Clinical application of posterior modified inlay retained adhesive fixed partial dentures in cases with a single missing tooth: a four-year clinical study

CLINICAL APPLICATION OF POSTERIOR MODIFIED INLAY RETAINEDADHESIVE FIXED PARTIAL DENTURES IN CASES WITH A SINGLE MISSINGTOOTH: A FOUR-YEAR CLINICAL STUDYDt. Ayça Deniz ZGSUMMARYTreatment with conventional fixed partial dentures will always cause a reduction ofhealthy dental tissue on the abutment teeth. The unwilling sacrifice of healthy tissue had ledscientists to investigate for conservative methods for the treatment of missing teeth. Theseinvestigations had brought the invention of the adhesive fixed partial dentures - minimallyinvasive restorations, especially for single missing tooth in the anterior or posterior region.Fifty-four patients were included in the study. Sixty-four modified inlay retained adhesivedentures were applied altogether. Fifty-two of the dentures were made of porcelain fused on ametal framework, for the rest 12, fiber reinforced composite resin was used. Periodontalhealth of the abutment teeth was followed-up 6 months after the treatment and regularly,every 1-year after the treatment with an aid of periapical radiographs and periodontal indexes.Modified US Public Health Service (USPHS) criterion was used to evaluate the resin ponticsand the health condition of the abutment teeth.At the end of the study the collected data was evaluated distinct from one another for theend of the follow-up and before the treatment. Periodontal index results and gingival pocketdepths were compared with a Student?s t test statistically. The data for Silness-Löe PlaqueIndex and Sulcus Bleeding Index was found statistically different for the before treatment andafter follow-up period. Gingival depth measurement results were statistically indifferent.According to the evaluation made using the Modified USPHS criterion, after the follow-upperiod the ?A? quantity (set as ideal) was; 96.09% for retention, 60.93% for color stability,40.62% for the coloring of the cavity margins, 93.75% for anatomic form, 96.09% formarginal adaptation. Secondary caries was detected only in one denture and the ?A? quantitywas calculated as 99.21%. Two failures occurred with fiber reinforced dentures and 75% werefound as ideal for the fracture of the fiber reinforced pontics. No decementation was detectedfor the fiber reinforced dentures while the ?A? quantity in this group for the unaltered surfacesmoothness was 83.33%, and 75% for color matching.The time until failure occurred was evaluated from, type of the denture, localization ofmissing tooth and the sex of the patient, point of view using Kaplan-Meiers test. Thedifference between the results of the Kaplan-Meiers test was statistically evaluated using theBreslow test. According to these evaluations porcelain-fused-to-metal dentures were foundmore reliable than fiber reinforced composite resin dentures. The sex of the patient and thelocalization of the missing tooth were statistically indifferent for the success of the treatment.The average time until the failure occurred for the adhesive inlay retained fixed partialdentures was measured as 30.01 months. Since the decementation of a denture and thefracture of the pontic of a denture were accepted as failure, the success rate was calculated ashigh as 92.18% (59 dentures). The decementation rate was 4.68% (3 dentures) and thefracture rate was 3.1% (2 dentures). Considering recementing the decemented dentures thefunctional success rate was calculated as 96.87%.Key Words: Modified inlay, adhesive denture, posterior single missing tooth