGROUND

Failure to restore missing teeth in time can easily lead to the mesial tilting of the distal abutment teeth. However, a fixed partial denture (FPD) can improve stress conduction and distribution and prevent periodontal injuries. In these more complex cases, it is necessary to consider various factors comprehensively to improve conventional treatment planning and achieve better results.

METHODS

We selected a patient with a missing first molar and a mesial inclination of the second molar, leaving inadequate space or bone mass for implant denture restoration, necessitating an FPD for restoration. Three-dimensional finite element analysis (3D-FEA) combined with photoelastic analysis were used to explore how the inclination angle (0 ‒ 30°) and different dental restoration materials (zirconia, lithium disilicate, polymer-infiltrated ceramic network, and resin composite) affect the biomechanical behaviour of FPD‒abutments‒periodontal tissue complex.

RESULTS

The stress was easily concentrated in the FPD connectors, enamel shoulder collar, periapical area, and root bifurcation. The stress on FPD and the periodontal ligament (PDL) of the second premolar increased with an increase in the elastic modulus of FPD, with an opposite trend in the abutments, the alveolar bone, and the PDL of the second molar. The stress on the FPD and alveolar bone increased with increased inclination angle of the distal abutment. The stress on two abutments and their PDL were positively correlated with the inclination angle in two stages; however, when the inclination angle > 12°, the second premolar and its PDL showed a negative correlation.

CONCLUSIONS

FPDs can be used for restoration within 24° of distal abutment inclination, but protecting the abutments (< 12° especially) and the periodontal tissue (> 12° especially) must be taken seriously. For this purpose, an FPD material with higher strength is recommended.

Survival and complication rates of tooth- and implant-supported restorations after an observation period up to 36 years

BACKGROUND

Tooth- and implant-supported fixed dental prostheses are well-documented and aesthetic treatment alternatives, and after a comprehensive periodontal treatment, a protocol with a good long-term prognosis if the maintenance program is strictly followed.

AIM

To reexamine a pre-existing patient cohort in order to obtain estimated long-term survival and complication outcomes of fixed dental prostheses.

MATERIALS AND METHODS

For this study, patients treated with fixed dental prostheses between 1978 and 2002 were reexamined between 2019 and 2020. The restorations were divided in single crowns and fixed dental prostheses supported by teeth (TSC, FPTDP) and implants (ISC, FPIDP). Survival and complication rates were obtained. Kaplan-Meier functions were used to model complication probabilities, and average hazard ratios of different strata were compared using weighted Cox regression.

RESULTS

The mean observation time of 40 patients and 223 reconstructions was 20.3 (±9.7, 1.2-36.2) years. The estimated survival rates were 84% (CI: 77%-92%) for TSC, 63% (CI: 51%-79%) for FPTDP, 87% (CI: 71%-100%) for ISC, and 64% (CI: 34%-100%) for FPIDP after 25 years. Biological complications included carious lesions (10.6%), periodontitis (7.9%), and peri-implantitis (6.8%). Technical complications included chipping (20.2%) and loss of retention (10.8%).

CONCLUSION

Biological complications lead to abutment loss in more than two-thirds of cases, regardless of the type of abutment (tooth or implant). Technical complications are less associated with abutment loss than biological complications.

Biomechanical reinforcement by CAD-CAM materials affects stress distributions of posterior composite bridges: 3D finite element analysis

OBJECTIVES

This 3D finite element analysis study aimed to investigate the effect of reinforcing CAD-CAM bars on stress distribution in various components of a posterior composite bridge.

METHODS

A virtual model mimicking the absence of an upper second premolar was created, featuring class II cavity preparations on the proximal surfaces of the adjacent abutment teeth surrounding the edentulous space. Five distinct finite element analysis (FEA) models were generated, each representing a CAD-CAM reinforcing bar material: 3-YTZP (IPS. emax ZirCAD MO; Zr), lithium disilicate (IPS e.max CAD; EX), nano-hybrid resin composite (Grandio Blocs; GB), Fibre-reinforced composite (Trilor; Tri), and polyetheretherketone (PEEK). A veneering resin composite was employed to simulate the replacement of the missing premolar (pontic). In the FEA, an axial force of 600 N and a transverse load of 20 N were applied at the center of the pontic. Subsequently, maximum von Mises (mvM) and maximum principal stresses (σmax) were computed across various components of the generated models. Additionally, shear stresses at the interface between the CAD-CAM bars and the veneering resin composite were determined.

