Study on gingival tissue reaction to the materials used for making dental prosthesis

Abstract

Fixed prosthetic restorations may generate periodontal irritation by various and complex mechanisms especially in the presence of the microbial factor. In this regard, changes that compromise the functional value of the support structures of the teeth occur. Studies on patients wearing fixed denture show that those prosthetic structures facilitate plaque accumulation. Close supervision leads to prevention of periodontal diseases, through learning of a proper hygiene. Between the marginal periodontium and the prosthetic restoration, there must be a relation of ‘mutual protection’ or at least ‘mutual respect’. In this study, we tried to analyze the reaction of the periodontal tissue in contact with fixed prosthesis depending on the prosthetic material used. There were 102 fixed prostheses considered by this study that have generated reactions in the periodontal tissues with which came into contact. Thus, from the total number of 102 fixed dental prostheses, 75% were made from metal alloys based on copper, 18% from Cr–Ni alloys, 2% from Cr–Co alloys, 4% from gold alloys, and one from stainless steel. In 35% of the cases, the patients had multiple fixed dentures made from different types of dental alloys, cases in which the symptoms of the periodontal problems may be also linked to the phenomenon of oral galvanism. The histological study showed various morphological changes from one patient to another, depending on the intensity of the inflammatory and reparative response, the associated diseases (diabetes, dyslipidemia, cardiovascular diseases) and especially on the dental hygiene status. Fixed prosthesis, in the absence of a proper cervical adaptation and an adequate local hygiene, may act as an irritative thorn and may induce gingivitis and periodontitis phenomena.