Original articleFifteen-year survival of resin-bonded vs full-coverage fixed dental prostheses
Introduction
Fixed dental prostheses (FDPs), which restore form, function, and esthetics by connecting and fixing to remaining teeth as an abutment tooth, is a flawed functional restoration method frequently used in dental treatment. Because conventional full-coverage FDPs, which cover the entire abutment tooth, require the undercut of the abutment tooth to be removed, the amount of tooth removed increases and there is a risk of causing complications in some cases such as pulp extirpation of the abutment tooth. Conversely, because resin-bonded FDPs (RBFDPs), in which cutting of the abutment tooth is limited in the enamel, can minimize cutting of the abutment tooth, RBFDPs may be a less invasive treatment than conventional FDPs. The history of RBFDPs is thought to have originated with the so-called Rochette bridge [1]. Early Rochette bridges had high failure rates; a study by Creugers et al. [2] on non-perforated cast-metal resin-bonded bridges inserted in 1983–1984 reported a survival rate of only 28% in the posterior regions after 7.5 years. Since then, RBFDPs have evolved including developments in framework design (e.g., Maryland bridge) and adhesive procedure (e.g., metal surface treatment and resin cement system), all of which have improved clinical success rates [3]. Moreover, the degree of patient satisfaction with RBFDPs appeared to be high and did not seem to be influenced by the occurrence of failure [4], [5], [6], [7], [8].
The clinical success rate of RBFDPs varies. The latest report declared that the survival rates of metal-frame RBFDPs after 5, 10, and 15 years were 86%, 42%, and 15% with repair, respectively, whereas 69%, 32%, and 14% of the prostheses survived without repair, respectively [9]. Conversely, the estimated cumulative survival rate of RBFDPs was 95% after 5 years, 88% after 10 years, and 66% after 20 years [10]. Concerning FDPs, the 15-year cumulative survival rate of 3-unit porcelain-fused FDPs was 90% [11]. There are some reports regarding the respective prognostic evaluations for RBFDPs or conventional full-coverage FDPs; however, there are no reports comparing the cumulative survival and success rates of both RBFDPs and full-coverage FDPs using the same population and study design. In addition, no reports have considered the risk factors related to the occurrence of non-survival cases and events in detail, such as persistent tooth number. Moreover, there are also no reports regarding the presence of occurrence of abutment tooth extraction or decision-making on prosthodontic treatment at the time of re-treatment in the event of non-survival in subject RBFDPs and full-coverage FDPs, although it is said that RBFDP failure is often less catastrophic than FDP failure [12].
Therefore, the purposes of this study included clarifying (1) the cumulative survival and event-free rates of 3-unit metal-framed 2-retainer (wing-wing) RBFDPs and comparing them to those of full-coverage FDPs; (2) the risk factors related to the occurrence of non-survival/event in each FDP; and (3) the circumstances in which abutment tooth extraction occurred for each FDP as well as decisions made regarding prosthodontic treatment at the time of re-treatment.
Section snippets
Materials and methods
Study subjects were selected among patients who consecutively attended the Fixed Prosthodontic Clinic (patients were treated by dentists specialized in prosthodontics of Okayama University Hospital, Okayama, Japan) between May 1, 1990 and February 28, 1994. Eligible patients were those who received 3-unit metal-framed 2-retainer (wing-wing) RBFDPs (Fig. 1) or conventional full-coverage FDPs with the middle portion missing and whose structured RBFDP/FDP charts were appropriately completed.
Results
Among 323 target subject prostheses (RBFDPs/FDPs/unknown: 138/184/1 prostheses, 318 patients), we excluded 12 prostheses (12 patients) with prognoses that were not confirmed by medical records since the date of setting and 5 prostheses (5 patients) with medical records that did not match the RBFDP/FDP chart. Thus, 306 prostheses (RBFDPs/FDPs: 129/177 prostheses, 301 patients) were finally included in the analysis. No significant differences in basic characteristics were observed between target
Discussion
The purposes of this study included clarifying the cumulative survival and event-free rates of RBFDPs and comparing them to those of FDPs, clarifying the risk factors related to the occurrence of non-survival/event in the RBFDPs/FDPs, and clarifying the risk factors related to the occurrence of tooth extraction by examining the differences in the circumstances in which abutment tooth extraction occurred for subjects with RBFDPs/FDPs. Retrospective research designs are often adopted in long-term
Conclusion
The following conclusions were obtained in our retrospective >15-year prognostic investigation regarding 3-unit RBFDPs and full-coverage FDPs.
The 15-year cumulative survival and event-free rates of RBFDP and FDP groups were not significantly different.
Cases in which RBFDPs/FDPs resulted in non-survival due to abutment tooth extraction were significantly less frequent in the RBFDP group. In addition, the abutment tooth as a non-vital tooth was identified as a risk factor for non-survival of
Acknowledgment
This work was supported by JSPS KAKENHI grant numbers JP23792227.
References (25)
Attachment of a splint to enamel of lower anterior teeth
J Prosthet Dent
(1973)- et al.
Survival of cast-metal, resin-bonded fixed partial dental prostheses after nearly 20-year follow-up: a retrospective study
J Prosthet Dent
(2016) - et al.
Veneered zirconia inlay-retained fixed dental prostheses: 10-year results from a prospective clinical study
J Dent
(2017) - et al.
Long-term clinical evaluation of 211 two-unit cantilevered resin-bonded fixed partial dentures
J Dent
(2014) - et al.
Long-term evaluation of cantilevered versus fixed-fixed resin-bonded fixed partial dentures for missing maxillary incisors
J Dent
(2016) - et al.
Fiber-reinforced composites in fixed prosthodontics-Quo vadis?
Dent Mater
(2017) - et al.
Clinical survival of indirect, anterior 3-unit surface-retained fibre-reinforced composite fixed dental prosthesis: up to 7.5-years follow-up
J Dent
(2015) - et al.
Ten-year outcome of zirconia ceramic cantilever resin-bonded fixed dental prostheses and the influence of the reasons for missing incisors
J Dent
(2017) - et al.
Improved retention of acid-etched fixed partial dentures: a longitudinal study
J Prosthet Dent
(1992) - et al.
Effect of groove placement on the retention/resistance of resin-bonded retainers for maxillary and mandibular second molars
J Prosthet Dent
(2001)
Anterior fixed partial dentures utilizing the acid-etch technique and a cast metal framework
J Prosthet Dent
A seven-and-a-half-year survival study of resin-bonded bridges
J Dent Res
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Equal first-author contribution.