RESULTS

CAD-CAM materials with high modulus of elasticity, such as Zr and EX, exhibited the highest mvM stresses and shear stresses while transferring the lowest stress to the veneering resin composite in comparison to other materials. Conversely, PEEK demonstrated the lowest mvM stresses but produced the highest stresses within the veneering resin composite. There was a uniform distribution of mvM stresses in the remaining tooth structure among all groups, except for a noticeable elevation in the molar region of Zr and EX groups.

SIGNIFICANCE

Reinforcing CAD-CAM bar materials with a high modulus of elasticity, such as Zr and EX, may result in debonding failures at the connector sites of posterior composite bridges. Conversely, GB, PEEK, and Tri have the potential to cause fracture failures at the connectors rather than debonding.

Quality of Fixed Dental Prostheses and Patient Satisfaction in a Sample From Saudi Arabia

BACKGROUND

The objective of the study was to retrospectively assess the clinical performance of dental prostheses, single crowns, and three-unit bridges to identify clinical biological and mechanical complications in the Ha'il province of Saudi Arabia.

METHODS

The study was conducted between March 2021 to October 2021 and included 421 patients who underwent crown and tooth-supported fixed partial denture (FPD) procedures at the Dental Polyclinics Center in the Ha'il region of Saudi Arabia from 2010-2020. The planned sampling approach was applied. Patients who underwent crown and FPD placements at the dental center within the scheduled period were identified through clinical assessments. The inclusion criteria were met by patients with three-unit FPDs and a single crown containing a natural contralateral tooth or teeth. A total of six general dentists conducted clinical exams. Patient satisfaction and technical and biological issues were the evaluation criteria for crowns and FPDs. The frequency and percentage of the various characteristics employed in the current investigation were ascertained using cross-tabulation. The Chi-square test was employed to assess the associations between categorical variables, with p-values ≤ 0.05 considered significant.  Results: Marginal integrity was recorded in 332 participants (78.9%), which was satisfactory for the majority of the restoration. The acceptance morphology was present in 252 (59.9%) restorations. The highest rate of the restorations 274 (66.2%) had satisfactory color. In 86 cases (20.4%), there was visible periodontal depth of at least 5 mm. Three hundred and six (72.7%) of the fixed restorations had gingival bleeding connected to them, and 96 (22.8%) teeth had periapical lesions. A total of 311 patients (73.9%) reported they were satisfied with their fixed restorations.

CONCLUSIONS

The technical and biological complications noted in the current study were not higher compared with other studies of crowns and fixed dental prostheses. The majority of patients were satisfied with the restoration.

Clinical outcomes of tooth-supported monolithic zirconia vs. porcelain-veneered zirconia fixed dental prosthesis, with an additional focus on the cement type: a systematic review and meta-analysis

PURPOSE

To compare the failure rates and the prevalence of technical complications between full-coverage tooth-supported monolithic zirconia (MZ) and porcelain-veneered zirconia (PVZ) fixed dental prosthesis, based on a systematic literature review.

METHODS

An electronic search was performed in three databases, supplemented by hand searching. Several statistical methods were used.

RESULTS

Seventy-four publications reported 6370 restorations (4264 PVZ; 2106 MZ; 8200 abutment teeth; 3549 patients), followed up until 152 months. A total of 216 prostheses failed, and survival was statistically significant different between groups. PVZ had higher occurrence of complications than MZ; the difference was especially greater for either minor or major chipping. The difference in prevalence of either minor or major chipping was statistically significant for PVZ prostheses between cementation with glass ionomer and adhesive resin cement (higher), adhesive resin and resin-modified glass ionomer cement (RMGIC, higher), and between RMGIC (higher) and glass ionomer cement. For MZ the difference was significant only for minor chipping between RMGIC (higher) and adhesive resin cement. Abutment teeth to PVZ prostheses more often lost vitality. Decementation was not observed with RMGIC. Air abrasion did not seem to clinically decrease the decementation risk. The 5-year difference in the occurrence of minor or major chipping between MZ and PVZ prostheses was statistically significant, but nor for catastrophic fracture.

