title: Fixed prosthodontic treatment outcomes in the long-term management of patients with periodontal disease: a 20-year follow-up report.
abstract: OBJECTIVE
  The aim of this long-term cohort study was to evaluate the efficacy and complications of fixed partial dentures in a convenience sample of 100 patients with periodontal disease who were treated and maintained periodontal patients after 20 years.
  
  
  METHODS
  After active treatment, including periodontal surgery and endodontic and prosthetic treatment, patients were enrolled in a supportive periodontal care (SPC) program with 3- to 6-month recalls. All patients showed clinical data recorded at (1) the original consultation (T0), (2) the first SPC visit following the completion of prosthetic treatment (T1), and (3) at the latest SPC clinical session 20 years after T1 (T2). Multivariate analyses were performed to investigate the influence of clinical variables on the risk of prosthetic abutment (PA) loss after 20 years' visits.
  
  
  RESULTS
  The final sample comprised 100 patients. At T1, a total of 948 PAs represented the original sample of experimental teeth. At the 20-year follow-up, a total of 854 PAs (90.1%) were still in function, while 94 (9.9%) PAs in 41 patients (41%) were lost during SPC; 98% of lost PA were endodontically treated. Vertical root fracture (48%) was the major cause of PA loss, while progression of periodontitis caused 31% of PA loss. Age (P = .002), Full-Mouth Plaque Score (P < .0001), Full-Mouth Bleeding Score (P = .0002), and oral parafunctions (P = .0083) were associated with increased probability of PA failure. Among clinical-related factors, endodontic treatment (P = .0082), root resection/ amputation (P < .0001), multi-rooted teeth (P = .0005), and abutment associated with parafunction (P < .0001) were associated with increased risk of abutment loss after 20 years.
  
  
  CONCLUSIONS
  Perioprosthetic treatment in compliant patients is highly successful after 20 years of SPC.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Di Febo
authors.forename: Attilio
authors.initials: A
authors.lastname: Bedendo
authors.forename: Attilio
authors.initials: A
authors.lastname: Bebendo
authors.forename: Federica
authors.initials: F
authors.lastname: Romano
authors.forename: Francesco
authors.initials: F
authors.lastname: Cairo
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Carnevale
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D000044:Dental Abutments; D003769:Dental Occlusion, Traumatic / Q000150:complications; D003774:Dental Plaque Index; D019232:Dental Restoration Failure; D003830:Denture, Partial, Fixed; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000517:prevention & control / Q000628:therapy*; D010512:Periodontal Index; D010518:Periodontitis / Q000503:physiopathology; D012189:Retrospective Studies; D016019:Survival Analysis; D014082:Tooth Fractures / Q000150:complications; D016388:Tooth Loss / Q000209:etiology; D014092:Tooth Root / Q000293:injuries / Q000601:surgery; D019553:Tooth, Nonvital / Q000150:complications; D016896:Treatment Outcome; D055815:Young Adult