Impact of Occlusal Overloads on Complications in Fixed Prosthetic Dentures.

Background/

Objectives

Fixed prosthetic dentures (FPD) represent a reliable treatment option to rehabilitate oral function and aesthetics. The concentration of loads at a certain level of the bridge causes overloading of the bridge components. The objectives of this study were to identify the frequency and severity of complications in FPDs associated with occlusal overload for patients prosthetically treated with metal-ceramic and metal-acrylic FPDs.

Methods

This retrospective cross-sectional clinical study included 306 patients of both sexes, aged 30+, with an FPD requiring rehabilitation. The following data were collected: general demographic data of the patients, data on dental bridges, data on occlusal overloads, and complications of FPDs according to severity. Statistical processing was performed in SPSS.

Results

Metal-ceramic FPDs had more abutment teeth (p = 0.035), fewer intermediaries (p < 0.0005), and less severe complications (p = 0.001). Maxillary FPDs had a higher number of abutment teeth, compared to mandible FPDs (p < 0.001). As the life duration of the FPDs increased, the number of intermediaries and the severity grade also increased (p < 0.001). Compared to intercalated and pontics, cantilever pontics of FPDs had a longer duration (p < 0.001), a lower number of intermediaries (p < 0.001), and a higher severity grade (p < 0.001). The presence of occlusal interferences was associated only with a lower FPD duration (p = 0.007). The presence of unbalanced occlusion planes was associated with a higher severity grade, while the presence of shortened arches was associated with a longer FPD duration (p < 0.001), a higher number of intermediaries (p = 0.005), and a higher severity grade (p < 0.001).

Conclusions

The most severe complications of FPDs were recorded in the case of shortened arches and cantilever bridges. This study draws attention to the need for preprosthetic and postprosthetic occlusal balancing and the need for complete rehabilitation of the dental arches.