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Survival of fixed prosthetic restorations on vital and nonvital teeth: A systematic review
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: 0000-0002-3912-0830
Malmö University, Faculty of Odontology (OD).ORCID iD: 0000-0002-3460-3374
2024 (English)In: Journal of Prosthodontics, ISSN 1059-941X, E-ISSN 1532-849X, Vol. 33, no 2, p. 110-122Article, review/survey (Refereed) Published
Abstract [en]

PURPOSE: To evaluate the survival rate of full-coverage tooth-supported fixed prosthetic restorations, single crowns (SCs), and fixed dental prostheses (FDPs), taking into consideration the potential influence of tooth-vitality, presence and type of post, and type of prosthetic restoration material.

MATERIALS AND METHODS: In October 2022, two authors independently conducted a search in PubMed, Web of Science, and Scopus electronic databases as well as a hand search to identify clinical human studies on full-coverage SCs and FDPs supported by vital and/or non-vital abutments and/or a combination of both, with a minimum observation period of 24 months.

RESULTS: Out of 4198 studies identified through the database search and 22 through hand searching, 26 studies fulfilled the inclusion criteria and were included in the analysis of the present systematic review. Included studies scored six points and more according to Newcastle-Ottawa Scale (NOS). The highest estimated 5-year survival rate was observed for (metal-ceramic and all-ceramic) SCs on vital teeth (98.3%; 95% CI [98.1, 98.6%]) and all ceramic SCs on non-vital teeth with fiber post (95.0%; 95% CI [94.5-95.4%]). Metal-ceramic SCs on vital teeth (97.1%; 95% CI [95.6-98.7%]) showed a statistically significant higher estimated 5-year survival rate compared to metal-ceramic SCs with cast metal post (90.7%; 95% CI [87.4-94.0%], P < 0.001), fiber post (91.3%; 95% CI [90.9-91.6%], P < 0.001) and without post (85.7%; 95% CI [80.7, 90.6%], P < 0.032). All-ceramic SCs with fiber post had a statistically significant higher estimated 5-year survival rate (95.0%; 95% CI [94.5-95.4%]) compared to metal-ceramic SCs on non-vital teeth with fiber post (91.3%; 95% CI [90.9-91.6%], P < 0.001). SCs (all-ceramic and metal-ceramic) with fiber post had a statistically significantly higher estimated 5-year survival rate of (92.7%; 95% CI [92.4-92.9%]) than SCs made of metal-ceramic and retained by cast metal post (90.7%; 95% CI [87.4-94.0%], P < 0.001). For FDPs, the 5-year survival rate was significantly higher for FDPs on vital abutments (84.9%; 95% CI [75.9, 93.9%]) compared to FDPs retained by non-vital abutment/s (81.3%; 95% CI [80.3, 82.2%], P = 0.049) irrespective to presence, type of post, and FDPs material. The results are limited by the limited number of studies and the presence of uncontrolled confounding clinical variables.

CONCLUSIONS: Within the limitations of the study, tooth vitality is suggested to contribute positively to the survival of SCs and FDPs.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024. Vol. 33, no 2, p. 110-122
Keywords [en]
post and core, single crown and fixed dental prosthesis, survival and failure rates, systematic review, tooth vitality, tooth-supported prosthesis
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-61981DOI: 10.1111/jopr.13735ISI: 001045218000001PubMedID: 37455556Scopus ID: 2-s2.0-85167659757OAI: oai:DiVA.org:mau-61981DiVA, id: diva2:1789354
Available from: 2023-08-18 Created: 2023-08-18 Last updated: 2024-02-27Bibliographically 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, MohammedLarsson, ChristelChrcanovic, Bruno R.

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