Long-term outcomes on direct fiber reinforced composite fixed partial dentures: A 14-year practice-based study.

Statement of problem: A single-visit replacement of missing teeth without compromising future treatment options is an attractive solution valued by both patients and clinicians. Direct fiber-reinforced composite fixed partial dentures (DFRC-FPDs) offer a minimally invasive, immediate restorative option. However, clinical studies on DFRC-FPDs, especially those preserving intact enamel on abutment teeth, remain limited.

Purpose: The purpose of this clinical study was to report the long-term outcomes of DFRC-FPDs from a single-center, practice-based cohort study and to investigate factors influencing their survival and success.

Material and methods: A total of 153 DFRC-FPDs were inserted in 120 patients in a single private practice by 3 restorative dentists. The treatment encompassed either using cavities from existing restorations or direct bonding on intact enamel. The DFRC-FPDs were reinforced with fiber-splints (Everstick C+B). At the latest routine follow-up visit, restoration survival and success were recorded. Multi-level Cox proportional hazard models were used to evaluate the association between clinical factors and time (α=.05).

Results: Within a mean follow-up period of 82 (range: 2 to 172) months, 18 DFRC-FPDs did not survive (cumulative survival rate: 88%) while additional 43 DFRC-FPDs received a restorative follow-up treatment (cumulative success rate: 60%). The annual failure rate was 1.7% for survival and 7.1% for success, respectively. In the multivariate analysis bruxism (P=.007) and the extensive use of flowable composite resin (CeramX+SDR Flow versus ELS, P=.015) were significant predictors for reduced success. Similarly, location (molars versus incisors or canines, P=.002) and the extensive use of flowable composite resin (CeramX+SDR Flow versus ELS, P=.015) significantly negatively influenced survival. The presence of proximal cavities did not significantly affect survival or success (P≥.593).

Conclusions: For DFRC-FPDs, high survival and moderate success were observed after up to 14 years. DFRC-FPDs represent an immediate, long-term treatment option for replacing up to 2 missing teeth with no or minimal tooth preparation.