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Long-term retrospective clinical study of tooth-supported fixed partial dentures: A multifactorial analysis
Malmö University, Faculty of Odontology (OD). Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia.ORCID iD: 0000-0002-4510-5071
Malmö University, Faculty of Odontology (OD).ORCID iD: 0000-0002-3460-3374
Malmö University, Faculty of Odontology (OD).ORCID iD: 0000-0002-3912-0830
2023 (English)In: Journal of Prosthodontic Research, ISSN 1883-1958, E-ISSN 2212-4632, Vol. 67, no 2, p. 238-245Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To assess the influence of several factors on the survival of tooth-supported fixed partial dentures (FPDs) with vital and non-vital abutments.

MATERIALS AND METHODS: The present retrospective cohort study was based on the records of patients treated with 3-to-7-unit tooth-supported FPDs with a minimum follow-up time of 6 months after prosthesis delivery. Cumulative survival rate (CSR) was calculated over the maximum follow-up period. Cox regression models were used to evaluate the association between the clinical covariates and prosthesis failure.

RESULTS: A total of 331 FPDs in 229 patients were included. The CSRs were 90.1% and 77.6% after 5 and 10 years and 67.9% and 52.1% after 15 and 20 years, respectively. Tooth-supported FPD failure was more prevalent within the first years of prosthesis delivery. Loss of one or more abutment teeth and loss of prosthesis retention were the main reasons for failure. Smoking and type of prosthesis material significantly influenced the survival of FPDs. Abutment vitality, position of the non-vital abutment, or prosthesis length did not show any significant influence on the occurrence of prosthesis failure.

CONCLUSION: Smoking and the type of prosthesis material are suggested to contribute to an increased rate of FPD failure irrespective of abutment vitality.

Place, publisher, year, edition, pages
Japan Prosthodontic Society , 2023. Vol. 67, no 2, p. 238-245
Keywords [en]
Post and Core, Prosthesis failure, Prosthesis material, Smoking, Survival rate
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-55213DOI: 10.2186/jpr.JPR_D_21_00222ISI: 000943346200001PubMedID: 36031347Scopus ID: 2-s2.0-85149769941OAI: oai:DiVA.org:mau-55213DiVA, id: diva2:1699716
Available from: 2022-09-28 Created: 2022-09-28 Last updated: 2024-02-05Bibliographically approved
In thesis
1. On failures and complications of tooth-supported fixed prostheses
Open this publication in new window or tab >>On failures and complications of tooth-supported fixed prostheses
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Loss of tooth structure or loss of the tooth may affect masticatory function, phonetics, a person´s appearance, and might ultimately impair quality of life. Fixed prosthetic rehabilitation in the form of either fixed dental prosthesis (FDP)or single crown (SC) is a reliable treatment alternative to restore lost functions. Tooth-supported fixed prosthetic restorations (FDPs, SCs) are influenced by multiple combined general and local factors that may affect the risk of complication and failure. Recognizing risk factors is important in treatment planning, and will help the clinician optimize treatment outcomes. This will also be beneficial for both the patient and society from a cost-effective aspect, as a reduction in complications and failures reduces costs. Several factors have been suggested to impact the survival and failure rates of FDPs and SCs, but there is still limited evidence concerning the clinical outcomes of FDPs and SCs when subjected to a combination of multiple factors in a clinical setting. The aim of the present thesis was to evaluate whether the survival and failure rates of full-coverage tooth-supported fixed prosthetic restorations (FDPs, SC) are influenced by general and/or local factors. This thesis is based on a systematic review (Paper I) and three retrospective studies (Papers II, III, and IV). In Study I, PubMed, Web of Science and ScienceDirect databases were searched and manual searches were conducted to identify clinical human studies reporting on full-coverage tooth-supported FDPs and SCs. Cumulative survival rate (CSR) was calculated over the maximal period of follow-up reported, in a life-table survival analysis. Seventeen studies fulfilled the inclusion criteria. The highest 5-year survival rate was observed for all-ceramic and metal–ceramic SCs on vital teeth 97.8% (95%CI [97.1– 98.5%]), and all-ceramic SCs on non-vital teeth with fiber post 99.1% (95% CI [97.7– 100.4%]). Metal–ceramic SCs on vital teeth 97.5% (95% CI[96.8–98.3%]) showed a statistically significant higher estimated 5-year survival rate compared to metal–ceramic SCs with cast metal post 94.5% (95% CI [93.3–95.8%], p <0.001) and fiber post 95.1% (95% CI [93.4–96.6%], p <0.007), respectively. For FDPs, the 5-year survival rate was higher for metal–ceramic FDPs on vital abutments 96.9% (95% CI [95.5–98.4%]), compared to FDPs retained by non-vital abutment(s) with cast metal posts 94.3% (95% CI [89.3–99.3%]). The difference was not statistically significant. Tooth vitality is suggested to contribute positively to the survival of SCs. The results are, however, limited by the small number of studies and the presence of uncontrolled cofounding clinical variables. In the retrospective studies II, III, and IV, dental records archives and the digital journals of all patients at the Faculty of Odontology, Malmö University, Sweden were reviewed to identify patients rehabilitated with full-coverage toothsupported FDPs and SCs. Cox regression was used to evaluate the associations between clinical covariates and prosthesis failure. The CSR was similar for FDPs and SCs after 5 years of function. CSR was higher for SCs compared to FDPs after 10, 15, and 20 years of function. Smoking, type of prosthesis material, and bruxism significantly influenced the survival of FDPs, whereas abutment vitality, position of the non-vital abutment, or prosthesis length did not show any significant influence on the occurrence of FDP failure. The survival of SC was influenced by anterior placement, non-vital abutments, and bruxism, while the patient’s age and sex, the location of the crowns in relation to the jaws, the type of tooth, the presence of post and core, and the type of crown material, treatment providers, or smoking did not show significant effects on the survival of SC.In summary, within the limitations of the review and retrospective studies, bruxism, smoking, and type of prosthesis material are suggested to contribute toFDP failure. Anterior placement, non-vital abutments, and bruxism are factors increasing the rate of SC failure.

Place, publisher, year, edition, pages
Malmö: Malmö University Press, 2023. p. 88
Series
Malmö University Odontological Dissertations, ISSN 1650-6065
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-58360 (URN)10.24834/isbn.9789178773558 (DOI)978-91-7877-354-1 (ISBN)978-91-7877-355-8 (ISBN)
Public defence
2023-03-31, Aulan, Odontologiska fakulteten, Smedjeg. 16, Malmö, 09:15
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Note

Paper I in dissertation as manuscript with title "The longevity of fixed prosthetic restorations on vital and non-vital teeth: A systematic review"

Available from: 2023-02-27 Created: 2023-02-27 Last updated: 2023-08-18Bibliographically approved

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Hawthan, MohammedChrcanovic, Bruno RamosLarsson, Christel

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