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Long-term outcomes on direct fiber reinforced composite fixed partial dentures: A 14-year practice-based study
Andrea Roccuzzo1, Philippe Perrin2, Hendrik Meyer-Lueckel3
1Professor, Vice-chairman, Shanghai Perio-Implant Innovation Center, Institute of Integrated Oral, Craniofacial and Sensory Research, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China and Professor, College of Stomatology, Shanghai Jiao Tong University, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China and Privatdozent, Staff Member, Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Statement Of Problem:
A single-visit replacement of missing teeth without compromising future treatment options is an attractive solution valued by both patients and clinicians. Direct fiber-reinforced composite fixed partial dentures (DFRC-FPDs) offer a minimally invasive, immediate restorative option. However, clinical studies on DFRC-FPDs, especially those preserving intact enamel on abutment teeth, remain limited.
Purpose:
The purpose of this clinical study was to report the long-term outcomes of DFRC-FPDs from a single-center, practice-based cohort study and to investigate factors influencing their survival and success.
Material And Methods:
A total of 153 DFRC-FPDs were inserted in 120 patients in a single private practice by 3 restorative dentists. The treatment encompassed either using cavities from existing restorations or direct bonding on intact enamel. The DFRC-FPDs were reinforced with fiber-splints (Everstick C+B). At the latest routine follow-up visit, restoration survival and success were recorded. Multi-level Cox proportional hazard models were used to evaluate the association between clinical factors and time (α=.05).
Results:
Within a mean follow-up period of 82 (range: 2 to 172) months, 18 DFRC-FPDs did not survive (cumulative survival rate: 88%) while additional 43 DFRC-FPDs received a restorative follow-up treatment (cumulative success rate: 60%). The annual failure rate was 1.7% for survival and 7.1% for success, respectively. In the multivariate analysis bruxism (P=.007) and the extensive use of flowable composite resin (CeramX+SDR Flow versus ELS, P=.015) were significant predictors for reduced success. Similarly, location (molars versus incisors or canines, P=.002) and the extensive use of flowable composite resin (CeramX+SDR Flow versus ELS, P=.015) significantly negatively influenced survival. The presence of proximal cavities did not significantly affect survival or success (P≥.593).
Conclusions:
For DFRC-FPDs, high survival and moderate success were observed after up to 14 years. DFRC-FPDs represent an immediate, long-term treatment option for replacing up to 2 missing teeth with no or minimal tooth preparation.
