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Survival of Fixed Prosthetic Restorations on Vital and Nonvital Teeth

Now online in the Journal of Prosthodontics, an Open Access systematic review of full-coverage tooth-supported fixed prosthetic restorations, single crowns (SCs), and fixed dental prostheses (FDPs).

Databases were searched to identify clinical human studies on full-coverage SCs and FDPs supported by vital and/or non-vital abutments and/or a combination of both, with a minimum observation period of 24 months.

Out of 4198 studies identified through the database search and 22 through hand searching, 26 studies met the inclusion criteria and were included in the analysis. Studies were classified according to the type of fixed prosthetic restoration (SC, FDP), type of prosthesis material (metal-ceramic, all-ceramic), abutment vitality condition (vital, non-vital), and presence and type of post (no-post, fiber post, cast metal post).

For each study, event rates for the prostheses were calculated by dividing the total number of events by the total prosthesis exposure time in years. The 5-year survival proportions were calculated via the relationship between event rate and survival function.

The highest estimated 5-year survival rate was observed for (metal-ceramic and all-ceramic) SCs on vital teeth and all ceramic SCs on non-vital teeth with fiber post. For FDPs, the 5-year survival rate was significantly higher for FDPs on vital abutments compared to FDPs retained by non-vital abutment/s regardless of presence, type of post, and FDP material.

The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of each study and all included studies scored six points or more and were considered high-quality.

Within the limitations of the present review, preserved tooth vitality is suggested to contribute positively to SC and FDP survival. However, due to the presence of uncontrolled confounding factors, it was not possible to draw strong conclusions about the influence of either the presence or type of post and core and the type of prosthesis material on the prosthesis survival.

Hawthan, M, Larsson, C, Chrcanovic, BR. Survival of fixed prosthetic restorations on vital and nonvital teeth: A systematic review. J Prosthodont. 2023; 1–13. https://doi.org/10.1111/jopr.13735

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