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  • Title: Clinical comparison of metal ceramic resin-bonded fixed dental prostheses with a conventional and a mixed retainer design.
    Author: Boemicke W, Kappel S, Stober T, Rammelsberg P.
    Journal: J Prosthet Dent; 2014 Sep; 112(3):472-80. PubMed ID: 24912399.
    Abstract:
    STATEMENT OF PROBLEM: Little is known about the clinical performance of fixed dental prostheses that rigidly connect adhesive retainers and crowns. PURPOSE: The purpose of this retrospective analysis was to assess and compare the clinical performance of resin-bonded fixed dental prostheses with a conventional and a mixed retainer design. MATERIAL AND METHODS: Included as participants were all patients of the hospital since 2004 with regular clinical follow-up who were treated with 3-unit or 4-unit metal ceramic resin-bonded fixed dental prostheses with a conventional 2-adhesive retainer design (conventional group) or with a mixed type combining an adhesive retainer with a crown or a partial crown retainer (mixed group). The analysis included 84 participants with a total of 57 (64%) prostheses in the conventional group and 32 (36%) prostheses in the mixed group. Treatment and data collection were standardized. Cumulative survival without failure (defined as a restoration in need of replacement), chipping, and debonding were estimated by the Kaplan-Meier method and compared for the groups (log-rank test) (α=.05). RESULTS: During a mean observation period of 4.1 years (SD, 2.5 years; minimum, 0.4 years; maximum, 9.4 years), 12 complications occurred in 10 restorations. Defects of the ceramic veneer (n=6) were observed most frequently. The estimated 5-year failure-free survival rate was 97.4% (standard error, .025) in the conventional group and 95% (standard error, .049) in the mixed group (log-rank, P=.32). The 5-year cumulative survival rate without chipping was 90.7% (standard error, .064) for the conventional group and 93.8% (standard error, .061) for the mixed group (log-rank, P=.44). The 5-year cumulative survival rate without debonding was 95.1% (standard error, .034) for the conventional group and 91.5% (standard error, .058) for the mixed group (log-rank, P=.54). CONCLUSIONS: Limited by a small sample size and a short follow-up period, the findings of this retrospective analysis indicate that the clinical performance, in terms of survival and the incidence of complications, is comparable for conventional resin-bonded fixed dental prostheses and those that rigidly connect an adhesive wing and a partial or complete crown. Acceptable 5-year survival and complication rates imply that the medium-term prognosis for resin-bonded restorations with a retentive preparation design is comparable with that for conventional fixed dental prostheses.
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