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. 2023 Feb;9(1):249-257.
doi: 10.1002/cre2.696. Epub 2022 Nov 26.

Secondary caries in fixed dental prostheses: Long-term clinical evaluation

Ali Alenezi  1 , Omar Alkhudhayri  2 , Fahad Altowaijri  2 , Lina Aloufi  2 , Fatimah Alharbi  2 , Maha Alrasheed  2 , Hind Almutairi  2 , Abdulltif Alanazi  3 , Mohammed Yehya  1 , Dhafer Al Asmari  4
Affiliations

Secondary caries in fixed dental prostheses: Long-term clinical evaluation

Ali Alenezi et al. Clin Exp Dent Res. 2023 Feb.

Abstract

Objectives: Even with excellent fixed dental prostheses (FDPs), there will be a substantial risk of biological complications, such as caries, if proper oral hygiene is not maintained. This study aimed to evaluate the risks of developing secondary caries with FDPs in relation to the patient oral hygiene status.

Material and methods: Clinical and radiographic examinations were performed for patients to collect data related to their FDP complications and oral hygiene status. The main clinical parameter analyzed was secondary caries. Complications such as a fracture, debonding, or the need for endodontic therapy were also analyzed. The interval survival rate and the cumulative survival rate of FDPs from the time of treatment to the time of follow-up were analyzed.

Results: A total of 423 patients (with a total of 1116 FDPs) were examined in this study, with a mean age of 43.7 years and a mean follow-up time of 7 years. Regarding complications, secondary caries was detected in 94 FDPs (8.4%), fracture (or chipping) in 85 (7.6%) cases, need for endodontic treatment in 42 cases (3.7%), and debonding in four (0.3%) cases. Secondary caries was found in nine out of 219 FDPs (4%) in patients with good oral hygiene, 35 out of 634 FDPs (5.5%) in patients with fair oral hygiene, and 50 out of 272 FDPs (18.4%) in patients with poor oral hygiene (p ≤ .001).

Conclusions: Good oral hygiene has a great influence on reducing the risk of secondary caries in patients with FDPs. The occurrence of secondary caries is a common complication in patients with poor oral hygiene.

Keywords: fixed dental prosthesis; oral hygiene; plaque index; secondary caries.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Secondary caries lesions at the margins of two connected porcelain fused to metal crowns on upper central incisors with poor plaque control.
Figure 2
Figure 2
Female patient (37 years) presented to the clinic complaining of halitosis and periodontal inflammation related to the maxillary 5‐unit FPD, which was received 5 years ago. Secondary caries lesions can be seen around the margins of some teeth.
Figure 3
Figure 3
Kaplan–Meier survival function of FDPs for primary outcome “secondary caries” (p ≤ .001).
See this image and copyright information in PMC

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