Prosthetic treatment options in single tooth edentulism

Abstract

Introduction. Preservation of soft and hard tissues after tooth loss in order to restore function and aesthetics through prosthetic treatment is one of the main goals of clinicians. The treatment of single missing tooth can be achieved by several methods. In order to make an optimal decision, it is necessary to evaluate all treatment alternatives. Purpose. Elaboration and argumentation of a management algorithm of patients with single tooth edetulism based on the comparative estimation of the treatment results with implant supported prostheses or with conventional fixed partial dentures. Material and methods. The prospective controlled clinical trial included 180 consecutive patients aged 18-60 years with single missing tooth in the upper or lower jaw, restored with fixed partial conventional dentures (90 patients) or with crowns on implant support (90 patients), which signed the written consent to participate in the study. The main reasons for the lack of teeth were complications of dental caries, periodontitis, dental trauma and orthodontic causes. Results. In this study, the survival rate of fixed partial dentures (FPD) was statistically significantly lower compared to the implant supported crown (94.4% and 100.0%, p<0.05). Total complication rates (61.1% and 43.3%; p<0.05), technical(5.6% and 0%; p <0.05) and biological complications were statistically significantly higher in patients with single missing tooth treated with FPD, and the rate of aesthetic complications (23.3% and 43.3%,p <0.01) - statistically significantly higher in patients with single missing tooth treated with implant supported prostheses. By the results of our study, we developed a management algorithm for patients with single tooth edentulism. Conclusions. Given the large number of variables that affect treatment decisions, there is no universally effective solution for treating single missing tooth. The selection of the treatment method must be made on the basis of a risk profile specific to the situation of each patient.