A retrospective clinical evaluation of extensive tooth-supported fixed dental prostheses after 10 years. 2021

Helena Alsterstål-Englund, and Lars-Erik Moberg, and Jenny Petersson, and Jan-Ivan Smedberg
Specialist in Dental Prosthetics, Department of Prosthetic Dentistry, Folktandvården Eastman Institute, Stockholm, Sweden. Electronic address: Helena.alsterstal-englund@sll.se.

BACKGROUND The survival and success of tooth-supported fixed dental prostheses (FDPs) in long-term studies vary greatly, depending on the patient and the size of the FDP. Influencing factors for FDP survival or success may include advanced patient age at the time of FDP treatment, treatment severity, and use of new and cheaper FDP materials. As the patient population ages, prosthodontists will treat tooth wear in a greater number of older adults; however, recent long-term studies on such treatments are lacking. OBJECTIVE The purpose of this retrospective clinical study was to examine extensive, tooth-supported FDPs made at 2 specialist clinics in Sweden after 10 years and to compare the outcomes with those of previous studies. METHODS Patients rehabilitated by using FDPs of at least 5 units at 2 specialist clinics in Sweden between 2002 and 2006 were recalled after 10 years. Clinical examinations were supplemented by reviewing clinical records and existing radiographs. Statistical analysis was performed by using the Student t test, chi-squared test, Fisher exact test, and Kruskal-Wallis test (α=.05). RESULTS A total of 152 patients were recalled for clinical examination. Of these, 78 patients attended and were examined. The mean age of the examined group was 70 years (range 36-94), lower than that of those not attending (80 years; range 46-100; P<.05). The mean number of units of the 78 examined FDPs was 7.3 (range 5-12) and 8.0 (range 5-14) for those not examined. FDP configurations in terms of number of units, abutments, pontics, and post-and-cores did not differ significantly between the 2 groups (P>.05). The survival proportion of the examined 78 FDPs (all units of the original FPD) was 74.4%. The success proportion (FDPs without complications) was 52.6%. The most frequent complications were caries (14.1%), endodontic complications (11.5%), loose retainers (7.7%), root fractures (5.1%), and framework fractures (3.8%). FDPs with post-and-cores (P<.05) and cantilevers (P=.054), especially when in combination (P<.05), showed more complications than FDPs without. Chipping fractures in porcelain were found in 38% of the FDPs (7.7% of the units), with more porcelain fractures on Co-Cr frameworks than on gold and titanium alloy frameworks (P<.05). CONCLUSIONS This long-term retrospective study indicated that the prognosis for complicated and extensive FDPs in aging patients does not worsen with increased clinical complexity. New materials, treatment complexity, and older patients did not seem to markedly influence prognosis.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003776 Dental Porcelain A type of porcelain used in dental restorations, either jacket crowns or inlays, artificial teeth, or metal-ceramic crowns. It is essentially a mixture of particles of feldspar and quartz, the feldspar melting first and providing a glass matrix for the quartz. Dental porcelain is produced by mixing ceramic powder (a mixture of quartz, kaolin, pigments, opacifiers, a suitable flux, and other substances) with distilled water. (From Jablonski's Dictionary of Dentistry, 1992) Porcelain,Porcelain, Dental,Dental Porcelains,Porcelains,Porcelains, Dental
D003830 Denture, Partial, Fixed A partial denture attached to prepared natural teeth, roots, or implants by cementation. Fixed Bridge,Fixed Partial Denture,Pontic,Bridge, Fixed,Bridges, Fixed,Denture, Fixed Partial,Dentures, Fixed Partial,Fixed Bridges,Fixed Partial Dentures,Partial Denture, Fixed,Partial Dentures, Fixed,Pontics
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D015040 Zirconium A rather rare metallic element with atomic number 40, atomic weight 91.224, and symbol Zr.
D019232 Dental Restoration Failure Inability or inadequacy of a dental restoration or prosthesis to perform as expected. Dental Prosthesis Failure,Dental Prosthesis Failures,Dental Restoration Failures,Failure, Dental Prosthesis,Failure, Dental Restoration,Failures, Dental Prosthesis,Failures, Dental Restoration,Prosthesis Failure, Dental,Prosthesis Failures, Dental,Restoration Failure, Dental,Restoration Failures, Dental

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