Fiber‐reinforced composite partial fixed dental prostheses supported by short or extra‐short implants: A 10 year retrospective study

Abstract

Introduction This study evaluated the 10‐year survival and success of partial fixed dental prostheses (P‐FDPs) fabricated with a milled fiber‐reinforced composite (FRC) framework, supported by short or extra‐short implants. Methods Patients restored with FRC P‐FDPs supported by short or extra‐short implants were included in this retrospective study. Kaplan–Meier analysis was used to calculate the survival and success rates of the prostheses. Univariate and multivariate Cox regression models, clustered to adjust for multiple implants and prostheses being placed in the same patient, were used to correlate changes in peri‐implant bone levels with patient, implant, and prosthesis‐related covariates. Results This study followed 121 FRC P‐FDPs supported by 261 implants, placed in 96 patients. At 118 months in function, the P‐FDP survival rate was 95.9% (95% CI: 87.5%–98.7%), and the success rate was 89.8% (95%CI: 80.4%–94.8%). Differences in prosthesis span length, abutment/pontic ratio, and the presence of distal extensions (cantilevers) did not affect the prosthetic outcomes. Bone levels around implants were stable, with an average rate of change of −0.01 ± 0.05 mm/month. Cox regression revealed that grafted sites were correlated with peri‐implant bone loss, while longer prosthetic spans were correlated with bone gain. Conclusion P‐FDPs comprised of milled fiber‐reinforced composite frameworks, supported by short and extra‐short implants, had high survival and success rates for up to 10 years.

Indirect restorative systems—A narrative review

“…15 It is evident that, from a materials science perspective, the resin-matrix ceramics group could never be included in a restorative all-ceramic classification system as a ceramic material given that such CAD/CAM blocks are comprised also of organic compounds; for this reason the term "ceramic-like" has been suggested in the past, although likely due to insurance and refund purposes, it has been coined as a porcelain/ceramic by the American Dental Association Glossary of Dental Clinical Terms. 42 Another class of material that will be a topic of discussion is the fiber-reinforced composites (FRC) produced for CAD/CAM machining, which is gaining increased interest due to its high long-term survival rates especially in partial FDP 43 to full-arch implant-supported reconstructions. 44…”

“…Clinical studies have demonstrated a high survival rate for CAD/CAM FRC (e.g. TRINIA, Bicon LLC, Boston, MA) partial and full‐arch FDPs installed over short/extra‐short implants placed in severely atrophic mandibles, 94% and 100%, respectively, over a period of up to 10 years 43,44,249,250 . These data encourage the use of CAD/CAM FRC FDPs as a substitute for metal and Y‐TZP frameworks, especially in biomechanically unfavorable clinical scenarios; however, long‐term prospective studies are still required.…”

“…The translucency of dental ceramics has shown to be affected by restoration thickness, number of firings, luting agent, core/abutment color, and texture. [76][77][78] Within a standard thickness and shade, LDS presented the lowest translucency (translucency parameter-TP: 26-33), followed by LEU (TP: 35-39) and felspathic ceramics (TP: [40][41][42][43][44][45][46]. Additionally, fabrication method has shown to influence translucency parameter of LDS (higher translucency for CAD/CAM, TP: 33, relative to heat-pressing, TP: 26), LEU (higher translucency for heat-pressing, TP: 39, relative to CAD/CAM, TP: 35), and feldspathic ceramics (higher translucency for conventional method, TP: 40-46, relative to CAD/CAM, TP: 33).…”

Prefabricated shouldered abutments enable successful restoration of molar crowns on implants

“…Such universal prefabricated shouldered abutments allow the restoration of a variety of challenging scenarios, ranging from single crowns, FDPs, to full-arch prostheses. [8][9][10][11] They also included a hemispherical base, which has been shown to promote bone gain. 12 Despite the merits of the abutment design, the efficacy of these abutments has not been evaluated systematically prior to this study.…”

“…Another advancement in abutment design introduced a universal geometry of the cementation surface with available variations in angles and post lengths (so‐called Universal abutments). Such universal prefabricated shouldered abutments allow the restoration of a variety of challenging scenarios, ranging from single crowns, FDPs, to full‐arch prostheses 8–11 . They also included a hemispherical base, which has been shown to promote bone gain 12 .…”