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Maxillary rehabilitation of periodontally compromised patients with extensive one-piece fixed prostheses supported by natural teeth: a retrospective longitudinal study

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Abstract

Objectives

This study aims to evaluate the long-term success and stability of periodontal tissue around extensive one-piece prostheses supported by natural teeth in periodontally compromised maxillae.

Materials and methods

A total of 28 fixed dental prostheses (FDPs) fabricated by different technologies were inserted in 28 patients with a history of chronic periodontitis after successful periodontal treatment. Subsequently, a program of supportive periodontal therapy (SPT) was instituted. Clinical parameters were evaluated in each patient after insertion of the FDP and during a follow-up examination.

Results

The reported follow-up examinations took place after a mean clinical service of 75.7 (9.9–232.7) months. Probing depths had remained essentially unchanged by that time (2.6 ± 0.8 mm at baseline versus 2.7 ± 0.6 mm at follow-up). Significant deteriorations were observed based on plaque index scores (from 24.8% to 33.2%) and bleeding on probing (from 8.5% to 26.2%). One case of framework fracture was noted.

Conclusions

Restorative treatment with extensive one-piece FDPs resulted in long-term stability of the periodontal outcomes. Gingival conditions were shown to deteriorate mildly despite periodic recalls for SPT. An association between deterioration and compliance was observed, suggesting that periodic examinations are essential for maintaining oral hygiene and hence to the success of treatment.

Clinical relevance

Given a favorable distribution of potential abutment teeth, treatment with tooth-supported extensive FDPs is desirable even in patients with a history of periodontitis. Removable dentures would involve a number of shortcomings, including functional problems and severe degradation of oral ecology. Tooth-supported FDPs are capable of restoring function, esthetics, phonation, and mastication.

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Conflicts of interest

The authors report no conflicts of interest related to this study.

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Authors and Affiliations

  1. Department of Dentistry and Maxillofacial Surgery, Division of Prosthodontics, Restorative Dentistry, Periodontology and Implantology, Medical University Graz, Auenbruggerplatz 12, 8036, Graz, Austria

    Alexander Heschl, Michael Haas, Walther Wegscheider & Raoul Polansky

  2. Department of Obstetrics and Gynecology, Medical University Graz, Graz, Austria

    Josef Haas

  3. Department of Oral Surgery and Radiology, Medical University Graz, Graz, Austria

    Michael Payer

Authors
  1. Alexander Heschl
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  2. Michael Haas
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  3. Josef Haas
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  4. Michael Payer
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  5. Walther Wegscheider
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  6. Raoul Polansky
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Correspondence to Alexander Heschl.

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Heschl, A., Haas, M., Haas, J. et al. Maxillary rehabilitation of periodontally compromised patients with extensive one-piece fixed prostheses supported by natural teeth: a retrospective longitudinal study. Clin Oral Invest 17, 45–53 (2013). https://doi.org/10.1007/s00784-012-0681-9

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  • DOI: https://doi.org/10.1007/s00784-012-0681-9

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