Advertisement

Clinical Oral Investigations

, Volume 22, Issue 8, pp 2799–2807 | Cite as

Impact of simulated reduced alveolar bone support, increased tooth mobility, and distal post-supported, root-treated abutment tooth on load capability of all-ceramic zirconia-supported cantilever FDP

  • M. NaumannEmail author
  • M. von Stein-Lausnitz
  • M. Rosentritt
  • C. Walter
  • H. Meyer-Lückel
  • G. Sterzenbach
Original Article

Abstract

Objectives

The aim of this in vitro study was an analysis of the impact of simulated reduced alveolar bone support and post-restored, endodontically treated distal abutment tooth on load capability of all-ceramic zirconia-based cantilever-fixed dental prosthesis (CFDP).

Material and methods

The roots of human lower sound premolars (n = 80) were divided into five experimental groups to be restored with all-ceramic zirconia-supported three-unit CFDP regarding bone loss (BL) relative to the cement-enamel junction (CEJ): 2 mm below CEJ = 0% BL (control group), group 25% distal BL, group 50% distal BL, group 50% mesial and distal BL, and group 50% distal BL and adhesive post-supported restoration. Specimens were exposed to simulated clinical function by thermo-mechanical loading (6.000 cycles 5°–55°; 1.2 × 106 cycles 0–50 N) and subsequent linear loading until failure.

Results

Tooth mobility increased significantly for groups with simulated bone loss (p < 0.001). Four specimens failed during thermal cycling and mechanical loading (TCML). The maximum load capability ranged from 350 to 569 N, and did not differ significantly between experimental groups (p = 0.095). Groups with simulated bone loss revealed more tooth fractures at distal abutment teeth, whereas technical failures were more frequent in the control group (p = 0.024).

Conclusions

Differences of alveolar bone support and respectively increased tooth mobility between mesial and distal abutments did not influence load capability. A distal adhesively post-and-core-supported, root-treated abutment tooth did not increase risk of three-unit CFDP failure.

Clinical relevance

CFDPs are a treatment option used with caution when reduced alveolar bone support, increased tooth mobility, and distal post-supported, root-treated abutment teeth are involved.

Keywords

Post-and-core Fixed dental prosthesis Load simulation Bone loss Fracture resistance 

Notes

Acknowledgements

Dentsply Sirona allowed the use of the milling machine to produce zirconia frameworks. No further external financial support was given.

Contribution to the paper

M. Naumann: idea, hypothesis, experimental design, and wrote the manuscript.

M. v. Stein-Lausnitz: idea, hypothesis, experimental design, and proofread the manuscript.

M. Rosentritt: performed TCML and proofread the manuscript.

C. Walter: contributed substantially to discussion and proofread the manuscript.

H. Meyer-Lückel: contributed substantially to discussion and proofread the manuscript.

G. Sterzenbach: experimental design, performed linear loading, and performed in part statistical evaluation.

Funding

The work was supported by the Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité – Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, D-14197, Berlin, Germany. This research was also supported by Ivoclar-Vivadent by Materials.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.

