Top

Clinical Oral Investigations

Published in:

01-11-2018 | Original Article

Impact of simulated reduced alveolar bone support, increased tooth mobility, and distal post-supported, root-treated abutment tooth on load capability of all-ceramic zirconia-supported cantilever FDP

Authors: M. Naumann, M. von Stein-Lausnitz, M. Rosentritt, C. Walter, H. Meyer-Lückel, G. Sterzenbach

Published in: Clinical Oral Investigations | Issue 8/2018

Abstract

Objectives

The aim of this in vitro study was an analysis of the impact of simulated reduced alveolar bone support and post-restored, endodontically treated distal abutment tooth on load capability of all-ceramic zirconia-based cantilever-fixed dental prosthesis (CFDP).

Material and methods

The roots of human lower sound premolars (n = 80) were divided into five experimental groups to be restored with all-ceramic zirconia-supported three-unit CFDP regarding bone loss (BL) relative to the cement-enamel junction (CEJ): 2 mm below CEJ = 0% BL (control group), group 25% distal BL, group 50% distal BL, group 50% mesial and distal BL, and group 50% distal BL and adhesive post-supported restoration. Specimens were exposed to simulated clinical function by thermo-mechanical loading (6.000 cycles 5°–55°; 1.2 × 10⁶ cycles 0–50 N) and subsequent linear loading until failure.

Results

Tooth mobility increased significantly for groups with simulated bone loss (p < 0.001). Four specimens failed during thermal cycling and mechanical loading (TCML). The maximum load capability ranged from 350 to 569 N, and did not differ significantly between experimental groups (p = 0.095). Groups with simulated bone loss revealed more tooth fractures at distal abutment teeth, whereas technical failures were more frequent in the control group (p = 0.024).

Conclusions

Differences of alveolar bone support and respectively increased tooth mobility between mesial and distal abutments did not influence load capability. A distal adhesively post-and-core-supported, root-treated abutment tooth did not increase risk of three-unit CFDP failure.

Clinical relevance

CFDPs are a treatment option used with caution when reduced alveolar bone support, increased tooth mobility, and distal post-supported, root-treated abutment teeth are involved.

Pjetursson BE, Tan K, Lang NP, Bragger U, Egger M, Zwahlen M (2004) A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res 15(6):667–676. https://doi.org/10.1111/j.1600-0501.2004.01120.x CrossRefPubMed

Jepson N, Allen F, Moynihan P, Kelly P, Thomason M (2003) Patient satisfaction following restoration of shortened mandibular dental arches in a randomized controlled trial. Int J Prosthodont 16(4):409–414PubMed

Ewing EE (1957) Reevaluation of the cantilever principle. J Prosthet Dent 7(1):78–92. https://doi.org/10.1016/0022-3913(57)90011-2 CrossRef

Lulic M, Bragger U, Lang NP, Zwahlen M, Salvi GE (2007) Ante’s (1926) law revisited: a systematic review on survival rates and complications of fixed dental prostheses (FDPs) on severely reduced periodontal tissue support. Clin Oral Implants Res 18(Suppl 3):63–72. https://doi.org/10.1111/j.1600-0501.2007.01438.x CrossRefPubMed

Nyman S, Lindhe J (1979) A longitudinal study of combined periodontal and prosthetic treatment of patients with advanced periodontal disease. J Periodontol 50(4):163–169. https://doi.org/10.1902/jop.1979.50.4.163 CrossRefPubMed

Wylie RS, Caputo AA (1991) Fixed cantilever splints on teeth with normal and reduced periodontal support. J Prosthet Dent 66(6):737–742. https://doi.org/10.1016/0022-3913(91)90406-M CrossRefPubMed

Yang HS, Chung HJ, Park YJ (1996) Stress analysis of a cantilevered fixed partial denture with normal and reduced bone support. J Prosthet Dent 76(4):424–430. https://doi.org/10.1016/S0022-3913(96)90549-1 CrossRefPubMed

Skupien JA, Opdam NJ, Winnen R, Bronkhorst EM, Kreulen CM, Pereira-Cenci T, Huysmans MC (2016) Survival of restored endodontically treated teeth in relation to periodontal status. Braz Dent J 27(1):37–40. https://doi.org/10.1590/0103-6440201600495 CrossRefPubMed

Iqbal MK, Johansson AA, Akeel RF, Bergenholtz A, Omar R (2003) A retrospective analysis of factors associated with the periapical status of restored, endodontically treated teeth. Int J Prosthodont 16(1):31–38PubMed

10.