CONCLUSION

Tooth-supported PVZ prostheses present higher failure and complication rates than MZ prosthesis. The difference in complications is striking when it comes to chipping.

CLINICAL RELEVANCE

Awareness of the outcome differences between different types of zirconia prostheses is important for clinical practice.

Clinical outcomes of single full-coverage lithium disilicate restorations: A systematic review

Introduction

Lithium disilicate glass-ceramic (LDC) restorations exhibit microorganism infiltration, recurrent caries, pulpal lesions, periodontal inflammation, and cement exposure to the oral environment over time. All these factors lead to restoration failure. This systematic review aimed to investigate the clinical outcomes of LDC full-coverage crowns (FCC) in permanent teeth compared with those of other full-coverage restoration materials.

Materials & Methods

Search strategies were developed for four databases: Web of Science, OVID, PubMed, and Scopus. Data extraction and quality appraisals were performed by two independent reviewers. Data on the presence of caries, post-operative sensitivity, and periodontal changes were extracted from the included clinical studies. In addition to the outcome measures, data on the sample size, study groups, method of restoration fabrication, type of impression, and type of abutment were recorded.

Results

We retrieved 3989 records for the title and abstract screening. Of these, 19 clinical studies met the inclusion criteria. The overall quality of the included studies indicates a low risk of bias. Most studies reported no pulpal involvement, recurrent caries, or post-operative sensitivity and presented a favorable periodontal response after the cementation of LDC-FCC during different follow-up periods.

Conclusion

Based on the endodontic and periodontic clinical responses of natural tooth abutments and their supporting periodontium, LDC-FCC can be considered a clinically successful restorative option.

In Vitro Evaluation of marginal adaptation of polyether ether ketone and zirconia copings

Background

Polyether ether ketone (PEEK) has emerged as a new thermoplastic material with potential applications as a restorative material. Aim: This study aimed to evaluate the marginal adaptation of PEEK copings compared to zirconia copings using field emission scanning electron microscopy.

Materials and Methods

A freshly extracted maxillary central incisor was prepared for a full-coverage restoration following standard principles of tooth preparation. The tooth was sent to a laboratory for fabrication of samples using computer-aided design and manufacturing (CAD/CAM). Twenty samples of polyether ether ketone (PEEK) copings (group A) and 20 of zirconia copings were fabricated (group B). The copings were scanned under a field emission scanning electron microscope and measurements were taken at four distinct points. The marginal adaptation over the buccal, lingual, mesial, and distal margins for both groups was evaluated. One-way analysis of variance (ANOVA) and independent t test were applied.

Results

Our findings indicate that PEEK showed better marginal adaptation than zirconia at all measurement points. The mean marginal gap value of the PEEK group was 33.99 ± 8.81 μm and of the zirconia group was 56.21 ± 15.07 μm. On comparing marginal adaptation among the mesial, distal, buccal, and lingual aspects, PEEK showed better adaptation on all four margins, with the best adaptation on the buccal margin that had the lowest mean gap value of 29.27 ± 6.07 μm. The zirconia group adapted best at the distal margin, with a lowest mean gap value of 53.58 ± 15.25 μm (P ≤ 0.05).

Conclusion

PEEK copings had better marginal adaptation and fit compared to zirconia copings. It may have applications as a restorative material in fixed prostheses.

Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations: a systematic review and meta-analysis

BACKGROUND

Restoring vital teeth with indirect restorations may threaten dental pulp integrity. However, the incidence of and influential factors on pulp necrosis and periapical pathosis in such teeth are still unknown. Therefore, this systematic review and meta-analysis aimed to investigate the incidence of and influential factors on pulp necrosis and periapical pathosis of vital teeth following indirect restorations.

