The Relationships Between Tooth‐Supported Fixed Dental Prostheses and Restorations and the Periodontium

Abstract

Purpose To search the literature and to critically evaluate the findings on the periodontal outcomes of restorations and tooth‐supported fixed prostheses. Materials and Methods PubMed was searched according to a systematic methodology, previously reported, but updated to include a larger database. Filters applied were: Case reports, clinical trial, review, guideline, randomized controlled trial, meta‐analysis, systematic reviews, and English. A narrative review was then synthesized to discuss periodontal outcomes related to restorations and tooth‐supported fixed prostheses. Relevant data was organized into four sections: Direct restorations, indirect restorations, biologic width or supracrestal tissue attachment and tooth preparation/finish line design. Results While increased gingival index, bleeding on probing, probing depth and clinical attachment loss have been associated with subgingival restorations, intracrevicular margins do not cause periodontal diseases. Inflammation and bone loss occur, for both direct and indirect restorations, only with large overhangs. Different restorative materials are associated with different clinical responses when placed in the gingival sulcus or within the epithelial and connective tissue attachments. When the connective tissue attachment is removed, histological changes occur causing its apical shift and subsequent re‐establishment. Gingival displacement during impression procedures can cause gingival recession. Emergence profile can have a range of values, not associated with periodontal diseases. Periodontal response appears to be clinically not different when compared among different finish line designs. Conclusions Contemporary procedures and materials used for the placement and fabrication of tooth‐supported restorations and fixed prostheses are compatible with periodontal health when adequate patient education and motivation in self‐performed oral hygiene are present. Periodontal diagnostic criteria should be thoroughly reviewed before fixed restorative treatments are planned and executed.

Bacteriological Evaluation of Gingival Crevicular Fluid in Teeth Restored Using Fixed Dental Prostheses: An In Vivo Study

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The Effect of the Different Service Lives of Class II Amalgam Restorations on Periodontal Health among Type 2 Diabetes Patients

“…Nevertheless, the two factors are beyond the scope of the present investigation. It is well established that an overhanging margin less than 0.2 mm should be harmless to periodontal health [31][32][33]. It is worth noting that the periodontal parameters of all examined groups significantly correlated with the service life of class II amalgam restorations but not with the incidence of overhanging restorations.…”

Fixed Prosthetic Restorations and Periodontal Health: A Narrative Review

“…The qualitative and quantitative assessment of the GCF can be an indicator of the periodontal status, and its examination helps in the diagnosis of oral diseases [ 117 , 118 , 119 , 120 ]. The examination of the GCF can be a diagnostic tool to discover host-microbial communications and to reveal the phase of periodontitis [ 121 , 122 , 123 ].…”