Clinical evaluation of metal-ceramic fixed partial dentures.

Abstract

Introduction. Edentulism - a pathological condition characterized by the absence of one or more teeth in the dental arch - is a major health problem regardless of societies, regions, ethnicities and social stratification. A fixed bridge (called also as fixed bridge prosthesis, bridge or fixed partial denture) is attached to remaining teeth to replace a missing tooth, and teeth serving as attachments for a fixed bridge are called abutments. The part of the fixed bridge, which veneers the abutment tooth is called a retainer and the part which replaces a missing tooth is called a pontic. Aim of the study. The study aims to evaluate the treatment need of fixed bridges according to the distribution of pontics in dentition, in different age groups and to investigate the primary and late complications and survival of the conventional fixed metal ceramic prostheses, as well as patients' satisfaction with the prosthetic treatment. Materials and methods. An electronic MEDLINE search supplemented by manual searching was conducted to identify prospective and retrospective cohort studies on FPDs with a mean follow-up time of at least 5 years. The whole material consisted of the patients treated with fixed metal ceramic prostheses at the Department of Dental Propaedeutics, Nicolae Testemitanu State University of Medicine and Pharmacy, during the years 2014–2018. Patients had to have been examined clinically at the follow-up visit. The study included 18 patients (6 men and 12 females) with partial edentulism. After clinical and paraclinical examination, patients were devided into two groups: first group consisted of 8 patients with dental bridges fixed on vital teeth. The second group consisted of 10 patients with dental bridges fixed on endodontically treated teeth. Results. Fixed bridges are most often prepared to replace upper first premolars and lower first molars also in the future. The most usual primary complications related to fixed bridges occurred during preprosthetic endodontic treatment of abutment teeth and during the preparation of the root canals. Patients were satisfied with aesthetics and function of the fixed metal ceramic prostheses. Late complications found in clinical examinations were few, and the survival rate for the fixed metal ceramic bridge prostheses was calculated to be 84 % after 10 years, long fixed bridges having a lower survival than the shorter ones. The treatment need for conventional fixed bridges seems to be highest among patients over 50 years of age in the future. No patients reported adverse reactions to the material. Conclusions. The success of prosthetic rehabilitation with metal-ceramic fixed partial dentures is the result of a medical reasoning based on theoretical and practical skills. Avoidance of tempestuous preparation, deficitary marginal closing, partial filling of the root canal, crown perforation with interradicular pivots, pushing the filling material by apex can prevent pulpits, necrosis, gangrene and other severe complications appearance, occurred in the post-prosthetic belated period.