ABSTRACT
Context:
In contemporary prosthodontics, implant-supported dental prostheses are frequently utilized to restore function and esthetics for individuals who are edentulous. The prosthetic material selection has a big impact on long-term performance and maintenance needs.
Methods:
A retrospective review of patient files from the dental implant clinic of a tertiary care facility was done. Included were patients who had dental prosthesis supported by implants between January 2018 and December 2022. Data were gathered and examined on the prosthesis material, follow-up visits, and maintenance interventions (adjustments, repairs, and replacements).
Results:
Materials for 50 prostheses made of porcelain, 45 prostheses made of acrylic, 35 prostheses made of metal, and 40 prostheses made of composite were assessed. When it came to modifications and repairs, porcelain prosthesis needed less work than acrylic prostheses. Composite prostheses required the least amount of maintenance overall, whereas metal prostheses indicated a considerable demand for maintenance.
Conclusion:
Superior durability is provided by porcelain, frequent repairs are needed for acrylic, structural strength is provided by metal, and composite material gives promising esthetics with low maintenance requirements. These results highlight how crucial it is to take material properties into account when choosing a prosthesis to maximize long-term results and patient happiness.
KEYWORDS: Acrylic, composite, implant-supported dental prosthesis, maintenance, material selection, metal, porcelain, tertiary care facility
INTRODUCTION
In situations of partial or total edentulism, implant-supported dental prostheses provide patients with a dependable means of restoring function and esthetics, revolutionizing the discipline of prosthodontics in the process. The success of these prostheses depends not only on the dental implant team’s experience but also on the choice of suitable materials that can endure the harsh oral environment while preserving stability and esthetics over the long run.[1,2,3]
Although there are many materials that may be used to create dental prostheses that are supported by implants, each material has special qualities and traits that affect clinical results and maintenance needs. In prosthetic dentistry, porcelain, acrylic, metal, and composite materials are often utilized; each has unique benefits and difficulties. Although porcelain is quite durable and esthetically pleasing, wear may need to be adjusted from time to time. Although it is less expensive and allows for greater creative versatility, acrylic resin is prone to chipping and discoloration. Although metal frames are incredibly strong and stable, they can also have mechanical problems and corrosion as side effects. A viable substitute is composite materials, which combine durability, simplicity of maintenance, and esthetics.[4,5,6]
MATERIALS AND METHODS
Patient data from a dental implant clinic at a tertiary care institution were used in this retrospective analysis. The investigation comprised patient records of individuals who had dental prosthesis supported by implants between January 2018 and December 2022. Electronic medical records and treatment notes were used to gather data on the kind of prosthesis material (porcelain, acrylic, metal, or composite), maintenance procedures (adjustments, repairs, replacements), and follow-up appointments. The study did not include patients whose records were incomplete or who were lost to follow-up. Descriptive statistics were used to examine data and compare the upkeep needs of various materials. Prior to data collection, ethical permission was secured from the research ethics board of the institution, guaranteeing adherence to ethical standards and patient privacy.
RESULTS
Within the research cohort, the distribution of implant-supported dental prosthesis by type of material is shown in Table 1. The most commonly utilized material was porcelain, which was followed by composite, metal, and acrylic.
Table 1.
Distribution of implant-supported dental prostheses by material type
| Prosthesis material | Number of prostheses |
|---|---|
| Porcelain | 50 |
| Acrylic | 45 |
| Metal | 35 |
| Composite | 40 |
The maintenance procedures and follow-up results linked to various prosthetic materials are shown in Table 2. Modifications were the most often performed maintenance procedure across all materials, with acrylic prostheses requiring the most modifications overall. Repairs were also prevalent; the most common kinds of prostheses that require repairs were acrylic, followed by porcelain and metal. Overall, the frequency of replacements was lower, with acrylic prosthesis requiring the most replacements on average.
Table 2.
Maintenance interventions and follow-up outcomes by prosthesis material
| Prosthesis material | Adjustments (mean±SD) | Repairs (mean±SD) | Replacements (mean±SD) |
|---|---|---|---|
| Porcelain | 2.5±1.2 | 1.8±0.9 | 0.3±0.5 |
| Acrylic | 3.2±1.5 | 2.5±1.0 | 0.5±0.7 |
| Metal | 1.8±0.9 | 1.2±0.6 | 0.4±0.6 |
| Composite | 1.5±0.7 | 1.0±0.5 | 0.2±0.4 |
SD=Standard deviation
Significant variations in the maintenance needs of the various prosthetic materials were found by statistical analysis. Generally speaking, porcelain prostheses needed less adjusting and repair work than acrylic prostheses. Composite prostheses required the least amount of maintenance overall, whereas metal prostheses required maintenance that was intermediate.
