Periodontal Behavior Around Teeth Prepared with Finishing Line for Restoration with Fixed Prostheses. A Systematic Review and Meta-Analysis

Abstract

Background: The objective of this systematic review and meta-analysis was to analyze the periodontal behavior around teeth prepared with horizontal finishing crowns supporting fixed metal-ceramic and zirconia full coverage crowns and fixed partial dentures (FDPs). Materials and methods: An electronic search was conducted to locate relevant clinical trials in four databases: PubMed, Embase, Cochrane, and Scopus. A manual search was made in the reference sections of the articles identified for any additional articles. No restrictions were applied regarding year of publication or language. The following variables were considered in quantitative and qualitative analysis: probing pocket depth (PPD); probing attachment level (PAL); plaque control record (PCR); bleeding on probing (BOP); and gingival margin migration. Results: Twenty articles were selected for qualitative synthesis, and of these, nine underwent meta-analysis. Higher PCR was found in control teeth, while BOP, PPD, and PAL were higher around teeth prepared with horizontal finishing lines supporting complete coverage crowns/FDPs Gingival migration results were the clearest manifestation of compromised periodontal health around teeth prepared with horizontal finishing lines. Conclusions: Meta-analysis revealed that teeth prepared with horizontal finishing lines supporting crowns and FDPs present more periodontal disorders than untreated control teeth.

Periodontal Behavior and Patient Satisfaction of Anterior Teeth Restored with Single Zirconia Crowns Using a Biologically Oriented Preparation Technique: A 6-Year Prospective Clinical Study

“…Preparations with a finish line, where the crown is supported by a horizontal shoulder that is not always regular and symmetrical, may cause a poor fit or a gap (Figure 13). According to various authors, incorrect marginal adaptation between the restoration and the prepared tooth is the main reason for increased gingival bleeding and periodontal inflammation [13,17,19,36,38,39]. In the present study, no significant changes in probing depth were observed over the 6-year follow-up, with 98.3% of the teeth presenting the same probing depth (ranging from 0-3 mm) as at the start of treatment.…”

“…But when dental preparations with horizontal finish lines are analyzed, apical migration of the gingival margin is a common response over time [10,12,17,36]. Studies subjected to metaanalysis have shown that 40.7% of samples prepared with horizontal finish lines suffer gingival migration, in comparison with 2.9% of the present work's sample [10][11][12]17,36].…”

“…The sample size was very similar to studies employing similar meth-ods, such as that of Paniz [28]. The clinical parameters that were evaluated have been investigated in similar articles in the literature, although they were always regarding teeth restored with horizontal finish lines [16][17][18]28,39].…”

“…In the present study, no significant changes in probing depth were observed over the 6-year follow-up, with 98.3% of the teeth presenting the same probing depth (ranging from 0-3 mm) as at the start of treatment. However, several studies of teeth with horizontal finish lines have observed an increase in probing depth during the follow-up period [13,17,40,41].…”

“…In this sense, an ideal prosthodontic treatment must achieve a healthy relationship between the prosthesis and the surrounding periodontal tissues [1][2][3][4][5]. Many factors in the design of a fixed prosthesis influence periodontal health: the prosthesis's cervical emergence profile, the materials used in fabrication, the finish line created in dental preparation, and especially the location of the prosthetic margin [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19].…”