A 5-year, randomized clinical trial on 3-unit fiber-reinforced versus 3- or 2-unit, metal-ceramic, resin-bonded fixed dental prostheses.

Abstract

To compare in a randomized controlled trial the 5-year clinical outcomes of (1) 3-unit fiber-reinforced resin-bonded fixed dental prostheses (RBFDPs) to 3-unit metal-ceramic RBFDPs; and (2) 3-unit fiber-reinforced RBFDPs to 2-unit cantilevered metal-ceramic RBFDPs. A consecutive sample of 50 young adult patients with tooth agenesis or trauma in the anterior region was included. The recruitment period was from 2005 to 2009, during which a total of 62 RBFDPs were inserted. In group A, 27 participants were randomly treated with 18 metal-ceramic 3-unit RBFDPs and 15 3-unit fiber-reinforced RBFDPs. In group B, 23 participants were randomly treated with 16 metal-ceramic 2-unit RBFDPs and 13 3-unit fiber-reinforced RBFDPs. All patients were followed up at baseline registration and at 1, 3, and 5 years. The primary outcome parameter was survival rate of the RBFDPs, and the secondary outcome parameters were periodontal and technical/esthetic outcomes and patient-reported evaluation of the RBFDPs. Seven patients dropped out of the study during the 5-year observation period. In group A, the fiber-reinforced RBFDPs had a cumulative survival rate of 23% after 5 years, which was significantly less than for the 3-unit metal-ceramic RBFDPs. In group B, the cumulative 5-year survival rate was 36% for the fiber-reinforced RBFDPs and 91% for the 2-unit cantilevered metal-ceramic RBFDPs. The 3- and 2-unit metal-ceramic RBFDPs had a significantly higher 5-year survival rate than the 3-unit fiber-reinforced RBFDPs. The accessibility for oral hygiene practice was better with 2-unit compared to 3-unit RBFDPs, and the degree of gingivitis was lower. The esthetic outcome was better for the RBFDPs with ceramic pontics than the composite ones.