Evaluation of clinical status of fixed prosthesis

Mi-Jung Yun; Young-Chan Jeon; Chang-Mo Jeong

doi:10.4047/jkap.2009.47.2.99

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Yun, Jeon, and Jeong: Evaluation of clinical status of fixed prosthesis

ORIGINAL ARTICLE

J Korean Acad Prosthodont 2009;47(2):99-107.

Published online: 18 December 2009

DOI: https://doi.org/10.4047/jkap.2009.47.2.99

Evaluation of clinical status of fixed prosthesis

Mi-Jung Yun, DDS, MSD¹, Young-Chan Jeon, DDS, MSD, PhD^2,^∗, Chang-Mo Jeong, MSD, DDS, PhD²

^¹Graduate student, Department of Prosrhodontics, College of Dentistry, Pusan National University, Korea

^²Professor, Department of Prosrhodontics, College of Dentistry, Pusan National University, Korea

Corresponding Author: Young-Chan Jeon Department of Dentistry, Graduate School, Pusan National University, 10 Ami-dong 1ga, Seo gu, Busan, 602-739, Korea +82 51 240 7438: e-mail, jeonyc@paran.com

Received 19 June 20084 December 2008 Accepted 15 December 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Statement of problem

Restoring and replacing teeth with fixed prostheses commonly used in dental practice. Because of improper oral hygiene care and inaccurate laboratory procedure, complications of fixed prostheses were found in the mouth of patients. Although many efforts have been continually made to obtain the data of long term prognosis of fixed prostheses, it was difficult to do it.

Purpose

The purpose of this study was to evaluate the clinical status of fixed prostheses.

Material and methods

In order to assess the clinical status of fixed prostheses, a total of 161 individuals (aged 17-85, 99 women and 62 men with 1596 unit of fixed prostheses, and 1169 abutments) who first visited the Department of Prosthodontics, Pusan National University Hospital, between April to September, in 2007 were examined.

Results and conclusion

The results of this study were as follows: 1. Length of service of fixed prostheses was 8.6±0.6 years (mean), 10.0 years (median). 2. Location of fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses (P > .05). But, the success rate was high in posterior region and in mandible where the failure rate was high in combination (P < .05). 3. Longevity of fixed prostheses made of metal was longest (mean: 13.0 ± 9.3, median: 14.0), gold, precious ceramic, non-precious ceramic trailing behind (P < .05). 4. Number of units in fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses (P > .05). But, the success rate was high in Single-unit and the failure rate was high in over 3-unit (P < .05). 5. Condition of opposing dentition was found to have no statistically significant influence on longevity of fixed prostheses (P > .05). But, the success rate was high in natural dentition (P < .05). 6. Defective margin (28.2%), dental caries (23.0%), periodontal disease (19.3%), periapical disease (16.9%) were frequent complications. In 30.1% of the cases, abutment state after removing fixed prostheses was needed to be extracted.

Keywords: fixed prosthesis, clinical status, longevity, complication

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Fig. 1.

Kaplan-Meier survival curve of all fixed prostheses.

Fig. 2.

Kaplan-Meier survival curve of fixed prostheses in location. A, in the maxilla and the mandible; B, in the anterior region, in the posterior region, and the combination.

Fig. 3.

Kaplan-Meier survival curve of fixed prostheses in number of unit.

Fig. 4.

Kaplan-Meier survival curve of fixed prostheses in material.

Table I.

Distribution of age group and gender

Age group	Gender				Total
	Woman		Man		Total
	No.	%	No.	%	No.	%
10-19	0	0	1	1.6	1	0.6
20-29	1	1	1	1.6	2	1.2
30-39	5	5	3	4.8	8	5
40-49	21	21.2	14	22.6	35	21.7
50-59	34	34.4	27	43.6	61	37.9
60-69	29	29.3	11	17.7	40	24.9
70-79	7	7.1	4	6.5	11	6.8
80-	2	2	1	1.6	3	1.9
Total	99	100	62	100	161	100

Table II.

