Clinical performance of anterior resin-bonded fixed dental prostheses with different framework designs: A systematic review and meta-analysis

Ya-Ru Wei; Xiao-Dong Wang; Qin Zhang; Xiang-Xia Li; Markus B Blatz; Yu-Tao Jian; Ke Zhao

doi:10.1016/j.jdent.2016.02.003

Clinical performance of anterior resin-bonded fixed dental prostheses with different framework designs: A systematic review and meta-analysis

J Dent. 2016 Apr:47:1-7. doi: 10.1016/j.jdent.2016.02.003. Epub 2016 Feb 11.

Authors

Ya-Ru Wei¹, Xiao-Dong Wang¹, Qin Zhang¹, Xiang-Xia Li¹, Markus B Blatz², Yu-Tao Jian³, Ke Zhao⁴

Affiliations

¹ Department of Prosthodontics, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
² Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, United States.
³ Institute of Stomatological Research, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
⁴ Department of Prosthodontics, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China. Electronic address: zhaoke@mail.sysu.edu.cn.

PMID: 26875611
DOI: 10.1016/j.jdent.2016.02.003

Abstract

Objectives: To systematically review the failure rate and complications of different framework designs of resin-bonded fixed dental prostheses (RBFDPs) in the anterior region.

Methods: A systematic search for clinical studies on RBFDPs published prior to December 2014 in Medline/PubMed, EMBASE, and Cochrane Library databases was conducted and complemented by a manual search. Randomized controlled trials (RCTs) as well as prospective and retrospective cohort studies that compared at least two RBFDP framework designs with a minimum of 2 years follow up were included in this review. The quality of the included studies were assessed using the Newcastle-Ottawa scale for cohort studies and Cochrane Handbook for RCT. Prostheses-based data on reported failure rate/survival rate, debonding, and fractures were analyzed by meta-analysis.

Results: Of 1010 screened articles, one RCT and 4 cohort studies fit the inclusion criteria and were included in the meta-analysis. All included articles have a high risk of bias. Failure rates of single-retainer cantilever RBFDPs were lower than two-retainer fixed-fixed RBFDPs (OR 0.42, 95% CI 0.19-0.94, P=0.04). Metal-ceramic RBFDPs showed no difference of failure rates between cantilever RBFDPs and two-retainer fixed-fixed RBFDPs (OR 0.93, 95% CI 0.33-2.63, P=0.89). Debonding was not significantly different between cantilever RBFDPs and two-retainer fixed-fixed RBFDPs (OR 0.61, 95% CI 0.23-1.60, P=0.32). Metal-ceramic RBFDPs showed no difference of debonding between cantilever RBFDPs and two-retainer fixed-fixed RBFDPs (OR 0.81, 95% CI 0.28-2.34, P=0.70,).

Conclusions: Within the limitations of the present study, cantilever RBFDPs demonstrate lower clinical failure than two-retainer RBFDPs in the anterior region. The failure of metal-ceramic RBFDPs is independent of the framework design, while the failure of all-ceramic RBFDPs with different designs has not been clear yet.

Clinical significance: Based on the principle of minimally invasive treatment, less number of retainers is recommended for RBFDPs.

Keywords: Denture; Meta-analysis; Resin-bonded; Systematic review.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Dental Bonding*
Dental Prosthesis Design*
Dental Restoration Failure*
Denture Retention
Denture, Partial, Fixed, Resin-Bonded*
Humans
Randomized Controlled Trials as Topic
Resin Cements*
Treatment Outcome

Substances

Resin Cements