Survival rates for resin bonded bridges

Abstract

Medline and hand searching of bibliographies of identified articles. Studies were selected independently by two reviewers. Prospective and retrospective cohort studies with a mean follow-up period of five or more years with clinical examination at follow-up that reported details of the characteristics of the superstructures were included. Information on survival and on biological and technical complications was retrieved. Survival was defined as the RBBs remaining in situ at the examination without multiple debonding, but irrespective of its condition. Failure was defined as the RBBs that were lost and required refabrication, or multiple recementations. Biological complications included caries on abutment teeth, and periodontal disease progression. Technical complications analyzed included loss of retention, with or without loss of the reconstruction, and fractures of veneers with or without loss of the reconstruction veneers, with or without loss of the reconstruction. 17 studies that met the inclusion criteria. Meta-analysis of these studies indicated an estimated survival of RBBs of 87.7% (95% confidence interval (CI): 81.6-91.9%) after 5 years. The most frequent complication was debonding (loss of retention), which occurred in 19.2% (95% CI: 13.8-26.3%) of RBBs over an observation period of 5 years. The annual debonding rate for RBBs placed on posterior teeth (5.03%) tended to be higher than that for anterior-placed RBBs (3.05%). This difference, however, did not reach statistical significance (P=0.157). Biological complications, like caries on abutments and RBBs lost due to periodontitis, occurred in 1.5% of abutments and 2.1% of RBBs, respectively. Despite the high survival rate of RBBs after 5 years, technical complications such as debonding are frequent. This, in turn, means that substantial amounts of extra chair time may by needed following the incorporation of RBBs. Thus, there is an urgent need for prospective studies with a follow-up time of 10 years or more, to evaluate the long-term outcomes of RBBs.