Evaluation of the 5-year clinical efficacy of cross-arch fixed dental prostheses as periodontal splints on periodontal tissue stability.

OBJECTIVES

To investigate the clinical efficacy of the cross-arch fixed dental prostheses as periodontal splints and to identify the key factors influencing its treatment outcomes.

MATERIALS AND

METHODS

Thirty-seven patients with 51 tooth-supported cross-arch prostheses (mean follow-up: 63 months; mean bridge length: 10.24 units) were retrospectively analyzed. Survival rates, complications, alveolar bone level (ABL), probing pocket depth (PPD), bleeding on probing (BoP), plaque index (PI), prosthesis characteristics, and patient satisfaction were documented at baseline (T0), 1 year (T1), 3 years (T2) and 5 years (T3) after loading. Cumulative survival rates (CSRs) were calculated using Kaplan-Meier curves. Risk factors for changes in PPD (ΔPPD) and alveolar bone level (ΔABL) were screened by univariate analyses and assessed using multivariable generalized linear and logistic regression models.

RESULTS

Five-year prosthesis survival was 95.16% (100% at 1- and 3-year). PPD decreased significantly from T0 (3.84 ± 0.81 mm) to T1 (3.26 ± 0.92 mm) and T2 (3.33 ± 0.84 mm; p < 0.05), while ABL remained clinically stable, and BoP and PI were maintained at low levels throughout the study period. Quadrilateral abutment configuration was significantly associated with reduced bone loss (β = -0.551, p = 0.002) and reduced ΔPPD (β = -0.704, p < 0.001). Bilateral terminal abutment prostheses (β = -0.389, p= 0.013) also showed a protective effect on ΔPPD. Patient satisfaction remained high (p > 0.05).

CONCLUSION

Cross-arch fixed prostheses provided predictable periodontal stabilization with high survival rates. Periodontal maintenance and prosthetic design are key determinants of outcomes.

CLINICAL SIGNIFICANCE: Tooth-supported cross-arch prostheses achieved long-term survival and maintained periodontal parameters in Stage III/IV periodontitis, supporting their use as long-span splints when properly planned and maintained. Abutment distribution and strict supportive periodontal care were key determinants, guiding prosthetic design and follow-up.