Periodontal and Pulpal Conditions of Abutment Teeth. Status After Four to Eight Years Following the Incorporation of Fixed Reconstructions

In the present retrospective clinical study, 58 patients were examined 4 to 8 years (median 77 months) following the incorporation of a fixed reconstruction. No regular maintenance care had been provided during the interval period. The periodontal conditions represented by the Plaque Control Record (PCR), the Gingival Index (GI) and pocket probing depths were examined on 182 abutment teeth of 94 reconstructions. Pulpal vitality and periapical pathology were assessed clinically as well as radiographically. The periodontal parameters of the abutment teeth were compared with homologous contralateral uncrowned teeth. Significantly higher plaque prevalence, gingival indices, and pocket probing depths were found in the crowned teeth. Also, bleeding on probing was observed more frequently whenever the crown margins were located subgingivally. At the end of the interval period, 3.7% of the originally vital abutments had lost their vitality. A technical failure rate of 7.4% with no apparent differences between conventional and extension bridges was noted. This study indicates that even with precise marginal fit and in the absence of a regular maintenance program, the supragingival location of the crown margin is more favourable than the subgingival location for the maintenance of oral health.