Extended all-ceramic fixed partial dentures - clinical performance after one year

Objectives: The aim of this study was to evaluate the clinical performance of extended zirconia all-ceramic fixed partial dentures (FPD).

Methods: 30 extended all-ceramic FPDs with a span length of at least 36mm (max.: 46mm, mean: 40.33mm ± 3.27mm) were fabricated using a CAM system (Cercon, DeguDent, Germany). The occlusal thickness of the zirconium framework was at least 1.0mm (1.27mm ± 0.34mm) and a minimum of two teeth had to be replaced. The framework was veneered using the recommended ceramic material (Cercon Ceram S). For the preparation of the teeth a chamfer design with at least 0.8mm circular reduction was used. The FPDs were cemented using glass-ionomer cement. Follow-ups were scheduled after one year. Postoperative sensitivity, pocket depth and the aesthetics of the all-ceramic FPDs were evaluated after cementation (baseline) and after one year using a numeric rating scale (NRS 0-10).

Results: One total failure occurred after 29 days, because of a fracture. Thus 29 bridges were in function after the first year. Additional complications were a root canal treatment of an abutment tooth after 258 days, and one loss of retention occurring after 267 days, that could be solved by re-cementation of the FPD.

The aesthetic attributes were rated to be excellent after the cementation (9.10 ± 1.09 on the NRS) and after one year (9.10 ± 0.94 on the NRS).The patients rarely reported a postoperative sensitivity at the beginning (0.97 ± 1.90) and regressive values (0.59 ± 1.70) after one year. At baseline, the maximal pocket depth was 3.33mm, one year later 3.86mm (p = 0.026).

Conclusion: Extended all-ceramic FPDs with a span length of up to 46mm display excellent aesthetic properties in combination with a promising clinical performance after one year. Further follow-ups are necessary to evaluate long-term performance.