Long-term outcome of anterior cantilever zirconia ceramic resin-bonded fixed dental prostheses: Influence of the pontic location.

Abstract

Statement of problem: Scientific data on the long-term clinical performance of cantilever zirconia resin-bonded fixed dental prostheses (RBFDPs) replacing missing incisors are lacking.

Purpose: The purpose of this clinical study was to evaluate the survival, retention, and success rates of cantilever zirconia ceramic RBFDPs replacing missing maxillary and mandibular incisors.

Material and methods: A total of 258 patients had been provided with 328 cantilever zirconia RBFDPs to replace missing incisors in the period 2001 to 2022. Tooth preparation was minimal, limited to the enamel, and consisted of a veneer design. All restorations had been adhesively bonded, and the patients were periodically followed up. The Kaplan-Meier test was applied to assess survival, retention, and success rates. The Log-Rank test was used to compare the aforementioned rates among 3 groups (Group C: maxillary central incisor RBFDPs; Group L: maxillary lateral incisor RBFDPs; and Group M: mandibular central and lateral RBFDPs).

Results: Seventeen patients could not be evaluated because of loss of contact (dropout rate 6.6%). A total of 310 cantilever zirconia RBFDPs inserted in 241 patients were followed for a mean period of 85 ±55 months. A 15-year survival rate of 97.3% (confidence interval [CI]: 95.7%-98.9%) was calculated using the Kaplan-Meier method. Over the observation time, 17 RBFDPs debonded, resulting in a retention rate of 82.3% (CI: 77.2%-87.4%), of which 16 were adhesively rebonded with no further complications. Pontic location did not statistically affect the survival or retention rates (P>.05) but did significantly affect the success rate (P=.021).

Conclusions: Zirconia ceramic cantilever RBFDPs provided a minimally invasive treatment option for replacing missing maxillary and mandibular incisors with excellent clinical outcomes.