Abstract
Statement of problem
Metal and metal-ceramic fixed dental prostheses (FDPs) have been clinically determined
to provide long-term durable restorations. However, data on their performance under
practice conditions are sparse.
Purpose
The purpose of this clinical study was to evaluate the longevity of FDPs under practice
conditions by analyzing a large insurance claims database.
Material and methods
Data were extracted from the data warehouse of a major German national health insurance
company (BARMER). The analysis focused on the FDP types with the lowest deductibles
in the insurance system. All metal-based FDPs replacing up to 3 adjacent teeth were
included. Ceramic veneering was optional and only approved on the labial surfaces
of maxillary teeth mesial to the first molar and mandibular teeth mesial to the second
premolar. Fee codes allowed clinical courses to be traced on a day count basis. Three
groups with FDPs replacing 1 tooth, 2 teeth, and 3 teeth were formed. Kaplan-Meier
survival analyses were conducted for the target events removal or extraction, indicating
FDP failure and extraction of an abutment tooth.
Results
The sample comprised 124 660 FDPs that replaced 1 tooth (76.5%), 2 teeth (19.8%),
or 3 teeth (3.7%). The cumulative survival rates for removal or extraction at 6 years
differed significantly, with 83.0% for 1-pontic FDPs, 78.1% for 2-pontic FDPs, and
74.0% for 3-pontic FDPs. Thus, approximately 1 of 6 one-pontic FDPs, 1 of 5 two-pontic
FDPs, and 1 of 4 three-pontic FDPs failed. The cumulative survival rates for extraction
of an abutment tooth at 6 years showed no significant difference, with 96.0% for 1-pontic
FDPs, 95.6% for 2-pontic FDPs, and 95.1% for 3-pontic FDPs.
Conclusions
The survival rates of FDPs according to insurance data were lower than those reported
by clinical studies, indicating a gap between efficacy and effectiveness.
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Article info
Publication history
Published online: February 20, 2021
Footnotes
Supported in part by the BARMER, a German national health insurance company.
Identification
Copyright
© 2021 by the Editorial Council for the Journal of Prosthetic Dentistry.
