Purpose: This study reported on the modes of failure and the influence of various clinical
characteristics on the outcome of 515 metal-ceramic fixed partial dentures (FPD)
involving 1,209 abutments and 885 pontics placed by one operator in a specialist
prosthodontic practice between January 1984 and December 1997. Materials and
Methods: Fifty-three percent of maxillary and 84% of mandibular FPDs involved one or
more nonrigid abutment-pontic connections. Patients were recalled in 1993 (review 1)
and 1998 (review 2) and clinically examined by the author. The modes of failure and
influence of clinical characteristics, including abutment-pontic connection, post design in
nonvital abutments, and regularity of professional maintenance, were evaluated. Results:
At review 2, 80% of the FPDs were still in function, while 9% required retreatment. Tooth
fracture accounted for 38%, caries for 11%, loss of retention for 13%, and periodontal
breakdown for 27% of retreatments. Nonrigid abutment-pontic connection in posterior
FPDs and regular professional maintenance were associated with significantly reduced
failure rates. Except in posterior molars, there was no difference in failure rates between
parallel-sided preformed stainless steel serrated posts and cast–gold alloy posts.
Conclusion: Tooth fracture was the most common reason for retreatment of the FPDs,
although the rate of periodontal breakdown and caries increased significantly with time.
Nonrigid abutment-pontic connection and regular professional maintenance were
associated with significantly reduced failure rates. Post design and composition were not
related to outcome. Int J Prosthodont 2003;16:177–182.