JC 11 A Systematic Review of The Survival and Complication
JC 11 A Systematic Review of The Survival and Complication
JC 11 A Systematic Review of The Survival and Complication
Implant
Resin Bonded Fixed dental
Removable supported
Bridges (RBBs) Prosthesis
partial denture single crowns
(FDPs)
(SCI)
FOCUSED QUESTIONS
Outcome
• Survival and complication rates
Time
• Time interval of at least 5 years
Study design
• Randomized controlled trials, prospective studies, retrospective studies
OBJECTIVES
29 studies
13
included in
13
Retrospective
Retrospective
studies
studies
the
systematic
review
11 multi-
multi- center
center
study
study
Exposure
Exposure time
time up
up to
to aa
failure
failure of
of the
the RBBs
RBBs TOTAL
that
that were
were lost
lost due
due to
to EXPOSUR
EXPOSUR
failure during the
failure during the E
E TIME
TIME
observation
observation time.
time.
Exposure
Exposure time
time upup to
to
the end of
the end of
observation
observation time
time for
for
RBBs that did
RBBs that did notnot
complete
complete the
the
observation period
observation period
SURVIVA
L
ANNUAL SURVIVAL AND
FAILURE RATES
ACCORDING TO
DIFFERENT MATERIALS
UTILISED
SURVIVAL RATES ACCORDING TO NUMBER OF RETAINERS
The one retainer group had significantly (P < 0.0001) lower annual failure rate of 0.87 (95% CI: 0.59–1.28%)
compared with an annual failure rate of 2.17 (95% CI: 1.44–3.27%) for the two-retainer group.
SURVIVAL RATES ACCORDING TO LOCATION IN THE ORAL
CAVITY
MAXILLA
MAXILLA>>
MANDIBLE
MANDIBLE
ANTERIOR >
Dental
Dental caries
caries
Loss
Loss of
of
vitality
vitality of
of
abutment
abutment
teeth
teeth
Abutment
Abutment
Recurrent
Recurrent tooth
tooth
periodontitis
periodontitis fracture
fracture
BIOLOGICAL
COMPLICATIONS
TECHNICAL
COMPLICATIONS
• DEBONDIN
G
Framework Annual
material debonding rate
Metal Acrylic 4.17%
Metal Ceramic 2.89 %
Fibre reinforced 1.72%
composite
Zirconia 1.42%
framework
Glass infiltrated No debonding
and glass occurred
reinforced
ceramics
ANNUAL DEBONDING RATES ACCORDING TO LOCATION IN THE
ORAL CAVITY
MAXILLA
MAXILLA>>
MANDIBLE
MANDIBLE
ANTERIOR >
TECHNICAL
COMPLICATIONS
• FRAMEWOR
K AND
VENEER
FRACTURE
No failures Statistically
• RBBs made of significant
metal–ceramic failures
• zirconia • RBBs made of
• Reinforced glass metal–resin
ceramic • Glass-infiltrated
ceramic,
• Fber-reinforced
composite
TECHNICAL
COMPLICATIONS
• MINOR
VENEER
FRACTUES /
Framework Annual
CHIPPING
material chipping
rates
Metal Acrylic 2.89
Fibre reinforced 1.42
composite
Glass infiltrated 1.04
Ceramics
Glass reinforced 0.95
ceramics
Metal Ceramic 0.29
Zirconia framework 0
TECHNICAL
COMPLICATIONS
• ESTHETIC
FAILURES
DISCUSSION
CHANGE IN TRENDS
The factors influencing the
outcomes of the RBBs were Pjetursson BE, Tan WC, Tan K, Brägger U,
Zwahlen M, Lang NP. A systematic review
of the survival and complication rates of
resin-bonded bridges after an observation
The selection of period of at least 5 years. Clin Oral
Implants Res. 2008;19(2):131–141.
framework material
• Caries at abutment level was 1.7%, and incidence of RBBs lost due to periodontal diseases was 0.8% over and 5-year
observation period. For traditional tooth-supported end abutment FDPs, the respective figures are 4.8% and 0.4%.