METHODS

The search was conducted in five databases, using MEDLINE via PubMed, Web of Science, EMBASE, CINAHL, and Cochrane Library. Eligible clinical trials and cohort studies were included. The risk of bias was assessed using Joanna Briggs Institute's critical appraisal tool and Newcastle-Ottawa Scale. The overall incidences of pulp necrosis and periapical pathosis following indirect restorations were calculated using a random effects model. Subgroup meta-analyses were also performed to determine the potential influencing factors for pulp necrosis and periapical pathosis. The certainty of the evidence was assessed using the GRADE tool.

RESULTS

A total of 5,814 studies were identified, of which 37 were included in the meta-analysis. The overall incidences of pulp necrosis and periapical pathosis following indirect restorations were determined to be 5.02% and 3.63%, respectively. All studies were assessed as having a moderate-low risk of bias. The incidence of pulp necrosis following indirect restorations increased when the pulp status was objectively assessed (thermal/electrical testing). The presence of pre-operative caries or restorations, treatment of anterior teeth, temporization for more than two weeks, and cementation with eugenol-free temporary cement, all increased this incidence. Final impression with polyether and permanent cementation with glass ionomer cement both increased the incidence of pulp necrosis. Longer follow-up periods (> 10 years) and treatment provided by undergraduate students or general practitioners were also factors that increased this incidence. On the other hand, the incidence of periapical pathosis increased when teeth were restored with fixed partial dentures, the bone level was < 35%, and the follow-up was > 10 years. The certainty of the evidence overall was assessed as low.

CONCLUSIONS

Although the incidences of pulp necrosis and periapical pathosis following indirect restorations remain low, many factors affect these incidences that should thus be considered when planning indirect restorations on vital teeth.

DATABASE REGISTRATION

PROSPERO (CRD42020218378).

Fatigue Resistance of 3-Unit CAD-CAM Ceramic Fixed Partial Dentures: An FEA Study

PURPOSE

To estimate the fatigue life of 3-unit molar fixed partial dentures (FPDs) made from two different monolithic ceramic systems, zirconia cercon (ZC) and lithium disilicate (LD). The effect of the connector size on the fatigue resistance of the monolithic FPD was also investigated.

METHODS

Two models for the FPDs were built, a 3-unit all-ceramic and a porcelain-fused-to-metal. The porcelain-fused-to-metal FPD model was used as the control. Actual 3-unit FPDs (replacing the second lower premolar) were constructed using a computer aided design and computer-aided manufacturing (CAD-CAM) system. Finite element analysis (FEA) was executed. A hemispherical indenter was used to simulate occlusal load. The occlusal load phase of the chewing cycle was applied at the premolar pontic.

RESULTS

The failure location for the monolithic FPD was always located at the distal connector. Connector size played a key role in determining the long-term survival of the prosthesis. The fatigue resistance was predicted to be 670 N for the ZC with a connector size 4 × 3 mm, while it was only 226 N for LD. As for porcelain-fused-to-metal (PFM), FEA predicts that fatigue resistance can reach up to 770 N. Under the cyclic load of 670 N, the fatigue life for the zirconia FPD with connector size 4 × 3 mm was 2.23 × 10⁶ cycles while it survived only 3.1 × 10⁵ cycles when the connector was reduced to 3.5 × 2.5 mm. The angle of the oblique load has a significant effect on the stress distribution.

CONCLUSION

3-unit monolithic FPDs made of ZC have superior fatigue performance compared to those made of LD. The fatigue life of the zirconia FPD was about three times longer than that made of LD with a connector size of 4 mm × 3 mm. The survival rates of ZC FPDs are comparable to porcelain-fused-to-metal. A significant reduction in fatigue strength is predicted for reduced connector size. Therefore, it is necessary to establish general guidelines for the minimum connector size.

