title: Maxillary rehabilitation of periodontally compromised patients with extensive one-piece fixed prostheses supported by natural teeth: a retrospective longitudinal study.
abstract: OBJECTIVE
  This study aims to evaluate the long-term success and stability of periodontal tissue around extensive one-piece prostheses supported by natural teeth in periodontally compromised maxillae.
  
  
  METHODS
  A total of 28 fixed dental prostheses (FDPs) fabricated by different technologies were inserted in 28 patients with a history of chronic periodontitis after successful periodontal treatment. Subsequently, a program of supportive periodontal therapy (SPT) was instituted. Clinical parameters were evaluated in each patient after insertion of the FDP and during a follow-up examination.
  
  
  RESULTS
  The reported follow-up examinations took place after a mean clinical service of 75.7 (9.9–232.7) months. Probing depths had remained essentially unchanged by that time (2.6 ± 0.8 mm at baseline versus 2.7 ± 0.6 mm at follow-up). Significant deteriorations were observed based on plaque index scores (from 24.8% to 33.2%) and bleeding on probing (from 8.5% to 26.2%). One case of framework fracture was noted.
  
  
  CONCLUSIONS
  Restorative treatment with extensive one-piece FDPs resulted in long-term stability of the periodontal outcomes. Gingival conditions were shown to deteriorate mildly despite periodic recalls for SPT. An association between deterioration and compliance was observed, suggesting that periodic examinations are essential for maintaining oral hygiene and hence to the success of treatment.
  
  
  CONCLUSIONS
  Given a favorable distribution of potential abutment teeth, treatment with tooth-supported extensive FDPs is desirable even in patients with a history of periodontitis. Removable dentures would involve a number of shortcomings, including functional problems and severe degradation of oral ecology. Tooth-supported FDPs are capable of restoring function, esthetics, phonation, and mastication.
authors.affiliation: Department of Dentistry and Maxillofacial Surgery, Division of Prosthodontics, Restorative Dentistry, Periodontology and Implantology, Medical University Graz, Auenbruggerplatz 12, 8036 Graz, Austria. alexander.heschl@medunigraz.at
authors.forename: Alexander
authors.initials: A
authors.lastname: Heschl
authors.forename: Michael
authors.initials: M
authors.lastname: Haas
authors.forename: Josef
authors.initials: J
authors.lastname: Haas
authors.forename: Michael
authors.initials: M
authors.lastname: Payer
authors.forename: Walther
authors.initials: W
authors.lastname: Wegscheider
authors.forename: Raoul
authors.initials: R
authors.lastname: Polansky
mesh_terms: D000328:Adult; D055113:Chronic Periodontitis / Q000517:prevention & control / Q000628:therapy*; D000044:Dental Abutments; D003738:Dental Cements / Q000737:chemistry; D003774:Dental Plaque Index; D003776:Dental Porcelain / Q000737:chemistry; D019232:Dental Restoration Failure; D003779:Denture Design; D003830:Denture, Partial, Fixed; D005260:Female; D005500:Follow-Up Studies; D006047:Gold Alloys / Q000737:chemistry; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000534:rehabilitation*; D008137:Longitudinal Studies; D008297:Male; D008437:Maxilla / Q000473:pathology*; D008875:Middle Aged; D009910:Oral Hygiene; D010349:Patient Compliance; D057747:Periodontal Debridement; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000517:prevention & control / Q000628:therapy; D012189:Retrospective Studies; D019231:Tooth Preparation, Prosthodontic / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult; D015040:Zirconium / Q000737:chemistry
chemical_list: D003738:Dental Cements; D006047:Gold Alloys; D003776:Dental Porcelain; D015040:Zirconium; C028541:zirconium oxide