A retrospective study of combined fixed-removable reconstructions with their analysis of failures

The survival rate and the reasons for failures of 130 combined fixed-removable reconstructions (CFR), incorporated in 112 patients, were assessed. Each CFR reconstruction was classified depending on its attachments: 76 reconstructions were attached with rigid, precise attachments, and constituted the rigid group; 54 reconstructions were attached with either semi-precision or individual attachments and were defined as the semi-rigid group. Of the 130 reconstructions, 41 were determined as complete successes, 39 as partial successes and 50 as failures, leading to 37 major repairs and to 13 new reconstructions. Three reconstructions failed due to technical reasons, 36 due to biological reasons and for 11 reconstructions, both categories of reasons were responsible for their failure. In total, technical reasons were counted 15 times in comparison to 73 biological reasons for those 50 failed reconstruction, with 29 fractured abutment teeth as the most common biological reason. Within the rigid group, 45 failed reconstructions were observed, whereas within the semi rigid group only 5 failures occurred, leading to an 8-year survival estimate (+/- SD) of 30.1% (+/- 6.9%) for the rigid group and 93.1% (+/- 3.9%) for the semi rigid group. Beside the attachment type, the anatomy of the partially edentulous tooth arch in form of the free-end situation and the dentate opposing jaw were identified as risk factors.