Evaluation and Comparison of Five-Year Survival of Tooth-Supported Porcelain Fused to Metal and All-Ceramic Multiple Unit Fixed Prostheses: A Systematic Review

The prosthesis must have good survival despite being functional for at least 5-10 years. This makes sure that the replacement of missing teeth does not become a repeated expense. Of 579 identified articles, 15 met the inclusion criteria for systematic review. Missing teeth replacement materials are divided into two groups: porcelain fused to metal and all ceramics. Data related to survival rates as well as the most common mode of failure is observed from both groups. It was observed that porcelain fused to metal prostheses had an approximately 99.5% survival rate and an approximately 92% survival rate for all-ceramic tooth-supported prostheses after five years of insertion. Porcelain-fused-to-metal (PFM) prostheses had a better survival rate after five years of insertion as compared to all-ceramic prostheses. Porcelain fused to metal should be the treatment of choice for dentists and patients when missing teeth need to be fixed.

Additive or subtractive manufacturing of crown patterns used for pressing or casting: A trueness analysis

OBJECTIVES

To investigate the effect of subtractive and additive manufacturing techniques on the trueness of crown patterns used for pressing or casting.

MATERIAL AND METHODS

A complete-coverage mandibular right first molar crown was designed in standard tessellation language (STL) format. This STL served as the control (C-STL) and was used to fabricate 30 crown patterns in 3D-printed resin (PR, ProArt Print Wax), millable wax suitable for casting (BW, ProArt CAD Wax Blue), and millable wax suitable for pressing (YW, ProArt CAD Wax Yellow) (n = 10). Subtractively manufactured patterns were fabricated by using a 5-axis milling unit (PrograMill PM7), while 3D-printed patterns were fabricated by using a digital light processing-based 3D printer (PrograPrint PR5; Ivoclar Vivadent, Schaan, Liechtenstein). All fabricated patterns were digitized by using an intraoral scanner (CEREC Primescan SW 5.2) to generate test-STLs. C-STL and test-STLs were transferred into a 3D analysis software (Medit Link v 2.4.4). Trueness evaluation was performed at 4 different surfaces (external, intaglio with margin, marginal, and intaglio without margin) and for complete scan meshes (overall) by using the root mean square (RMS) method. Data were analyzed with Kruskal-Wallis and Mann-Whitney U tests (α = .05).

RESULTS

RMS values varied significantly at all surfaces (P < .001), except for marginal surface (P = .151). PR had the highest RMS values at external surface (P ≤ .007), intaglio surfaces (with (P ≤ .003) and without margin (P ≤ .005)), and overall (P ≤ .01). No significant differences were observed between YW and BW (P ≥ .223).

CONCLUSION

Patterns fabricated by using subtractive manufacturing exhibited high trueness. The deviation values, in general, were small, particularly at intaglio and marginal surfaces; thus, clinical difference in crown-fit may be negligible using additive or subtractive technique.

CLINICAL SIGNIFICANCE

The fit of definitive crowns may be similar when tested crown patterns are additively or subtractively manufactured. However, crowns fabricated by using tested 3D-printed resin patterns may require more chairside adjustments compared with those fabricated by using subtractively manufactured wax patterns.

Comparative Assessment of the Functional Parameters for Metal-Ceramic and All-Ceramic Teeth Restorations in Prosthetic Dentistry-A Literature Review

Simple Summary

In the last decades, the science and technology of all-ceramic teeth restorations witnessed the fastest-growing field of restorative materials in research and development for fixed prosthodontics. Due to their properties, characterized by a high level of biocompatibility, excellent optical properties, and high fracture resistance, all-ceramic material can also be used in the posterior areas of the dental arches. However, metal-ceramic fixed partial dentures are still perceived as the golden standard for those restorations, thanks to the positive clinical outcomes. Irrespective of the materials of which fixed partial dentures are performed, their success rates depend on the expected outcome and on how they perform in the oral environment. Such conditions of failure restorations may include biological factors (i.e., secondary decay, loss of vitality, periodontal disease, or abutment fracture) or technical factors (i.e., chipping, ceramic fracture, framework fracture, or loss of retention). Our aim is to provide the current evidence for the efficacy of metal-ceramics and all-ceramics in the treatment of multiple posterior edentulous spaces. Moreover, we aim to compare the survival rates of metal-ceramic and all-ceramic fixed partial dentures in terms of functionality and biocompatibility in all the aforementioned clinical situations. Our results have shown that all all-ceramic systems, especially densely sintered zirconia and reinforced glass ceramics, have a promising future to satisfy both practitioners and patients. However, technical and biological complications need to be taken into account when planning multi-unit fixed partial dentures for the posterior areas.

