Complications in Metal-Ceramic Fixed Dental Prostheses: Literature Review

Abstract

Introduction: Fixed dental prostheses (FDPs) using riretal-ceramic (MC) technology are widely employed. Despite high success rate reported for MCFDPs, patients and dental practitioners encounter complications in these.

Methodology: Seventy one English language publications with information and findings on various types of complications in MC FDPs during the period from 1961 to 2013, provided as the source for this narrative review.

Results: Longevity and success of MCFDPs in general has been promising. This can be seen from their good success seen over a follow-up periods ranging from L5 to 20 years. The problems or complications observed in these prostheses have been attributed to reasons including; lack of attention to proper planning and case selection, inadequate clinical and technical expertise and lack of patients' compliance with the instruction. ln general, complications occurring in MCFDPs have been categorized as simple or extensive with the latter requiring replacement or even using other alternatives. Complications that occur in abutments have also been categorized as biological or technical. Those in the former category occur in the supporting abutments. ln this context, not only the extent of the FDP and the availability of required number of abutments is important but also is the health and integrity of their supporting tissues. Such complication includes primary and secondary caries, pulp pathology, periodontal disease and abutment fracture. Technical complications that occur in the prosthesis comprise in general the FDP de-cementation, ceramic de-bonding, aesthetic problems, occlusal errors and fracture of the FDP framework.

Conclusions & Recommendations: MCFDPS having shown promising success rate shall continue to be provided to patients. However, proper treatment planning for these FDPs is necessary for avoiding and minimizing the reported rate of complications. Due consideration should be given to appropriate designing of the prosthesis (mechanical factors) as well as the evaluation of FDP abutments (biological factors). lt is important to assess abutments for features such as crown and root form and length, crown-root ratio, structural integrity, pulp health, periodontal status, available support, axial inclination and abutment mobility. Apart from these, factors such as number of missing teeth, alveolar ridge shape, arch curvature and occlusal forces should also be considered.