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First clinical experiences with CAD/CAM-fabricated PMMA-based fixed dental prostheses as long-term temporaries
Fabian Huettig1, Andreas Prutscher2, Christoph Goldammer2
1Department of Prosthodontics with Section "Medical Materials and Technology" at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tübingen, Germany. fabian.huettig@med.uni-tuebingen.de.
Objective:
The clinical performance of polymethylmethacrylate (PMMA)-based fixed dental prostheses (FDP) was evaluated in the indication of long-term temporaries.
Materials And Methods:
In the current indication of the applied machinable PMMA-based material (Vita CAD-Temp), i.e. temporary crowns and FDPs, 27 patients with compromised dentitions (uncertain dental prognosis or postponement of a removable treatment option) were recruited and 45 FDPs (3 or 4 units, 37 terminal-retained, 8 cantilevered) were inserted. Frameworks were computer-aided design (CAD)/computer-aided manufacturing (CAM)-manufactured after conventional impression taking and labside scanning of stone master casts. A resin-modified hybrid cement material (RelyX Unicem) was used for luting in a conventional protocol. Clinical follow-up was performed biannually.
Results:
Over an observation time from 2 to 26 months (median 13 months), 11 complications were found in 9 out of 45 PMMA restorations: 4 losses of retention, 5 complete fractures; two of these subsequent to a trepanation for endodontic treatment. Thereby, 3 out of 8 cantilevered FDPs had to be removed within 8 months. Thus, the statistical evaluation included FDPs with abutment at end, only. These standard design FDPs (n = 37) showed a 90.4 % survival rate with a complication-free rate of 88.3 % estimated for an observation time of 16 months.
Conclusion:
Cantilevered FDPs and reconstructions on abutment teeth with markedly reduced biological prognosis or endodontic intervention yielded a high-failure rate. Terminal-retained FDPs performed clinically well in cases without compromised abutment teeth.
Clinical Relevance:
PMMA-based material might be used successfully for long-term temporization with 3- to 4-unit FDPs in a standard design over at least one year.