Examination method and list and evaluation of fixed prostheses

Examination method
Intra-oral examination
Model examination
Radiographic examination
Examination list
Patient
Age and gender
Prosthesis
Location
Number of unit
Length of service
Material
Complication
Biologic disease: dental caries, periodontal disease, periapical disease
Mechanical problem: margin defect, loose retainer, tooth fracture, prosthesis fracture
Abutment vitality
Opposing dentition
Evaluation of prosthesis
Satisfactory (Success)
Excellence
: The restoration is of acceptable quality and is expected to adequately protect the tooth and the surrounding tissue
Acceptability
: The restoration is of satisfactory quality, but exhibits one or more features which might lead to premature failure
Not acceptable (Failure)
Replace or correct for prevention
: The restoration is not of acceptable quality. Future damage to the tooth and/or its surrounding tissues is likely to occur
Replace immediately
: The restoration is not of acceptable quality. Damage to the tooth and/or its surrounding tissues is now occurring

Table III.

Distribution of fixed prostheses in success and failure according to location

Location		Success		Failure		Total
Location		No.	%	No.	%	No.	%
Mandible	Anterior	16	44.4^a	20	55.6^b	36	100
	Combination	6	14.3^b	36	85.7^a	42	100
	Posterior	77	41.2^a	110	58.8^b	187	100
	Total	99	37.4^a	166	62.6^b	265	100
Maxilla	Anterior	18	25.7^b	52	74.3^b	70	100
	Combination	8	15.1^b	45	84.9^a	53	100
	Posterior	61	35.7^a	110	64.3^b	171	100
	Total	87	29.6^b	207	70.4^a	294	100

Identical superscripted small letters denote no significant differences among material of fixed prostheses in each success and failure (P > .05).

Table IV.

Distribution of fixed prostheses in success and failure according to material

Material	Success		Failure		Total
Material	No.	%	No.	%	No.	%
Gold	103	39.9^a	155	60.1^b	258	100
Metal	7	10.9^b	57	89.1^a	64	100
Noble MC	29	44.6^a	36	55.4^b	65	100
Base MC	47	27.8^b	122	72.2^a	169	100
Resin	0	0.0	3	100.0	3	100
Total	186	33.3	373	66.7	599	100

Identical superscripted small letters denote no significant differences among material of fixed prostheses in each success and failure (P > .05). Number less than 5 was excluded from significant test. MC, metal ceramic restoration.

Table V.

Distribution of fixed prostheses in success and failure according to unit

Unit	Success		Failure		Total
Unit	No.	%	No.	%	No.	%
1	100	52.9^a	89	47.1^b	189	100
2	20	30.8^b	45	69.2^b	65	100
3	39	25.0^b	117	75.0^a	156	100
4	17	25.4^b	50	74.6^a	67	100
5	3	10.0^b	27	90.0^a	30	100
≥ 6	7	13.5^b	45	86.5^a	52	100
Total	186	33.3	373	66.7	559	100

Identical superscripted small letters denote no significant differences among material of fixed prostheses in each success and failure (P > .05).

Table VI.

Distribution of fixed prostheses in success and failure according to condition of opposing dentition

Opposing dentition	Success		Failure		Total
Opposing dentition	No.	%	No.	%	No.	%
Natural	93	41.0^a	134	59.0^b	227	100.0
FPD	88	29.8^b	207	70.2^a	295	100.0
RPD	0	0.0^b	21	100.0^a	21	100.0
CD	0	0.0	2	100.0	2	100.0
Implant	1	25.0	3	75.0	4	100.0
no	4	40.0^b	6	60.0^b	10	100.0
Total	186	33.3	373	66.7	559	100.0

Identical superscripted small letters denote no significant differences among condition of opposing dentition of fixed prostheses in each success and failure (P > .05). Number less than 5 was excluded from significant test. FPD, fixed partial denture; RPD, removable partial denture; CD, complete denture.

Table VII.

Complication of fixed prostheses

Complication	No.	%
Oral disease
Dental caries	86	23.1
Periodontal disease	72	19.3
Periapical disease	63	16.9
Mechanical problem
Margin defect	105	28.2
Loose retainer	18	4.8
Tooth fracture	4	1.1
Prosthesis fracture	25	6.7
Porcelain fracture	12	3.2
Connector fracture	5	1.3
Resin fracture	1	0.3
Perforation	3	0.8
Miscellaneous	4	1.1
Total	373	100

Table VIII.

Quality rating of fixed prostheses

Quality	No.	%
Satisfactory
Excellent	63	11.3
Acceptable	123	22.0
Not acceptable
Replace/Correct for prevention	140	25.0
Replace immediately	233	41.7
Total	559	100.0

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