Fixed Prosthetic Restorations and Periodontal Health: A Narrative Review.

Viritpon Srimaneepong,Artak Heboyan,Anand Marya,Gustavo V O Fernandes,Dinesh Rokaya,Muhammad Sohail Zafar,Zohaib Khurshid

doi:10.3390/jfb13010015

Abstract

Periodontal health plays an important role in the longevity of prosthodontic restorations. The issues of comparative assessment of prosthetic constructions are complicated and not fully understood. The aim of this article is to review and present the current knowledge regarding the various technical, clinical, and molecular aspects of different prosthetic biomaterials and highlight the interactions between periodontal health and prosthetic restorations. Articles on periodontal health and fixed dental prostheses were searched using the keywords “zirconium”, “CAD/CAM”, “dental ceramics”, “metal–ceramics”, “margin fit”, “crown”, “fixed dental prostheses”, “periodontium”, and “margin gap” in PubMed/Medline, Scopus, Google Scholar, and Science Direct. Further search criteria included being published in English, and between January 1981 and September 2021. Then, relevant articles were selected, included, and critically analyzed in this review. The margin of discrepancy results in the enhanced accumulation of dental biofilm, microleakage, hypersensitivity, margin discoloration, increased gingival crevicular fluid flow (GCF), recurrent caries, pulp infection and, lastly, periodontal lesion and bone loss, which can lead to the failure of prosthetic treatment. Before starting prosthetic treatment, the condition of the periodontal tissues should be assessed for their oral hygiene status, and gingival and periodontal conditions. Zirconium-based restorations made from computer-aided design and computer-aided manufacturing (CAD/CAM) technology provide better results, in terms of marginal fit, inflammation reduction, maintenance, and the restoration of periodontal health and oral hygiene, compared to constructions made by conventional methods, and from other alloys. Compared to subgingival margins, supragingival margins offer better oral hygiene, which can be maintained and does not lead to secondary caries or periodontal disease.

Highlights

Proper treatment planning and prosthetic treatment are essential for the long-term outcome of prosthetic dental treatment
Marginal as well as an internal discrepancy with an external gap in a prosthetic crown/fixed partial denture are critical factors as they deal with the structural rigidity, marginal integrity, and maintenance of pulpal and periodontal health [15]
Another study showed no significant difference in the margin fit, both horizontally and vertically between the lost wax and computer-aided design and computer-aided manufacturing (CAD/CAM) techniques for full coverage lithium disilicate crowns [25]

Summary

Introduction

Proper treatment planning and prosthetic treatment are essential for the long-term outcome of prosthetic dental treatment. There is a strong association between prosthetic dentistry and periodontics as periodontal health has an important role in the longevity of fixed dental restorations [1,2,3]. The final finish of the prosthetic restoration affects the development of biofilm, as increased surface roughness creates a favorable environment for microbial growth. A good prosthesis surface finish from proper manufacturing technique is important [5]. To achieve a successful treatment outcome, prosthodontists and periodontists should collaborate, to enhance the longevity of the restoration and improve periodontal health, as well as improve the quality of life for dental patients [3,6]

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Conclusion