Clinical complications in fixed prosthodontics

Abstract

The purpose of this article is to identify the incidence of complications and the most common complications associated with single crowns, fixed partial dentures, all-ceramic crowns, resin-bonded prostheses, and posts and cores. A Medline and an extensive hand search were performed on English-language publications covering the last 50 years. The searches focused on publications that contained clinical data regarding success/failure/complications. Within each type of prosthesis, raw data were combined from multiple studies and mean values calculated to determine what trends were noted in the studies. The lowest incidence of clinical complications was associated with all-ceramic crowns (8%). Posts and cores (10%) and conventional single crowns (11%) had comparable clinical complications incidences. Resin-bonded prostheses (26%) and conventional fixed partial dentures (27%) were found to have comparable clinical complications incidences. The 3 most common complications encountered with all-ceramic crowns were crown fracture (7%), loss of retention (2%), and need for endodontic treatment (1%). The 3 most common complications associated with posts and cores were post loosening (5%), root fracture (3%), and caries (2%). With single crowns, the 3 most common complications were need for endodontic treatment (3%), porcelain veneer fracture (3%), and loss of retention (2%). When fixed partial denture studies were reviewed, the 3 most commonly reported complications were caries (18% of abutments), need for endodontic treatment (11% of abutments), and loss of retention (7% of prostheses). The 3 most common complications associated with resin-bonded prostheses were prosthesis debonding (21%), tooth discoloration (18%), and caries (7%). (J Prosthet Dent 2003;90:31-41.) A complication has been defined 1 as "a secondary disease or condition developing in the course of a primary disease or condition." Although complications may be an indication that clinical failure has occurred, this is not typically the case. It is also possible that complications may reflect substandard care. But once again, this is usually not true. Most of the time, complications are conditions that occur during or after appropriately performed fixed prosthodontic treatment procedures.Knowledge regarding the clinical complications that can occur in fixed prosthodontics enhances the clinician's ability to complete a thorough diagnosis, develop the most appropriate treatment plan, communicate realistic expectations to patients, and plan the time intervals needed for post-treatment care. Although a plethora of articles present clinical complications data, none provide a comprehensive comparison of the complications associated with the most commonly used restorations/ prostheses.One of the purposes of this article is to present data regarding the incidence of clinical complications associated with the following restorations/prostheses: single crowns (all-metal, metal ceramic, resin veneered metal); fixed partial dentures (all-metal, metal ceramic, resinvenee...

Complications Associated with Fixed Prosthodontics in a Population Presenting for Treatment to a Dental School in Jeddah, Saudi Arabia

“…Prevalence of caries was higher for FPD as compared to single crowns and the prevalence increased with increasing time since restorations placement. These findings are consistent with results of other studies [3,7,27] . Periodontal disease affected about 38% of the abutment in the present study, whereas a mean prevalence of 4% was reported by others [3] .…”

“…These findings are consistent with results of other studies [3,7,27] . Periodontal disease affected about 38% of the abutment in the present study, whereas a mean prevalence of 4% was reported by others [3] . This high prevalence of periodontal disease measurements could be due to lack of professional maintenance therapy where oral hygiene measures are regularly reinforced.…”

Complications Associated with Fixed Prosthodontics in a Population Presenting for Treatment to a Dental School in Jeddah, Saudi Arabia

“…Prevalence of caries was higher for FPD as compared to single crowns and the prevalence increased with increasing time since restorations placement. These findings are consistent with results of other studies [3,7,27] . Periodontal disease affected about 38% of the abutment in the present study, whereas a mean prevalence of 4% was reported by others [3] .…”

“…These findings are consistent with results of other studies [3,7,27] . Periodontal disease affected about 38% of the abutment in the present study, whereas a mean prevalence of 4% was reported by others [3] . This high prevalence of periodontal disease measurements could be due to lack of professional maintenance therapy where oral hygiene measures are regularly reinforced.…”

Survival Outcomes of Crowns with and without Repaired Endodontic Access Cavities: A Retrospective Propensity Score Matching Study