• The incidence of RBBs lost due to esthetic failures was only 0.3%. For implant-supported SCs, 7.1% of the cases were
reported to have unacceptable esthetic outcome
COMPARISON BETWEEN DIFFERENT MATERIALS
CHIPPING
DEBONDING
FRAMEWORK FRACTURE Framework Annual
Framework Annual material chipping
material debonding rate rates
Metal Acrylic 4.17% Metal Acrylic 2.89
Metal Ceramic 2.89 % No failures Statistically Fibre reinforced 1.42
Fibre reinforced 1.72% • RBBs made of significant composite
composite metal–ceramic failures
• zirconia Glass infiltrated 1.04
Zirconia 1.42% • Reinforced glass
• RBBs made of Ceramics
framework metal–resin
ceramic • Glass-infiltrated Glass reinforced 0.95
Glass infiltrated No debonding ceramic, ceramics
and glass occurred • Fiber-reinforced
Metal Ceramic 0.29
reinforced composite
ceramics Zirconia framework 0
COMPARISON BETWEEN DIFFERENT MATERIALS
CHIPPING
DEBONDING
FRAMEWORK FRACTURE Framework Annual
Framework Annual material chipping
material debonding rate rates
Metal Acrylic 4.17% Metal Acrylic 2.89
Metal Ceramic 2.89 % No failures Statistically Fibre reinforced 1.42
Fibre reinforced 1.72% • RBBs made of significant composite
composite metal–ceramic failures
• zirconia Glass infiltrated 1.04
Zirconia 1.42% • Reinforced glass
• RBBs made of Ceramics
framework metal–resin
ceramic • Glass-infiltrated Glass reinforced 0.95
Glass infiltrated No debonding ceramic, ceramics
and glass occurred • Fiber-reinforced
Metal Ceramic 0.29
reinforced composite
ceramics Zirconia framework 0
COMPARISON BETWEEN DIFFERENT MATERIALS
CHIPPING
DEBONDING
FRAMEWORK FRACTURE Framework Annual
Framework Annual material chipping
material debonding rate rates
Metal Acrylic 4.17% Metal Acrylic 2.89
Metal Ceramic 2.89 % No failures Statistically Fibre reinforced 1.42
Fibre reinforced 1.72% • RBBs made of significant composite
composite metal–ceramic failures
• zirconia Glass infiltrated 1.04
Zirconia 1.42% • Reinforced glass
• RBBs made of Ceramics
framework metal–resin
ceramic • Glass-infiltrated Glass reinforced 0.95
Glass infiltrated No debonding ceramic, ceramics
and glass occurred • Fiber-reinforced
Metal Ceramic 0.29
reinforced composite
ceramics Zirconia framework 0
COMPARISON BETWEEN DIFFERENT MATERIALS
CHIPPING
DEBONDING
FRAMEWORK FRACTURE Framework Annual
Framework Annual material chipping
material debonding rate rates
Metal Acrylic 4.17% Metal Acrylic 2.89
Metal Ceramic 2.89 % No failures Statistically Fibre reinforced 1.42
Fibre reinforced 1.72% • RBBs made of significant composite
composite metal–ceramic failures
• zirconia Glass infiltrated 1.04
Zirconia 1.42% • Reinforced glass
• RBBs made of Ceramics
framework metal–resin
ceramic • Glass-infiltrated Glass reinforced 0.95
Glass infiltrated No debonding ceramic, ceramics
and glass occurred • Fiber-reinforced
Metal Ceramic 0.29
reinforced composite
ceramics Zirconia framework 0
COMPARISON BETWEEN DIFFERENT MATERIALS
CHIPPING
DEBONDING
FRAMEWORK FRACTURE Framework Annual
Framework Annual material chipping
material debonding rate rates
Metal Acrylic 4.17% Metal Acrylic 2.89
Metal Ceramic 2.89 % No failures Statistically Fibre reinforced 1.42
Fibre reinforced 1.72% • RBBs made of significant composite
composite metal–ceramic failures
• zirconia Glass infiltrated 1.04
Zirconia 1.42% • Reinforced glass
• RBBs made of Ceramics
framework metal–resin
ceramic • Glass-infiltrated Glass reinforced 0.95
Glass infiltrated No debonding ceramic, ceramics
and glass occurred • Fiber-reinforced
Metal Ceramic 0.29
reinforced composite
ceramics Zirconia framework 0
In specific and clearly defined patient
situations, RBBs may be considered as
valid minimally invasive treatment
CONCLUSIO alternative to conventional FDPs or
single implant crowns
N
Combining the information and
knowledge from the present systematic
review, The RBBs exhibited the best
outcomes in anterior regions, with a
single-retainer design and when made of
zirconia-ceramic
RESULT:
1. The 15 year cumulative survival rates of RBFDPs was 66.5 % and that of FDPs
was 61.6%
2. The 15-year cumulative event-free rates were 53.4% for the RBFDP group and
59.2% for the FDP group
Yoshida T, Kurosaki Y, Mine A, et al. Fifteen-year survival of resin-bonded vs full-coverage fixed dental prostheses. J Prosthodont Res. 2019;63(3):374‐
OBJECTIVE :
To evaluate the survival rate of resin bonded
bridges (RBBs) and understand the
relationship between various prognostic
factors and survival rate
ASSOCIATION BETWEEN
The predicted survival rate:
PROGNOSTIC FACTORS AND
SURVIVAL OF RBB:
5 Years 83.6% 1. Tooth preparation design
2. Tooth preparation depth
3. Occlusion
10 Years 64.9% 4. Surface treatment of retainer
5. Retainer type
6. Gingival finish line location
7. Retainer alloy
COMPLICATIONS: 8. Luting cements
9. Location of bridge
77% are due to 13% are due to
debonding of RBBs porcelain fracture
Balasubramaniam GR. Predictability of resin bonded bridges - a
systematic review. Br Dent J. 2017;222(11):849‐858.
PROGNOSTIC CONCLUSIONS
FACTOR
Tooth preparation design A minimal preparation or no preparation design had more chances of failure than a
retentive preparation
Tooth preparation depth All preparation should lie only in enamel whatever may be the design chosen as bond
strength to dentine is lower than in enamel
Occlusion Occlusion on retention wings, occlusion on pontics, a pontic directly involved in protrusive
and laterotrusive contacts had no significant effect on longevity of rbbs
Surface treatment of retainer Silicoating the retainers showed better survival than other surface treatments.
Retainer type Chemically etched retainers performed better and the MOD design or extracoronal retainer
performed better than the inlay design
Gingival finish line location Bridges with both retainers having supra gingival finish lines showed a better retention rate
Retainer alloy It was concluded that ni-cr and co-cr alloys are preferred over gold or titanium alloys as
they double the modulus of elasticity.
Luting cements Multi link (93%) and panavia (82%)