Splinting: a retrospective 17-year follow-up study

Effectiveness of porcine-derived xenograft with enamel matrix derivative for periodontal regenerative treatment of intrabony defects associated with a fixed dental prosthesis: a 2-year follow-up retrospective study

Purpose

Due to the difficulty of the hygienic care and sanitary management of abutment teeth and subpontic areas associated with fixed dental prostheses (FDPs), intrabony defects occur and accelerate due to the accumulation of plaque and calculus. This study aimed to evaluate the efficacy of regenerative periodontal surgery for intrabony defects associated with FDPs.

Methods

The study inclusion criteria were met by 60 patients who underwent regenerative treatment between 2016 and 2018, involving a total of 82 intrabony defects associated with FDPs. Periodontal osseous lesions were classified as 1-, 2-, and 3-wall intrabony defects and were treated with an enamel matrix derivative in combination with bone graft material. The changes in clinical (pocket probing depth [PPD] and clinical attachment level [CAL]) and radiographic (defect depth and width) outcomes were measured at baseline and at 6, 12, and 24 months.

Results

Six months after regenerative treatment, a significant reduction was observed in the PPD of 1-wall (P<0.001), 2-wall (P<0.001), and 3-wall (P<0.001) defects, as well as a significant reduction in the CAL of 2-wall (P<0.001) and 3-wall (P<0.001) intrabony defects. However, there was a significant increase in the CAL of 1-wall intrabony defects (P=0.003). Radiographically, a significant reduction in the depth of the 3-wall (P<0.001) defects and a significant reduction in the width of 2-wall (P=0.008) and 3-wall (P<0.001) defects were observed. The depth decreased in 1-wall defects; however, this change was not statistically significant (P=0.066).

Conclusions

Within the limitations of the current study, regenerative treatment of 2- and 3-wall intrabony defects associated with FDPs improved clinical and radiological outcomes. Additional prospective studies are necessary to confirm our findings and to assess long-term outcomes.

Preservation of Hypermobile Teeth by Establishing Posterior Occlusal Support Using Implant Prostheses: A 5-Year Follow-Up

For patients with periodontally compromised, hypermobile teeth, implant-supported fixed dental prostheses (FDPs) or removable dentures are often used after extracting mobile teeth. The loss of native teeth may carry social consequences, depending upon the patient's age, state of health, and degree of social functioning. This report represents successful stabilization and preservation of questionable, hypermobile teeth that have been damaged by traumatic occlusion due to the loss of posterior support with a cross-arch splinted FDP, as well as the implementation of posterior support using implant-supported prostheses.

A systematic review of outcome measurements and quality of studies evaluating fixed tooth-supported restorations

PURPOSE

The purpose of this systematic review was to review clinical studies of fixed tooth-supported prostheses, and to assess the quality of evidence with an emphasis on the assessment of the reporting of outcome measurements. Multiple hypotheses were generated to compare the effect of study type on different outcome modifiers and to compare the quality of publications before and after January 2005.

MATERIALS AND METHODS

An electronic search was conducted using specific databases (MEDLINE via Ovid, EMBASE via Ovid, Cochrane Library) through July 2012. This was complemented by hand searching the past 10 years of issues of the Journal of Oral Rehabilitation, Journal of Prosthetic Dentistry, Journal of Prosthodontics, and the International Journal of Prosthodontics. All experimental and observational clinical studies evaluating survival, success, failure, and complications of tooth-supported extracoronal fixed partial dentures, crowns, and onlays were included. No restrictions on age or follow-up time were placed.

RESULTS

The electronic search generated 14,869 papers, of which 206 papers were included for full-text review. Hand-searching added 23 papers. Inclusion criteria were met by 182 papers and were included for the review. The majority were retrospective studies. Only 8 (4.4%) were randomized controlled trials. The majority of the studies measured survival and failure, and few studies recorded data on success; however, more than 60% of the studies failed to define survival, success, and failure. Many studies did not use any standardized criteria for assessment of the quality of the restorations and, when standardized criteria were used, they were modified, thereby not allowing for comparisons with other studies. There was an increase of 21.8% in the number of studies evaluating outcome measurements of all-ceramic restorations in past 8 years.

CONCLUSIONS

Prosthodontic literature presents with a reduced percentage of RCTs compared to other disciplines in dentistry. The overall quality of recording prosthodontic outcome measurements has not improved greatly in the past 8 years.

Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs)

OBJECTIVES

The objective of this systematic review was to assess and compare the 5- and 10-year survival of different types of tooth-supported and implant-supported fixed dental prosthesis (FDPs) and single crowns (SCs) and to describe the incidence of biological and technical complications.

METHODS

Three electronic searches complemented by manual searching were conducted to identify prospective and retrospective cohort studies on FDPs and SCs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Failure and complication rates were analyzed using random-effects Poisson's regression models to obtain summary estimates of 5- and 10-year survival proportions.

