Journal
JOURNAL OF CLINICAL PERIODONTOLOGY
Volume 49, Issue -, Pages 182-207Publisher
WILEY
DOI: 10.1111/jcpe.13482
Keywords
dental prostheses; partial edentulism; periodontal indices; periodontitis; tooth loss
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Funding
- Department of Periodontology, Sahlgrenska Academy at the University of Gothenburg
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The study aimed to evaluate the efficacy and effectiveness of tooth-supported fixed prostheses in partially edentulous patients with stage IV periodontitis. Results showed that tooth-supported fixed prostheses appeared to be a valid treatment approach for restoring masticatory function in patients with severe periodontitis. However, the comparative efficacy of this treatment between periodontitis and non-periodontitis patients remains unclear due to the lack of clinical trials.
Aim The aim was to evaluate the efficacy and effectiveness of tooth-supported fixed prostheses in partially edentulous patients with stage IV periodontitis. Material and Methods Randomized and controlled clinical trials (RCTs and CCTs) and prospective/retrospective cohort studies or case series were searched in three databases. Survival rate of abutment teeth was considered the primary outcome. Meta-analyses were performed whenever possible. Results Twenty-four publications were included. No RCTs or CCTs compared the efficacy of tooth-supported fixed prostheses between patients with severe periodontitis or non-periodontitis patients. Most of the data retrieved were derived from case series. The incidence of abutment-tooth loss after a follow-up period from 2 to 35.4 years was low (n = 17 studies; weighted mean incidence (WMI) = 4.8%; confidence interval (CI) [3.2, 6.5]). The corresponding figure for prostheses failure was WMI = 6.9% (n = 18; 95% CI [4.1, 9.7]). Technical complications seemed to be more frequent than biological complications (caries, endodontic failure, root fracture, etc.). Periodontal outcomes tended to remain stable over time. Conclusion Tooth-supported fixed prostheses seemed to be a valid treatment approach to restore masticatory function in patients with stage IV periodontitis once periodontal therapy has been accomplished. However, the comparative efficacy of this treatment among periodontitis and non-periodontitis patients is unclear due to the absence of clinical trials.
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