After 10 years seven out of ten fixed dental prostheses (FDP) remain intact and nine out of ten FDPs remain in function following biological and technical complications that have been repaired.

SELECTION CRITERIA: From a beginning MEDLINE search listing 3658 titles, subsequent selections ultimately yielded 19 studies being included in the systematic review. There were no randomized controlled trials identified, so the review included only prospective and retrospective studies written in English of patients followed for at least 5 years and having experienced actual intraoral examinations regularly.

KEY STUDY FACTOR: Adverse clinical events associated with fixed dental prostheses (FDPs) and the time-to-event. Clinical adverse events were categorized either as biological (e.g., caries, pulpal and periodontal diseases) or as technical complications (e.g., retention loss and fractures).

MAIN OUTCOME MEASURE: Parameters used to describe the clinical performance of the FDPs were "Success" if the FDP remained intact without any complications, and "Survival" if any of the adverse events associated with an FDP did not result in a failure. The incidences of the various types of adverse events were related to the cumulated exposure time of the FDPs and reported as "failure rates" or "complication rates" of particular types of adverse events. Complication rates were also calculated for the individual abutments as a function of caries or pulpal problems.

MAIN

RESULTS

The estimated 10-year survival rate of FDPs was 89% (CI: 81-94%), and the success rate was 71%(CI: 48%-85%). The estimated risk of FDP loss over 10 years caused by caries is 2.6%, by abutment fracture 2.1% and periodontitis account for a 0.5% risk of failure. Estimated risks of restorable complications per FDP over 10 years are 6.4% loss of retention and 3.2% risk of material fractures of any kind. The estimated risk of FDP abutment tooth complications related to caries is 9.5% and the risk loss of pulp vitality is 10% over 10 years.

CONCLUSIONS

The estimated rate of FDP loss over 10 years due to caries and abutment fracture is lower (4.7%) compared to the rate of repairable FDP complications due to technical complications (9.6%). The most common complications of abutment teeth are caries and/or loss of pulp vitality (19.5%).