Rodriguez FR, Paganoni N, Eickholz P, Weiger R, Walter C (2017) Presence of root canal treatment has no influence on periodontal bone loss. Clin Oral Investig 21(9):2741–2748. https://doi.org/10.1007/s00784-017-2076-4 CrossRefPubMed

11.

Ohlmann B, Marienburg K, Gabbert O, Hassel A, Gilde H, Rammelsberg P (2009) Fracture-load values of all-ceramic cantilevered FPDs with different framework designs. Int J Prosthodont 22(1):49–52PubMed

12.

Gabbert O, Ohlmann B, Schmitter M, Gilde H, Ruef T, Rammelsberg P (2008) Fracture behaviour of zirconia ceramic cantilever fixed dental prostheses in vitro. Acta Odontol Scand 66(4):200–206. https://doi.org/10.1080/00016350802241555 CrossRefPubMed

13.

Wolfart S, Harder S, Eschbach S, Lehmann F, Kern M (2009) Four-year clinical results of fixed dental prostheses with zirconia substructures (Cercon): end abutments vs. cantilever design. Eur J Oral Sci 117(6):741–749. https://doi.org/10.1111/j.1600-0722.2009.00693.x CrossRefPubMed

14.

Zenthofer A, Ohlmann B, Rammelsberg P, Bomicke W (2015) Performance of zirconia ceramic cantilever fixed dental prostheses: 3-year results from a prospective, randomized, controlled pilot study. J Prosthet Dent 114(1):34–39. https://doi.org/10.1016/j.prosdent.2015.02.006 CrossRefPubMed

15.

Sterzenbach G, Kalberlah S, Beuer F, Frankenberger R, Naumann M (2011) In-vitro simulation of tooth mobility for static and dynamic load tests: a pilot study. Acta Odontol Scand 69(5):316–318. https://doi.org/10.3109/00016357.2011.563244 CrossRefPubMed

16.

Rosentritt M, Behr M, Gebhard R, Handel G (2006) Influence of stress simulation parameters on the fracture strength of all-ceramic fixed-partial dentures. Dent Mater 22(2):176–182. https://doi.org/10.1016/j.dental.2005.04.024 CrossRefPubMed

17.

Rosentritt M, Behr M, van der Zel JM, Feilzer AJ (2009) Approach for valuating the influence of laboratory simulation. Dent Mater 25(3):348–352. https://doi.org/10.1016/j.dental.2008.08.009 CrossRefPubMed

18.

Anusavice KJ, Kakar K, Ferree N (2007) Which mechnical and physical testing methods are relevant for predicting the clinical performance of ceramic-based dental prostheses? Clin Oral Implants Res Suppl 3(18):218–231CrossRef

19.

Kelly JR (1999) Clinically relevant approach to failure testing of all-ceramic restorations. J Prosthet Dent 81(6):652–661. https://doi.org/10.1016/S0022-3913(99)70103-4 CrossRefPubMed

20.

Bolhuis HP, de Gee AJ, Pallav P, Feilzer AJ (2004) Influence of fatigue loading on the performance of adhesive and nonadhesive luting cements for cast post-and-core buildups in maxillary premolars. Int J Prosthodont 17(5):571–576PubMed

21.

Romeo E, Lops D, Margutti E, Ghisolfi M, Chiapasco M, Vogel G (2003) Implant-supported fixed cantilever prostheses in partially edentulous arches. A seven-year prospective study. Clin Oral Implants Res 14(3):303–311. https://doi.org/10.1034/j.1600-0501.2003.120905.x CrossRefPubMed

22.

Naumann M, Blankenstein F, Dietrich T (2005) Survival of glass fibre reinforced composite post restorations after 2 years-an observational clinical study. J Dent 33(4):305–312CrossRefPubMed

23.

Tan K, Pjetursson BE, Lang NP, Chan ES (2004) A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res 15(6):654–666. https://doi.org/10.1111/j.1600-0501.2004.01119.x CrossRefPubMed

24.

Karlsson S (1989) Failures and length of service in fixed prosthodontics after long-term function. A longitudinal clinical study. Swed Dent J 13(5):185–192PubMed

25.

Rodriguez AM, Aquilino SA, Lund PS (1994) Cantilever and implant biomechanics: a review of the literature, Part 2. J Prosthodont 3(2):114–118. https://doi.org/10.1111/j.1532-849X.1994.tb00138.x CrossRefPubMed

26.

Wang CH, Du JK, Li HY, Chang HC, Chen KK (2016) Factorial analysis of variables influencing mechanical characteristics of a post used to restore a root filled premolar using the finite element stress analysis combined with the Taguchi method. Int Endod J 49(7):690–699. https://doi.org/10.1111/iej.12499 CrossRefPubMed

27.

