10-year periodontal response to resin bonded bridges

The Relationships Between Tooth-Supported Fixed Dental Prostheses and Restorations and the Periodontium

PURPOSE

To search the literature and to critically evaluate the findings on the periodontal outcomes of restorations and tooth-supported fixed prostheses.

MATERIALS AND METHODS

PubMed was searched according to a systematic methodology, previously reported, but updated to include a larger database. Filters applied were: Case reports, clinical trial, review, guideline, randomized controlled trial, meta-analysis, systematic reviews, and English. A narrative review was then synthesized to discuss periodontal outcomes related to restorations and tooth-supported fixed prostheses. Relevant data was organized into four sections: Direct restorations, indirect restorations, biologic width or supracrestal tissue attachment and tooth preparation/finish line design.

RESULTS

While increased gingival index, bleeding on probing, probing depth and clinical attachment loss have been associated with subgingival restorations, intracrevicular margins do not cause periodontal diseases. Inflammation and bone loss occur, for both direct and indirect restorations, only with large overhangs. Different restorative materials are associated with different clinical responses when placed in the gingival sulcus or within the epithelial and connective tissue attachments. When the connective tissue attachment is removed, histological changes occur causing its apical shift and subsequent re-establishment. Gingival displacement during impression procedures can cause gingival recession. Emergence profile can have a range of values, not associated with periodontal diseases. Periodontal response appears to be clinically not different when compared among different finish line designs.

CONCLUSIONS

Contemporary procedures and materials used for the placement and fabrication of tooth-supported restorations and fixed prostheses are compatible with periodontal health when adequate patient education and motivation in self-performed oral hygiene are present. Periodontal diagnostic criteria should be thoroughly reviewed before fixed restorative treatments are planned and executed.

Maryland Bridge: An Interim Prosthesis for Tooth Replacement in Adolescents

A space in the anterior region of the dental arch of a youngster, either due to trauma or a congenitally missing tooth, can not only lead to psychological trauma but also create a functional dilemma for the dentist, as the usual treatment options of implant, removable partial denture and fixed partial denture available for adults, are often inapplicable or inconvenient for an adolescent. In such a situation, a resin-bonded fixed partial denture (RBFPD), such as Maryland Bridge fulfills all the requirements of an ideal interim solution till growth completion is achieved and a more permanent tooth replacement option can be explored.

The clinical performance of hybrid bridges delivered by undergraduate dental students: a retrospective study

The aim of this study was to retrospectively analyse the clinical performance of hybrid bridges and their effect on periodontal health. All the bridges in this study were delivered by undergraduate dental students at the University Dental School and Hospital Cork. The recall protocol took the form of a questionnaire and a full clinical examination of the abutments, retainers and contra lateral control teeth. In all, 22 patients with 25 bridges were examined. The periodontal response was generally favourable and soft tissue alteration was minimal. The outcome of the performance hybrid bridges is not encouraging, as 32% (8) of the bridges failed and 68% (17) were in service with a mean duration of clinical service of 48 months.

Clinical complications in fixed prosthodontics

The purpose of this article is to identify the incidence of complications and the most common complications associated with single crowns, fixed partial dentures, all-ceramic crowns, resin-bonded prostheses, and posts and cores. A Medline and an extensive hand search were performed on English-language publications covering the last 50 years. The searches focused on publications that contained clinical data regarding success/failure/complications. Within each type of prosthesis, raw data were combined from multiple studies and mean values calculated to determine what trends were noted in the studies. The lowest incidence of clinical complications was associated with all-ceramic crowns (8%). Posts and cores (10%) and conventional single crowns (11%) had comparable clinical complications incidences. Resin-bonded prostheses (26%) and conventional fixed partial dentures (27%) were found to have comparable clinical complications incidences. The 3 most common complications encountered with all-ceramic crowns were crown fracture (7%), loss of retention (2%), and need for endodontic treatment (1%). The 3 most common complications associated with posts and cores were post loosening (5%), root fracture (3%), and caries (2%). With single crowns, the 3 most common complications were need for endodontic treatment (3%), porcelain veneer fracture (3%), and loss of retention (2%). When fixed partial denture studies were reviewed, the 3 most commonly reported complications were caries (18% of abutments), need for endodontic treatment (11% of abutments), and loss of retention (7% of prostheses). The 3 most common complications associated with resin-bonded prostheses were prosthesis debonding (21%), tooth discoloration (18%), and caries (7%).

Tongue piercing: impact of time and barbell stem length on lingual gingival recession and tooth chipping

BACKGROUND

The increasing popularity of tongue piercing has prompted several case reports documenting oral complications of this practice. However, there are no studies assessing potentially significant parameters. The purpose of this study was to evaluate the effect of time (years of wear) and tongue barbell size (stem length) on gingival recession and tooth chipping.

METHODS

Fifty-two adults (mean age 22) with tongue piercings were examined for gingival recession on the lingual aspect of the 12 anterior teeth and for tooth chipping anywhere in the mouth. Subjects were grouped according to years of wear (0 to 2, 2 to 4, and 4+ years) and barbell stem length (long > or =1.59 cm, or short <1.59 cm). Data analysis was based on binomial test and non-parametric tests.

RESULTS

No subject with a tongue piercing <2 years (group 0-2) exhibited lingual recession or tooth chipping. Lingual recession was found on mandibular central incisors in 50% of subjects wearing long barbells for 2 or more years. Tooth chipping was found on molars and premolars in 47% of subjects with a tongue piercing for 4+ years.

CONCLUSIONS

Tongue piercing is associated with lingual recession of mandibular anterior teeth and chipping of posterior teeth. Long-term use of a tongue barbell increases the prevalence of these complications. Barbell stem length appears to differentially affect prevalence of recession and chipping. Since the overwhelming majority of subjects with tongue piercings are young adults, cessation efforts are needed to target this population.

Dental materials: 1995 literature review

This critical review of the published literature on dental materials for the year 1995 has been compiled by the Dental Materials Panel of the United Kingdom. It continues the series of annual reviews started in 1973 and published in the Journal of Dentistry. Emphasis has been placed upon publications which report upon the materials science or clinical performance of the materials. The review has been divided by accepted materials classifications (fissure sealants, glass polyalkenoate cements, resin composites, dentine bonding, dental amalgam, endodontic materials, casting alloys, investment materials, resin-bonded bridges and ceramo-metallic restorations, all ceramic restorations, denture base and soft lining materials, impression materials, dental implants, orthodontic materials and biomechanics). Three hundred and thirty articles published in 68 titles have been reviewed.

Resin-bonded fixed partial dentures. II. Clinical findings related to prosthodontic characteristics after approximately 10 years

A clinical study was conducted for patients who were functioning with resin-bonded fixed partial dentures for approximately 10 years. The purpose of this study was to evaluate the periodontal health and determine the prosthodontic characteristics of the fixed partial dentures. Results indicated that plaque indexes, probing, recession, and loss of attachment were greater for abutments than for control teeth. The differences were statistically significant but clinically small. The bonded restorations were generally well adapted and contoured for case of cleaning.