References

  1. 1.
    Pjetursson BE, Tan K, Lang NP, Bragger U, Egger M, Zwahlen M (2004) A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res 15(6):667–676.  https://doi.org/10.1111/j.1600-0501.2004.01120.x CrossRefGoogle Scholar
  2. 2.
    Jepson N, Allen F, Moynihan P, Kelly P, Thomason M (2003) Patient satisfaction following restoration of shortened mandibular dental arches in a randomized controlled trial. Int J Prosthodont 16(4):409–414PubMedPubMedCentralGoogle Scholar
  3. 3.
    Ewing EE (1957) Reevaluation of the cantilever principle. J Prosthet Dent 7(1):78–92.  https://doi.org/10.1016/0022-3913(57)90011-2 CrossRefGoogle Scholar
  4. 4.
    Lulic M, Bragger U, Lang NP, Zwahlen M, Salvi GE (2007) Ante’s (1926) law revisited: a systematic review on survival rates and complications of fixed dental prostheses (FDPs) on severely reduced periodontal tissue support. Clin Oral Implants Res 18(Suppl 3):63–72.  https://doi.org/10.1111/j.1600-0501.2007.01438.x CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Nyman S, Lindhe J (1979) A longitudinal study of combined periodontal and prosthetic treatment of patients with advanced periodontal disease. J Periodontol 50(4):163–169.  https://doi.org/10.1902/jop.1979.50.4.163 CrossRefGoogle Scholar
  6. 6.
    Wylie RS, Caputo AA (1991) Fixed cantilever splints on teeth with normal and reduced periodontal support. J Prosthet Dent 66(6):737–742.  https://doi.org/10.1016/0022-3913(91)90406-M CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Yang HS, Chung HJ, Park YJ (1996) Stress analysis of a cantilevered fixed partial denture with normal and reduced bone support. J Prosthet Dent 76(4):424–430.  https://doi.org/10.1016/S0022-3913(96)90549-1 CrossRefGoogle Scholar
  8. 8.
    Skupien JA, Opdam NJ, Winnen R, Bronkhorst EM, Kreulen CM, Pereira-Cenci T, Huysmans MC (2016) Survival of restored endodontically treated teeth in relation to periodontal status. Braz Dent J 27(1):37–40.  https://doi.org/10.1590/0103-6440201600495 CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Iqbal MK, Johansson AA, Akeel RF, Bergenholtz A, Omar R (2003) A retrospective analysis of factors associated with the periapical status of restored, endodontically treated teeth. Int J Prosthodont 16(1):31–38PubMedPubMedCentralGoogle Scholar
  10. 10.
    Rodriguez FR, Paganoni N, Eickholz P, Weiger R, Walter C (2017) Presence of root canal treatment has no influence on periodontal bone loss. Clin Oral Investig 21(9):2741–2748.  https://doi.org/10.1007/s00784-017-2076-4 CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Ohlmann B, Marienburg K, Gabbert O, Hassel A, Gilde H, Rammelsberg P (2009) Fracture-load values of all-ceramic cantilevered FPDs with different framework designs. Int J Prosthodont 22(1):49–52Google Scholar
  12. 12.
    Gabbert O, Ohlmann B, Schmitter M, Gilde H, Ruef T, Rammelsberg P (2008) Fracture behaviour of zirconia ceramic cantilever fixed dental prostheses in vitro. Acta Odontol Scand 66(4):200–206.  https://doi.org/10.1080/00016350802241555 CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Wolfart S, Harder S, Eschbach S, Lehmann F, Kern M (2009) Four-year clinical results of fixed dental prostheses with zirconia substructures (Cercon): end abutments vs. cantilever design. Eur J Oral Sci 117(6):741–749.  https://doi.org/10.1111/j.1600-0722.2009.00693.x CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Zenthofer A, Ohlmann B, Rammelsberg P, Bomicke W (2015) Performance of zirconia ceramic cantilever fixed dental prostheses: 3-year results from a prospective, randomized, controlled pilot study. J Prosthet Dent 114(1):34–39.  https://doi.org/10.1016/j.prosdent.2015.02.006 CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Sterzenbach G, Kalberlah S, Beuer F, Frankenberger R, Naumann M (2011) In-vitro simulation of tooth mobility for static and dynamic load tests: a pilot study. Acta Odontol Scand 69(5):316–318.  https://doi.org/10.3109/00016357.2011.563244 CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Rosentritt M, Behr M, Gebhard R, Handel G (2006) Influence of stress simulation parameters on the fracture strength of all-ceramic fixed-partial dentures. Dent Mater 22(2):176–182.  https://doi.org/10.1016/j.dental.2005.04.024 CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Rosentritt M, Behr M, van der Zel JM, Feilzer AJ (2009) Approach for valuating the influence of laboratory simulation. Dent Mater 25(3):348–352.  https://doi.org/10.1016/j.dental.2008.08.009 CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Anusavice KJ, Kakar K, Ferree N (2007) Which mechnical and physical testing methods are relevant for predicting the clinical performance of ceramic-based dental prostheses? Clin Oral Implants Res Suppl 3(18):218–231CrossRefGoogle Scholar
  19. 19.
    Kelly JR (1999) Clinically relevant approach to failure testing of all-ceramic restorations. J Prosthet Dent 81(6):652–661.  https://doi.org/10.1016/S0022-3913(99)70103-4 CrossRefGoogle Scholar
  20. 20.
    Bolhuis HP, de Gee AJ, Pallav P, Feilzer AJ (2004) Influence of fatigue loading on the performance of adhesive and nonadhesive luting cements for cast post-and-core buildups in maxillary premolars. Int J Prosthodont 17(5):571–576PubMedPubMedCentralGoogle Scholar
