Abstract
The aim of this study was to assess retrospectively the survival and success rates of monolithic zirconia restorations supported by teeth and implants in bruxer versus non-bruxer patients. Methods: A total of 15 bruxer and 25 non-bruxer patients attended the recall appointment. The bruxer group (mean age of 61.2 ± 13.3 years and follow-up of 58.7 ± 16.8 months) were treated with 331 monolithic zirconia restorations, while the non-bruxer group, with a comparable mean age and follow-up time, were treated with 306 monolithic zirconia restorations. Clinical data were retrieved from the patients’ files. At the recall appointment, all supporting teeth and implants were examined for biological and technical complications, and the restorations were evaluated using modified California Dental Association (CDA) criteria. Data were statistically analyzed using survival analysis methods. A significance level of p < 0.05 was used. A total of 31 versus 27 biologic and technical complications were recorded in the bruxer and non-bruxer groups, respectively. No significant differences were found between the two groups regarding overall complications and survival rate. Regarding the type of complication, a significantly higher rate of veneered porcelain chipping (p = 0.045) was observed in the bruxer group. With regard to biological complications, the only complications that exhibited a borderline, although not significant, difference were three fractured teeth exclusively in the bruxer group (p = 0.051), which were replaced with implant-supported restorations. Within the limitations of this study, we conclude that there were no significant differences in the overall survival and success rates of the monolithic zirconia restorations in bruxer versus non-bruxer patients, although veneered zirconia restorations and single tooth abutments exhibited a higher rate of complications in the bruxer group.
Highlights
According to the international consensus obtained in 2013, bruxism, either during sleep or while awake, is defined as a repetitive masticatory muscle activity, characterized by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible [1].Bruxism has been reported to have a positive association with various biological and technical complications, such as porcelain chipping, tooth cracks/fracture, loosened screws on implants, and abutment/implant fracture
Bruxism was considered a contraindication for implant treatment, and since an excessive overload may result in bone loss or even in implant failure, practical guidelines and recommendations were established to minimize implant overload [2]
The aim of the current study was to assess retrospectively the survival and success rates of monolithic zirconia restorations supported by teeth and implants in bruxer versus non-bruxer patients
Summary
Bruxism has been reported to have a positive association with various biological and technical complications, such as porcelain chipping, tooth cracks/fracture, loosened screws on implants, and abutment/implant fracture. Bruxism was considered a contraindication for implant treatment, and since an excessive overload may result in bone loss or even in implant failure, practical guidelines and recommendations were established to minimize implant overload [2]. Recent studies that evaluated the influence of bruxism on implant-supported restorations and implant failure rates have reported contradictory results. Manfredini et al suggested that bruxism should be considered a risk factor for mechanical rather than biological complications of dental implants [3]. Chrcanovic et al reported higher rates of implant failure and more mechanical and technical complications of implant-supported restorations in bruxers versus a matched group of non-bruxers [4]. A recent retrospective study demonstrated a 100% success and survival rate of all implants in bruxer patients, after a mean observation period of 28.2 (±16.8) months [5]
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