RESULTS

Meta-analysis of the included studies indicated an estimated 5-year survival of conventional tooth-supported FDPs of 93.8%, cantilever FDPs of 91.4%, solely implant-supported FDPs of 95.2%, combined tooth-implant-supported FDPs of 95.5% and implant-supported SCs of 94.5%. Moreover, after 10 years of function the estimated survival decreased to 89.2% for conventional FDPs, to 80.3% for cantilever FDPs, to 86.7% for implant-supported FDPs, to 77.8% for combined tooth-implant-supported FDPs and to 89.4% for implant-supported SCs. Despite high survival rates, 38.7% the patients with implant-supported FDPs had some complications after the 5-year observation period. This is compared with 15.7% for conventional FDPs and 20.6% for cantilever FDPs, respectively. For conventional tooth-supported FDPs, the most frequent complications were biological complications like caries and loss of pulp vitality. Compared with tooth-supported FDPs, the incidence of technical complications was significantly higher for the implant-supported reconstructions. The most frequent technical complications were fractures of the veneer material (ceramic fractures or chipping), abutment or screw loosening and loss of retention.

CONCLUSION

On the basis of the results of the present systematic review, planning of prosthetic rehabilitations should preferentially include conventional end abutment tooth-supported FDPs, solely implant-supported FDPs or implant-supported SCs. Only for reasons of anatomical structures or patient-centered preferences and as a second option should cantilever tooth-supported FDPs or FDPs supported by combination of implants and teeth be chosen.

Ante's (1926) law revisited: a systematic review on survival rates and complications of fixed dental prostheses (FDPs) on severely reduced periodontal tissue support

BACKGROUND

In subjects suffering from generalized severe periodontitis, only a few teeth may be treated and used as abutments for fixed dental prostheses (FDPs).

OBJECTIVE

To systematically review the impact of severely reduced, but healthy periodontal tissue support on the survival rate and complications of FDPs after a mean follow-up time of at least 5 years.

SEARCH STRATEGY

Publications considered for inclusion were searched in MEDLINE (PubMed) and relevant journals were hand searched. The search was performed in duplicate and was limited to human studies published in the dental literature from 1966 up to and including September 2006. Only publications in English, in peer-reviewed journals, were considered. Abstracts were excluded.

SELECTION CRITERIA

Prospective and retrospective cohort studies were included. The primary outcome measure included survival rates of FDPs and abutment teeth, whereas biological and technical complications of FDPs and abutment teeth represented secondary outcome measures.

DATA ANALYSIS

Summary estimates of survival rates and of biological and technical complications were calculated after 5 and 10 years.

RESULTS

The search provided 860 titles of which six publications were included. A total of 579 FDPs were incorporated and followed up to 25 years. Meta-analysis yielded an estimated FDP survival rate of 96.4% [95% confidence interval (95% CI): 94.6-97.6%] after five and of 92.9% (95% CI: 89.5-95.3%) after 10 years, respectively. After 10 years, the estimated rate of abutment teeth without endodontic complications amounted to 93% (95% CI: 62.6-98.9%). The 10-year estimated rate of caries-free abutment teeth was 98.1% (95% CI: 88.2-99.7%). FDPs without loss of retention were estimated to occur in 95.4% (95% CI: 92.6-97.2%) of cases after 10 years.

CONCLUSIONS

These results showed that (i) masticatory function could be established and maintained in subjects receiving FDPs on abutment teeth with severely reduced but healthy periodontal tissue support and (ii) FDPs survival rates compared favourably with those of FDPs incorporated in subjects without severely periodontally compromised dentitions.

Multi-unit fixed partial denture for a bilateral cleft palate patient: a clinical report

Patients with cleft palates eventually require definitive fixed or removable dental prostheses after the maintenance of arch alignment and occlusal relationship during adolescence. This case report presents application of a resin composite veneered fixed partial denture utilized as a definitive prosthesis for a bilateral cleft palate patient after stable occlusion had been established orthodontically. The composite veneered long span fixed partial denture provides adequate aesthetics and function.

A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. III. Conventional FPDs

The present study was done to determine the long-term success and survival of fixed partial dentures (FPDs) and to evaluate the risks for failures due to specific biological and technical complications. A MEDLINE search (PubMed) from 1966 up to March 2004 was conducted, as well as hand searching of bibliographies from relevant articles. Nineteen studies from an initial yield of 3658 titles were finally selected and data were extracted independently by three reviewers. Prospective and retrospective cohort studies with a mean follow-up time of at least 5 years in which patients had been examined clinically at the follow-up visits were included in the meta-analysis. Publications only based on patients records, questionnaires or interviews were excluded. Survival of the FPDs was analyzed according to in situ and intact failure risks. Specific biological and technical complications such as caries, loss of vitality and periodontal disease recurrence as well as loss of retention, loss of vitality, tooth and material fractures were also analyzed. The 10-year probability of survival for fixed partial dentures was 89.1% (95% confidence interval (CI): 81-93.8%) while the probability of success was 71.1% (95% CI: 47.7-85.2%). The 10-year risk for caries and periodontitis leading to FPD loss was 2.6% and 0.7%, respectively. The 10-year risk for loss of retention was 6.4%, for abutment fracture 2.1% and for material fractures 3.2%.