Purpose: This study reported on the modes of failure and the influence of various clinical characteristics on the outcome of 515 metal-ceramic fixed partial dentures (FPD) involving 1,209 abutment and 885 pontics placed by one operator in a specialist prosthodontic practice between January 1984 and December 1997.
Materials and methods: Fifty-three percent of maxillary and 84% of mandibular FPDs involved one or more nonrigid abutment-pontic connections. Patients were recalled in 1993 (review 1) and 1998 (review 2) and clinically examined by the author. The modes of failure and influence of clinical characteristics, including abutment-pontic connection, post design in nonvital abutments, and regularity of professional maintenance, were evaluated.
Results: At review 2, 80% of the FPDs were still in function, while 9% required retreatment. Tooth fracture accounted for 38%, caries for 11%, loss of retention for 13%, and periodontal breakdown for 27% of retreatments. Nonrigid abutment-pontic connection in posterior FPDs and regular professional maintenance were associated with significantly reduced failure rates. Except in posterior molars, there was no difference in failure rates between parallel-sided preformed stainless steel serrated posts and cast-gold alloy posts.
Conclusion: Tooth fracture was the most common reason for retreatment of the FPDs, although the rate of periodontal breakdown and caries increased significantly with time. Nonrigid abutment-pontic connection and regular professional maintenance were associated with significantly reduced failure rates. Post design and composition were not related to outcome.