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Volume 16 , Issue 2
March/April 2003

Pages 177–182

An up to 15-Year Longitudinal Study of 515 Metal-Ceramic FPDs: Part 2. Modes of Failure and Influence of Various Clinical Characteristics

Terry R. Walton, BDS, MDSc (Syd), MS (Mich), FRACDS

PMID: 12737251

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.

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