Abstract

The metal-ceramic fixed partial prosthesis is the golden standard for posterior tooth restorations. Following the demands of patients and clinicians for metal-free restorations, all-ceramic materials were developed as they offer an adequate alternative with better optical qualities and good mechanical properties. This study aims to carry out a bibliographic review to assess the survival rate and the biological and technical complications of all-ceramic and metal-ceramic fixed partial dentures. An electronic search for articles in the English language literature was performed using PubMed (MEDLINE). This literature review focused on research studies between 2010 and 2020 that performed clinical studies on tooth-supported fixed partial dentures with a mean follow-up of at least 3 years. All the studies, which analyzed the survival and complications of tooth-supported fixed partial dentures, were included. Thus, 14 studies reporting on 756 all-ceramic and 160 metal-ceramic fixed partial dentures met the inclusion criteria. A comparative analysis was carried out based on all the data existing in the studies included in this review. The metal-ceramic fixed partial dentures showed survival rates of 95% to 100% at 3-, 5-, and 10-year follow-up periods. Zirconia fixed partial dentures were reported to have survival rates of 81% to 100% at 3-, 5-, 9-, 10-year follow-up evaluations. The reinforced glass-ceramic fixed partial dentures showed survival rates of 70% to 93.35% at 5 years, while the alumina FPDs showed a survival rate of 68% at 3 years follow-up. The incidence of caries and loss of vitality were reported as higher for all-ceramic prostheses as compared to the metal-ceramic ones. A significant framework fracture was reported for glass-infiltrated alumina fixed partial dentures in comparison to metal-ceramic fixed partial dentures. All-ceramic and metal-ceramic restorations showed similar survival rates after 3 years, although all-ceramic restorations have problems with technical complications such as chipping, which can lead to framework fractures over time.

A retrospective comparison of the survival of vital teeth adjacent to single, bounded edentulous spaces rehabilitated using implant-supported, resin-bonded, and conventional fixed dental prostheses

OBJECTIVES

In this study, we aimed to compare the long-term survival of vital teeth adjacent to bounded edentulous spaces rehabilitated using an implant-supported prosthesis (ISP), a resin-bonded fixed partial denture (RBFPD), or a conventional fixed partial denture (CFPD). The risk factors for complications in teeth adjacent to the edentulous space (TAES) were also investigated.

METHODS

We followed-up a consecutive series of 514 patients who underwent rehabilitation of a single bounded edentulous space with vital TAES (ISP: 103; RBFPD: 216; and CFPD: 195) from 2008 to 2017. Cumulative survival rates of prosthesis and TAES, and complication-free rates of TAES, were evaluated using the Kaplan-Meier analysis and log-rank test. Risk factors were evaluated using a Cox proportional hazards model.

RESULTS

Cumulative complication-free rates of TAES showed no significant differences among the three groups. The cumulative survival rate of TAES in CFPD was significantly lower than that of ISP (p = 0.037); no significant differences were observed between ISP and RBFPD (p = 0.513), and RBFPD and CFPD (p = 0.076). Older age (p = 0.027) was the only independent significant risk factor for complications in TAES. Installation of CFPD (p = 0.019), ceramic prosthesis in edentulous space (p = 0.026), and deeper periodontal probing depth (p = 0.018) of TAES were significant risk factors for non-surviving TAES.

CONCLUSIONS

Rehabilitating a single bounded edentulous space with CFPD could increase the risk for TAES loss compared with ISP. Risk of TAES loss remained similar between ISP and RBFPD, which can minimize the loss of coronal tooth structure during tooth preparation.

CLINICAL SIGNIFICANCE

Teeth adjacent to edentulous space show equivalent longevity when rehabilitating a single bounded edentulous space with resin-bonded fixed partial dentures or single standing implant-supported prosthesis, at least 10 years post-installation.