An up to 20-year retrospective study of 4-unit fixed dental prostheses for the replacement of 2 missing adjacent teeth.
OBJECTIVE
This study evaluated treatment outcomes of 4-unit porcelain-fused-to-gold fixed dental prostheses (FDPs) replacing 2 adjacent missing teeth.


METHODS
A total of 102 FDPs made in an undergraduate university clinic for 73 patients were evaluated for up to 20 years, with a mean survival follow-up time of 11.4 years. All patients were offered an oral health maintenance program. Treatment failures were divided into irreversible (loss of FDPs/finish line involved) or reversible (FDPs and finish line intact after conservative treatment) complications and into biologic and technical/patient-related failures.


RESULTS
The Kaplan-Meier overall estimated survival rate was 68.3% at year 20. There was a statistically significant difference (P = .007) between the survival rates in the maxilla for the vital group (73.8%) and those for the root canal-treated group (25.1%). Comparing the survival rate in the root canal-treated group for the restorations in the maxilla (25.1%) versus the mandible (66.8%), a statistically significant difference (P = .011) was found. The main reason for irreversible failure was caries (32.0%).


CONCLUSIONS
The estimated successful outcome of 4-unit FDPs over an up to 20-year period is considered favorable and should be compared with the survival rates of other treatment options for the replacement of 2 adjacent teeth. Occurrence of a previously reversible complication appears to be a predictive factor for an irreversible complication later on. A reversible complication within the first 2 years will lead to an early irreversible complication.
De Backer
Hein
H
Centre for Special Care, PaeCaMed Research, Unit of Gnathology and Temporomandibular Disorders, Dental School, Faculty of Medicine and Health Sciences, Ghent University, Belgium. hein.debacker@skynet.be
Van Maele
Georges
G
De Moor
Nathalie
N
Van den Berghe
Linda
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000044:Dental Abutments; D003731:Dental Caries / Q000150:complications; D003776:Dental Porcelain / Q000737:chemistry; D019232:Dental Restoration Failure; D003779:Denture Design; D003781:Denture Retention; D003830:Denture, Partial, Fixed; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006047:Gold Alloys / Q000737:chemistry; D006801:Humans; D008297:Male; D016876:Metal Ceramic Alloys / Q000737:chemistry; D008875:Middle Aged; D010510:Periodontal Diseases / Q000150:complications; D011176:Post and Core Technique; D012189:Retrospective Studies; D016019:Survival Analysis; D019553:Tooth, Nonvital / Q000628:therapy; D016896:Treatment Outcome; D015036:Zinc Phosphate Cement / Q000737:chemistry
D006047:Gold Alloys; D016876:Metal Ceramic Alloys; D003776:Dental Porcelain; D015036:Zinc Phosphate Cement