Fixed metal ceramic prostheses:treatment need, complications and survival of conventional fixed prosthodontics

Abstract The aims of this study were to evaluate the treatment need of fixed bridges according to the distribution of pontics in dentition in different age groups, and to investigate the primary and late complications and survival of the conventional fixed metal ceramic prostheses, as well as patients' satisfaction with the prosthetic treatment. The whole material consisted of the patients treated with fixed metal ceramic prostheses by undergraduate students at the Institute of Dentistry during the years 1984 - 1996. There were altogether 772 patients, 460 women (60 %) and 312 men (40 %). Their mean age was 47 years (23 - 81 years). Altogether 944 single metal ceramic crowns and 543 fixed bridges (1374 abutments and 807 pontics) were prepared. It can be concluded that the fixed bridges are most often prepared to replace upper first premolars and lower first molars also in the future. The most usual primary complications related to fixed bridges occurred during preprosthetic endodontic treatment of abutment teeth and during the preparation of the root canals. Previous restoration of the prepared tooth does not have any marked effect on the prognosis of single crowns with dowels, although anatomically complicated upper lateral incisors and upper first premolars need special attention in the treatment planning. Patients were satisfied with aesthetics and function of the fixed metal ceramic prostheses. Late complications found in clinical examinations were few, and the survival rate for the fixed metal ceramic bridge prostheses was calculated to be 84 % after 10 years, long fixed bridges having a lower survival than the shorter ones. The treatment need for conventional fixed bridges seems to be highest among patients over 50 years of age in the future. Age does not influence the longevity of the fixed prostheses, but basic circumstances of the mouth, especially low secretion of saliva affected by diseases and/or medications and high scores of lactobacilli and streptococcus mutans of the saliva seem to decrease the survival