Goga R, Purton DG (2007) The use of endodontically treated teeth as abutments for crowns, fixed partial dentures, or removable partial dentures: a literature review. Quintessence Int 38(2):e106–e111PubMed

28.

Soderfeldt B, Palmqvist S (1998) A multilevel analysis of factors affecting the longevity of fixed partial dentures, retainers and abutments. J Oral Rehabil 25(4):245–252. https://doi.org/10.1111/j.1365-2842.1998.00248.x CrossRefPubMed

29.

Randow K, Glantz PO (1986) On cantilever loading of vital and non-vital teeth. An experimental clinical study. Acta Odontol Scand 44(5):271–277. https://doi.org/10.3109/00016358609004733 CrossRefPubMed

30.

Randow K, Glantz PO, Zoger B (1986) Technical failures and some related clinical complications in extensive fixed prosthodontics. An epidemiological study of long-term clinical quality. Acta Odontol Scand 44(4):241–255. https://doi.org/10.3109/00016358608997726 CrossRefPubMed

31.

Naumann M, Rosentritt M, Preuss A, Dietrich T (2006) The effect of alveolar bone loss on the load capability of restored endodontically treated teeth: a comparative in vitro study. J Dent 34(10):790–795. https://doi.org/10.1016/j.jdent.2006.03.003 CrossRefPubMed

32.

Tunjan R, Rosentritt M, Sterzenbach G, Happe A, Frankenberger R, Seemann R, Naumann M (2012) Are endodontically treated incisors reliable abutments for zirconia-based fixed partial dentures in the esthetic zone? J Endod 38(4):519–522. https://doi.org/10.1016/j.joen.2011.12.027 CrossRefPubMed

33.

Sterzenbach G, Tunjan R, Rosentritt M, Naumann M (2014) Increased tooth mobility because of loss of alveolar bone support: a hazard for zirconia two-unit cantilever resin-bonded FDPs in vitro? J Biomed Mater Res B Appl Biomater 102(2):244–249. https://doi.org/10.1002/jbm.b.33001 CrossRefPubMed

34.

Strub JR, Linter H, Marinello CP (1989) Rehabilitation of partially edentulous patients using cantilever bridges: a retrospective study. Int J Periodontics Restorative Dent Dent 9(5):364–375

35.

Reinhardt RA, Krejci RF, Pao YC, Stannard JG (1983) Dentin stresses in post-reconstructed teeth with diminishing bone support. J Dent Res 62(9):1002–1008. https://doi.org/10.1177/00220345830620090101 CrossRefPubMed

36.

Vire DE (1991) Failure of endodontically treated teeth: classification and evaluation. J Endod 17(7):338–342. https://doi.org/10.1016/S0099-2399(06)81702-4 CrossRefPubMed

37.

Axelsson P, Lindhe J, Nystrom B (1991) On the prevention of caries and periodontal disease. Results of a 15-year longitudinal study in adults. J Clin Periodontol 18(3):182–189CrossRefPubMed

38.

Tay FR, Pashley DH (2007) Monoblocks in root canals: a hypothetical or a tangible goal. J Endod 33(4):391–398. https://doi.org/10.1016/j.joen.2006.10.009 CrossRefPubMedPubMedCentral

Title: Impact of simulated reduced alveolar bone support, increased tooth mobility, and distal post-supported, root-treated abutment tooth on load capability of all-ceramic zirconia-supported cantilever FDP
Authors: M. Naumann
M. von Stein-Lausnitz
M. Rosentritt
C. Walter
H. Meyer-Lückel
G. Sterzenbach
Publication date: 01-11-2018
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 8/2018
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-018-2366-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Impact of simulated reduced alveolar bone support, increased tooth mobility, and distal post-supported, root-treated abutment tooth on load capability of all-ceramic zirconia-supported cantilever FDP

Abstract

Objectives

Material and methods

Results

Conclusions

Clinical relevance

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Material and methods

Results

Conclusions

Clinical relevance

Please log in to get access to this content

Other articles of this Issue 8/2018

Impact of different concentrations of an octenidine dihydrochloride mouthwash on salivary bacterial counts: a randomized, placebo-controlled cross-over trial

Correction to: Effectiveness of adjunctive hyaluronic acid application in coronally advanced flap in Miller class I single gingival recession sites: a randomized controlled clinical trial

Coexistence of oral lichen planus and pemphigus vulgaris

Novel evaluation method of dentin repair by direct pulp capping using high-resolution micro-computed tomography

Roughness, surface energy, and superficial damages of CAD/CAM materials after surface treatment

Treatment of intrabony defects with modified perforated membranes in aggressive periodontitis: a 12-month randomized controlled trial