DISCUSSION
The study’s findings highlight many important considerations while choosing and maintaining implant-supported dental prostheses. We evaluated porcelain, acrylic, metal, and composites, each with unique properties and maintenance needs.[1,2,3]
For implant-supported restorations, porcelain prostheses are preferred due to their resilience and beauty. Current studies show porcelain prostheses require less adjustment and repair than acrylic ones. This supports earlier research showing porcelain’s better wear resistance and biocompatibility.[1] Even though they were durable, porcelain prostheses needed frequent adjustments because of wear and occlusal variations. Although porcelain is stain-resistant, surface damage may occur over time, needing frequent cleaning to retain look and functioning.[2]
On the other hand, acrylic prostheses required more maintenance than porcelain ones. Acrylic resin is a popular building material due to its affordability and ease of use. Acrylic prostheses chipped, discolored, and wore out more often; therefore, they needed more repairs and alterations, according to current research. Acrylic materials are susceptible to esthetic and mechanical issues, as shown by prior research.[3] Acrylic prostheses may initially look good but require regular care to maintain patient satisfaction. For implant-supported prostheses, metal frames, often combined with porcelain or acrylic materials, provide better structural support. Current study shows that metal prostheses require less modification and maintenance than acrylic but more than porcelain. Metal frames are ideal for large-span restorations due to their strength and durability. However, metal prosthesis can still have marginal disparities or framework cracks that require occasional maintenance.[4] Metal prostheses may also provide cosmetic challenges, especially if the metal substructures are visible through thin gingival tissues.
Composite materials can replace implant-supported dental prostheses, balancing esthetics, durability, and maintenance. Current research shows that composite prostheses require the fewest adjustments, replacements, and repairs. Composite materials integrate well with soft tissues and the original teeth, providing excellent esthetics.[5,6,7] Composite materials are chairside repairable, allowing doctors to fix minor issues without lab help. However, composite materials’ stability and endurance in prosthesis supported by implants need additional investigation.
The optimum restoration for implant-supported dental prostheses must include patient-specific factors and material properties. The maintenance demands of prosthetic materials vary greatly. Clinicians must assess the merits and cons of each material as well as long-term maintenance, patient preferences, and esthetic and functional needs.[8,9,10]
This study stresses the importance of frequent care and monitoring of implant-supported dental prostheses to ensure their longevity and functioning. Patient education and oral hygiene guidance lower the risk of issues and the need for extensive maintenance after implant placement. Dental laboratory staff, clinicians, and patients must collaborate to keep patients happy with their prosthetic restorations and resolve issues quickly.
CONCLUSION
In summary, current research offers important new understandings into the upkeep needs related to various materials utilized in tertiary care implant-supported dental prostheses. Although porcelain prostheses are more esthetically pleasing and durable, they may need to be adjusted from time to time. Because acrylic prostheses are more likely to chip, discolor, and wear, they require more upkeep. Although they offer strong structural support, metal frames occasionally need to be repaired. Composite materials have minimum maintenance needs and provide promising durability and esthetics. These results highlight how crucial material selection and routine follow-up care are to maximizing the long-term performance of dental prosthesis supported by implants.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
- 1.Kim MJ, Oh SH, Kim JH, Ju SW, Seo DG, Jun SH, et al. Wear evaluation of the human enamel opposing different Y-TZP dental ceramics and other porcelains. J Dent. 2012;40:796–804. doi: 10.1016/j.jdent.2012.08.004. [DOI] [PubMed] [Google Scholar]
- 2.Heffernan MJ, Aquilino SA, Diaz-Arnold AM, Haselton DR, Stanford CM, Vargas MA, et al. Relative translucency of six all-ceramic systems. Part II: Core and veneer materials. J Prosthet Dent. 2002;88:10–5. [PubMed] [Google Scholar]
- 3.Sadowsky SJ. An overview of treatment considerations for esthetic restorations: A review of the literature. J Prosthet Dent. 2006;96:433–42. doi: 10.1016/j.prosdent.2006.09.018. [DOI] [PubMed] [Google Scholar]
- 4.Pjetursson BE, Tan WC, Tan K, Brägger U, Zwahlen M, Lang NP. A systematic review of the survival and complication rates of resin-bonded fixed dental prostheses after a mean observation period of at least 5 years. Clin Oral Implants Res. 2018;29((Suppl 16)):196–223. [Google Scholar]
- 5.Gehrt M, Wolfart S, Rafai N, Reich S, Edelhoff D. Clinical results of lithium-disilicate crowns after up to 9 years of service. Clin Oral Invest. 2013;17:275–84. doi: 10.1007/s00784-012-0700-x. [DOI] [PubMed] [Google Scholar]
- 6.Amer R, Kürklü D, Kateeb E, Seghi RR. Three-body wear potential of dental yttrium-stabilized zirconia ceramic after grinding, polishing, and glazing treatments. J Prosthet Dent. 2014;112:1151–5. doi: 10.1016/j.prosdent.2013.12.021. [DOI] [PubMed] [Google Scholar]
- 7.Park JH, Park S, Lee K, Yun KD, Lim HP. Antagonist wear of three CAD/CAM anatomic contour zirconia ceramics. J Prosthet Dent. 2014;111:20–9. doi: 10.1016/j.prosdent.2013.06.002. [DOI] [PubMed] [Google Scholar]
- 8.Mitov G, Heintze SD, Walz S, Woll K, Muecklich F, Pospiech P. Wear behavior of dental Y-TZP ceramic against natural enamel after different finishing procedures. Dent Mater. 2012;28:909–18. doi: 10.1016/j.dental.2012.04.010. [DOI] [PubMed] [Google Scholar]
- 9.Mandal NB, Kumari A, Yemineni BC, Airan M, Tiwari RV, Damarasingu R, et al. The prosthetic complications and the survival of the implant-fixed complete dental prostheses: An original study. J Pharm Bioallied Sci. 2022;14((Suppl 1)):S301–S303. doi: 10.4103/jpbs.jpbs_773_21. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Tyagi M, Kusum CK. Full mouth rehabilitation of the patient with severely mutilated dentition: a case report. Int J Community Med Public Health. 2022;9:3010–3. [Google Scholar]