  21. 21.
    Romeo E, Lops D, Margutti E, Ghisolfi M, Chiapasco M, Vogel G (2003) Implant-supported fixed cantilever prostheses in partially edentulous arches. A seven-year prospective study. Clin Oral Implants Res 14(3):303–311.  https://doi.org/10.1034/j.1600-0501.2003.120905.x CrossRefGoogle Scholar
  22. 22.
    Naumann M, Blankenstein F, Dietrich T (2005) Survival of glass fibre reinforced composite post restorations after 2 years-an observational clinical study. J Dent 33(4):305–312CrossRefGoogle Scholar
  23. 23.
    Tan K, Pjetursson BE, Lang NP, Chan ES (2004) A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res 15(6):654–666.  https://doi.org/10.1111/j.1600-0501.2004.01119.x CrossRefGoogle Scholar
  24. 24.
    Karlsson S (1989) Failures and length of service in fixed prosthodontics after long-term function. A longitudinal clinical study. Swed Dent J 13(5):185–192Google Scholar
  25. 25.
    Rodriguez AM, Aquilino SA, Lund PS (1994) Cantilever and implant biomechanics: a review of the literature, Part 2. J Prosthodont 3(2):114–118.  https://doi.org/10.1111/j.1532-849X.1994.tb00138.x CrossRefGoogle Scholar
  26. 26.
    Wang CH, Du JK, Li HY, Chang HC, Chen KK (2016) Factorial analysis of variables influencing mechanical characteristics of a post used to restore a root filled premolar using the finite element stress analysis combined with the Taguchi method. Int Endod J 49(7):690–699.  https://doi.org/10.1111/iej.12499 CrossRefGoogle Scholar
  27. 27.
    Goga R, Purton DG (2007) The use of endodontically treated teeth as abutments for crowns, fixed partial dentures, or removable partial dentures: a literature review. Quintessence Int 38(2):e106–e111Google Scholar
  28. 28.
    Soderfeldt B, Palmqvist S (1998) A multilevel analysis of factors affecting the longevity of fixed partial dentures, retainers and abutments. J Oral Rehabil 25(4):245–252.  https://doi.org/10.1111/j.1365-2842.1998.00248.x CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Randow K, Glantz PO (1986) On cantilever loading of vital and non-vital teeth. An experimental clinical study. Acta Odontol Scand 44(5):271–277.  https://doi.org/10.3109/00016358609004733 CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Randow K, Glantz PO, Zoger B (1986) Technical failures and some related clinical complications in extensive fixed prosthodontics. An epidemiological study of long-term clinical quality. Acta Odontol Scand 44(4):241–255.  https://doi.org/10.3109/00016358608997726 CrossRefGoogle Scholar
  31. 31.
    Naumann M, Rosentritt M, Preuss A, Dietrich T (2006) The effect of alveolar bone loss on the load capability of restored endodontically treated teeth: a comparative in vitro study. J Dent 34(10):790–795.  https://doi.org/10.1016/j.jdent.2006.03.003 CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Tunjan R, Rosentritt M, Sterzenbach G, Happe A, Frankenberger R, Seemann R, Naumann M (2012) Are endodontically treated incisors reliable abutments for zirconia-based fixed partial dentures in the esthetic zone? J Endod 38(4):519–522.  https://doi.org/10.1016/j.joen.2011.12.027 CrossRefGoogle Scholar
  33. 33.
    Sterzenbach G, Tunjan R, Rosentritt M, Naumann M (2014) Increased tooth mobility because of loss of alveolar bone support: a hazard for zirconia two-unit cantilever resin-bonded FDPs in vitro? J Biomed Mater Res B Appl Biomater 102(2):244–249.  https://doi.org/10.1002/jbm.b.33001 CrossRefGoogle Scholar
  34. 34.
    Strub JR, Linter H, Marinello CP (1989) Rehabilitation of partially edentulous patients using cantilever bridges: a retrospective study. Int J Periodontics Restorative Dent Dent 9(5):364–375Google Scholar
  35. 35.
    Reinhardt RA, Krejci RF, Pao YC, Stannard JG (1983) Dentin stresses in post-reconstructed teeth with diminishing bone support. J Dent Res 62(9):1002–1008.  https://doi.org/10.1177/00220345830620090101 CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Vire DE (1991) Failure of endodontically treated teeth: classification and evaluation. J Endod 17(7):338–342.  https://doi.org/10.1016/S0099-2399(06)81702-4 CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Axelsson P, Lindhe J, Nystrom B (1991) On the prevention of caries and periodontal disease. Results of a 15-year longitudinal study in adults. J Clin Periodontol 18(3):182–189CrossRefGoogle Scholar
  38. 38.
    Tay FR, Pashley DH (2007) Monoblocks in root canals: a hypothetical or a tangible goal. J Endod 33(4):391–398.  https://doi.org/10.1016/j.joen.2006.10.009 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • M. Naumann
    • 1
    Email author
  • M. von Stein-Lausnitz
    • 1
  • M. Rosentritt
    • 2
  • C. Walter
    • 3
  • H. Meyer-Lückel
    • 4
  • G. Sterzenbach
    • 1
  1. 1.Department of Prosthodontics, Geriatric Dentistry and Craniomandibular DisordersCharité – Universitätsmedizin BerlinBerlinGermany
  2. 2.Department of Prosthetic DentistryRegensburg University Medical CenterRegensburgGermany
  3. 3.Department of Periodontlogy, Cariology, and EndodontologyUniversity of BaselBaselSwitzerland
  4. 4.Department of Restorative, Preventive and Pediatric DentistryZMK Bern, University of BernBernSwitzerland

Personalised recommendations