Carlo Ercoli1, Dennis Tarnow2, Carlo E Poggio1, Alexandra Tsigarida1, Marco Ferrari3, Jack G Caton1, Konstantinos Chochlidakis1. 1. Departments of Prosthodontics and Periodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY. 2. Department of Periodontics, Columbia University College of Dentistry, New York, NY. 3. Department of Medical Biotechnologies, Division of Fixed Prosthodontics, Dean, University of Siena, Siena, Italy.
Abstract
PURPOSE: To search the literature and to critically evaluate the findings on the periodontal outcomes of restorations and tooth-supported fixed prostheses. MATERIALS AND METHODS: PubMed was searched according to a systematic methodology, previously reported, but updated to include a larger database. Filters applied were: Case reports, clinical trial, review, guideline, randomized controlled trial, meta-analysis, systematic reviews, and English. A narrative review was then synthesized to discuss periodontal outcomes related to restorations and tooth-supported fixed prostheses. Relevant data was organized into four sections: Direct restorations, indirect restorations, biologic width or supracrestal tissue attachment and tooth preparation/finish line design. RESULTS: While increased gingival index, bleeding on probing, probing depth and clinical attachment loss have been associated with subgingival restorations, intracrevicular margins do not cause periodontal diseases. Inflammation and bone loss occur, for both direct and indirect restorations, only with large overhangs. Different restorative materials are associated with different clinical responses when placed in the gingival sulcus or within the epithelial and connective tissue attachments. When the connective tissue attachment is removed, histological changes occur causing its apical shift and subsequent re-establishment. Gingival displacement during impression procedures can cause gingival recession. Emergence profile can have a range of values, not associated with periodontal diseases. Periodontal response appears to be clinically not different when compared among different finish line designs. CONCLUSIONS: Contemporary procedures and materials used for the placement and fabrication of tooth-supported restorations and fixed prostheses are compatible with periodontal health when adequate patient education and motivation in self-performed oral hygiene are present. Periodontal diagnostic criteria should be thoroughly reviewed before fixed restorative treatments are planned and executed.
PURPOSE: To search the literature and to critically evaluate the findings on the periodontal outcomes of restorations and tooth-supported fixed prostheses. MATERIALS AND METHODS: PubMed was searched according to a systematic methodology, previously reported, but updated to include a larger database. Filters applied were: Case reports, clinical trial, review, guideline, randomized controlled trial, meta-analysis, systematic reviews, and English. A narrative review was then synthesized to discuss periodontal outcomes related to restorations and tooth-supported fixed prostheses. Relevant data was organized into four sections: Direct restorations, indirect restorations, biologic width or supracrestal tissue attachment and tooth preparation/finish line design. RESULTS: While increased gingival index, bleeding on probing, probing depth and clinical attachment loss have been associated with subgingival restorations, intracrevicular margins do not cause periodontal diseases. Inflammation and bone loss occur, for both direct and indirect restorations, only with large overhangs. Different restorative materials are associated with different clinical responses when placed in the gingival sulcus or within the epithelial and connective tissue attachments. When the connective tissue attachment is removed, histological changes occur causing its apical shift and subsequent re-establishment. Gingival displacement during impression procedures can cause gingival recession. Emergence profile can have a range of values, not associated with periodontal diseases. Periodontal response appears to be clinically not different when compared among different finish line designs. CONCLUSIONS: Contemporary procedures and materials used for the placement and fabrication of tooth-supported restorations and fixed prostheses are compatible with periodontal health when adequate patient education and motivation in self-performed oral hygiene are present. Periodontal diagnostic criteria should be thoroughly reviewed before fixed restorative treatments are planned and executed.
Authors: Katharina Kuhn; David Zügel; Victor-Sebastian A Korbay; Thomas Papas; Sigmar Schnutenhaus; Ralph G Luthardt; Jens Dreyhaupt; Heike Rudolph Journal: J Clin Med Date: 2022-01-15 Impact factor: 4.241