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Clinical acceptability of metal-ceramic fixed partial dental prosthesis fabricated with direct metal laser sintering technique-5 year follow-up

View Article: PubMed Central - PubMed

ABSTRACT

Statement of problem:: In recent years, direct metal laser sintered (DMLS) metal-ceramic-based fixed partial denture prostheses have been used as an alternative to conventional metal-ceramic fixed partial denture prostheses. However, clinical studies for evaluating their long-term clinical survivability and acceptability are limited.

Aims and objective:: The aim of this study was to assess the efficacy of metal-ceramic fixed dental prosthesis fabricated with DMLS technique, and its clinical acceptance on long-term clinical use.

Materials and methods:: The study group consisted of 45 patients who were restored with posterior three-unit fixed partial denture prosthesis made using direct laser sintered metal-ceramic restorations. Patient recall and clinical examination of the restorations were done after 6months and every 12 months thereafter for the period of 60 months. Clinical examination for evaluation of longevity of restorations was done using modified Ryge criteria which included chipping of the veneered ceramic, connector failure occurring in the fixed partial denture prosthesis, discoloration at the marginal areas of the veneered ceramic, and marginal adaptation of the metal and ceramic of the fixed denture prosthesis. Periapical status was assessed using periodical radiographs during the study period. Survival analysis was made using the Kaplan–Meier method.

Results:: None of the patients had failure of the connector of the fixed partial denture prostheses during the study period. Two exhibited biological changes which included periapical changes and proximal caries adjacent to the abutments.

Conclusion:: DMLS metal-ceramic fixed partial denture prosthesis had a survival rate of 95.5% and yielded promising results during the 5-year clinical study.

No MeSH data available.


Radiographic assessment of the fixed partial denture
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Figure 6: Radiographic assessment of the fixed partial denture

Mentions: In this study group of 45 patients, (24 male and 21 female patients) who received the metal-ceramic posterior fixed partial denture done with DMLS technique had been evaluated periodically using modified Ryge criteria for the period of 60 months to assess the clinical longevity of these restorations. At the end of evaluation period of 60 months for fracture resistance 39 restorations which had smooth, shiny surface and without any defects were rated Alpha [Figure 1], four restorations with mild chipping of the veneering porcelain and was not impairing the functioning of the metal-ceramic prosthesis was reported Bravo [Figure 2], and two restorations reported Charlie had chipping of veneering porcelain impairing esthetics and exposing the framework material. The exposure was reported at the distolingual cusp areas of one case [Figure 3] and at the area of central fossa in the other case. These two restorations which had Bravo rating during the end of the 3rd year gradually progressed to the Charlie rating at the end of the 5th year of the study. On visual and probing examination for marginal adaptation, 43 restorations reported with Alpha rating and one each was reported for Bravo [Figure 4], and Charlie and no cases reported Delta ratings. For marginal discoloration, only two cases reported Bravo rating and all other cases reported Alpha rating. The distribution of clinical criteria and its ratings for the study group is shown graphically [Figure 5]. Radiographic assessment for the period of 60 months had 43 cases with no evidence of any periapical changes [Figure 6]. Only one case reported with radiographic evidence of incipient proximal caries requiring restoration of the proximal teeth adjacent to the abutments, and the other with abutment teeth exhibiting periapical changes requiring root canal therapy during the study period. None of the cases had fracture of the framework, and retention was maintained for all the posterior fixed partial denture cases. The survival rate of the laser sintered posterior metal-ceramic fixed partial denture without any major fracture of the ceramic material, or the connector framework was 95.5% with confidence interval of 78–96% during the observation period of 60 months [Figure 7], and mechanical complication [Figure 8] occurred as a result of major chipping of the veneer porcelain was only 4.5% with confidence interval of 85–98%.


Clinical acceptability of metal-ceramic fixed partial dental prosthesis fabricated with direct metal laser sintering technique-5 year follow-up
Radiographic assessment of the fixed partial denture
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4837776&req=5

Figure 6: Radiographic assessment of the fixed partial denture
Mentions: In this study group of 45 patients, (24 male and 21 female patients) who received the metal-ceramic posterior fixed partial denture done with DMLS technique had been evaluated periodically using modified Ryge criteria for the period of 60 months to assess the clinical longevity of these restorations. At the end of evaluation period of 60 months for fracture resistance 39 restorations which had smooth, shiny surface and without any defects were rated Alpha [Figure 1], four restorations with mild chipping of the veneering porcelain and was not impairing the functioning of the metal-ceramic prosthesis was reported Bravo [Figure 2], and two restorations reported Charlie had chipping of veneering porcelain impairing esthetics and exposing the framework material. The exposure was reported at the distolingual cusp areas of one case [Figure 3] and at the area of central fossa in the other case. These two restorations which had Bravo rating during the end of the 3rd year gradually progressed to the Charlie rating at the end of the 5th year of the study. On visual and probing examination for marginal adaptation, 43 restorations reported with Alpha rating and one each was reported for Bravo [Figure 4], and Charlie and no cases reported Delta ratings. For marginal discoloration, only two cases reported Bravo rating and all other cases reported Alpha rating. The distribution of clinical criteria and its ratings for the study group is shown graphically [Figure 5]. Radiographic assessment for the period of 60 months had 43 cases with no evidence of any periapical changes [Figure 6]. Only one case reported with radiographic evidence of incipient proximal caries requiring restoration of the proximal teeth adjacent to the abutments, and the other with abutment teeth exhibiting periapical changes requiring root canal therapy during the study period. None of the cases had fracture of the framework, and retention was maintained for all the posterior fixed partial denture cases. The survival rate of the laser sintered posterior metal-ceramic fixed partial denture without any major fracture of the ceramic material, or the connector framework was 95.5% with confidence interval of 78–96% during the observation period of 60 months [Figure 7], and mechanical complication [Figure 8] occurred as a result of major chipping of the veneer porcelain was only 4.5% with confidence interval of 85–98%.

View Article: PubMed Central - PubMed

ABSTRACT

Statement of problem:: In recent years, direct metal laser sintered (DMLS) metal-ceramic-based fixed partial denture prostheses have been used as an alternative to conventional metal-ceramic fixed partial denture prostheses. However, clinical studies for evaluating their long-term clinical survivability and acceptability are limited.

Aims and objective:: The aim of this study was to assess the efficacy of metal-ceramic fixed dental prosthesis fabricated with DMLS technique, and its clinical acceptance on long-term clinical use.

Materials and methods:: The study group consisted of 45 patients who were restored with posterior three-unit fixed partial denture prosthesis made using direct laser sintered metal-ceramic restorations. Patient recall and clinical examination of the restorations were done after 6months and every 12 months thereafter for the period of 60 months. Clinical examination for evaluation of longevity of restorations was done using modified Ryge criteria which included chipping of the veneered ceramic, connector failure occurring in the fixed partial denture prosthesis, discoloration at the marginal areas of the veneered ceramic, and marginal adaptation of the metal and ceramic of the fixed denture prosthesis. Periapical status was assessed using periodical radiographs during the study period. Survival analysis was made using the Kaplan–Meier method.

Results:: None of the patients had failure of the connector of the fixed partial denture prostheses during the study period. Two exhibited biological changes which included periapical changes and proximal caries adjacent to the abutments.

Conclusion:: DMLS metal-ceramic fixed partial denture prosthesis had a survival rate of 95.5% and yielded promising results during the 5-year clinical study.

No MeSH data available.