“…For non-surviving ETT, approximately 88% (15/17 teeth) exhibited unrestorable fractures involving the crown and/or tooth structure. This finding is consistent with failure patterns observed in non-surviving IC, where fractures represented the primary cause of failure, aligning with the findings of previous studies ( 20 , 21 ). Notably, crown restorations affected by access cavities rarely failed due to loss of retention (loosening or dislodgement).…”

Quality of Fixed Dental Prostheses and Patient Satisfaction in a Sample From Saudi Arabia

“…In the current study, poor color matching, unacceptable crown morphology, and faulty margins were recorded for crown-related problems. These results were in line with those of Goodacre et al, who noted that one of the most frequent issues with crowns was porcelain fractures and faulty margins [6]. Based on the current study, 22.8% of the cases needed endodontic treatment because of periapical lesions.…”

Complications Associated with Fixed Prosthodontics in a Population Presenting for Treatment to a Dental School in Jeddah, Saudi Arabia

“…Prevalence of caries was higher for FPD as compared to single crowns and the prevalence increased with increasing time since restorations placement. These findings are consistent with results of other studies [3,7,27] . Periodontal disease affected about 38% of the abutment in the present study, whereas a mean prevalence of 4% was reported by others [3] .…”

“…These findings are consistent with results of other studies [3,7,27] . Periodontal disease affected about 38% of the abutment in the present study, whereas a mean prevalence of 4% was reported by others [3] . This high prevalence of periodontal disease measurements could be due to lack of professional maintenance therapy where oral hygiene measures are regularly reinforced.…”

Survival Outcomes of Crowns with and without Repaired Endodontic Access Cavities: A Retrospective Propensity Score Matching Study

“…For non-surviving ETT, approximately 88% (15/17 teeth) exhibited unrestorable fractures involving the crown and/or tooth structure. This finding is consistent with failure patterns observed in non-surviving IC, where fractures represented the primary cause of failure, aligning with the findings of previous studies ( 20 , 21 ). Notably, crown restorations affected by access cavities rarely failed due to loss of retention (loosening or dislodgement).…”

Quality of Fixed Dental Prostheses and Patient Satisfaction in a Sample From Saudi Arabia

“…In the current study, poor color matching, unacceptable crown morphology, and faulty margins were recorded for crown-related problems. These results were in line with those of Goodacre et al, who noted that one of the most frequent issues with crowns was porcelain fractures and faulty margins [6]. Based on the current study, 22.8% of the cases needed endodontic treatment because of periapical lesions.…”

Complications Associated with Fixed Prosthodontics in a Population Presenting for Treatment to a Dental School in Jeddah, Saudi Arabia

“…Prevalence of caries was higher for FPD as compared to single crowns and the prevalence increased with increasing time since restorations placement. These findings are consistent with results of other studies [3,7,27] . Periodontal disease affected about 38% of the abutment in the present study, whereas a mean prevalence of 4% was reported by others [3] .…”

“…These findings are consistent with results of other studies [3,7,27] . Periodontal disease affected about 38% of the abutment in the present study, whereas a mean prevalence of 4% was reported by others [3] . This high prevalence of periodontal disease measurements could be due to lack of professional maintenance therapy where oral hygiene measures are regularly reinforced.…”

Survival Outcomes of Crowns with and without Repaired Endodontic Access Cavities: A Retrospective Propensity Score Matching Study

“…For non-surviving ETT, approximately 88% (15/17 teeth) exhibited unrestorable fractures involving the crown and/or tooth structure. This finding is consistent with failure patterns observed in non-surviving IC, where fractures represented the primary cause of failure, aligning with the findings of previous studies ( 20 , 21 ). Notably, crown restorations affected by access cavities rarely failed due to loss of retention (loosening or dislodgement).…”

Quality of Fixed Dental Prostheses and Patient Satisfaction in a Sample From Saudi Arabia

“…In the current study, poor color matching, unacceptable crown morphology, and faulty margins were recorded for crown-related problems. These results were in line with those of Goodacre et al, who noted that one of the most frequent issues with crowns was porcelain fractures and faulty margins [6]. Based on the current study, 22.8% of the cases needed endodontic treatment because of periapical lesions.…”