The consequences of fixed prosthetic constructions on periodontal health

Introduction. Periodontal health plays an important role in the longevity of prosthodontic restorations. Proper treatment planning and prosthetic treatment are essential for the long-term outcome of prosthetic dental treatment. Various environmental and dietary factors can adversely affect the balance of the oral cavity, leading to inflammatory and destructive diseases of the teeth. To achieve a successful treatment outcome, prosthodontists and periodontists should collaborate, to enhance the longevity of the restoration and improve periodontal health, as well as improve the quality of life for dental patients. Purpose. The aim of this study is to review and present the current knowledge regarding the various technical and clinical aspects of different prosthetic biomaterials and highlight the interactions between periodontal health and prosthetic restorations. Materials and methods. In the study we selected a sample of 10 patients aged 30-60. We used cobalt-chromium ceramic prostheses fabricated by the conventional method, cobalt-chromium ceramic prostheses fabricated by a CAD/CAM technique and zirconium prostheses fabricated by a CAD/CAM technique. Fixation is achieved by cementation. As research methods we used detailed clinical examinations, including measurement of periodontal pocket depth by means of periodontal probes, also intraoral radiographs for bone level assessment. Results. It has been found that the average duration of use of fixed prosthetic constructions is 8.8 years, offering a perspective on the period of functionality of the prosthesis. The prevalence of complications and/or failures of fixed prostheses, which may include a number of problems such as: mismatch of shades, overcontact, marginal opening, caries, periodontal disease, gingival bleeding, overlaping edges, fractured porcelain, discomfort, pain, periapical lesion, occlusal wear, abutment fracture. Conclusion. Before starting prosthetic treatment, the condition of the periodontal tissues should be evaluated for their oral hygiene status, as well as the gingival and periodontal conditions. Zirconium-based restorations made from the CAD/CAM technology provide better results, in terms of marginal fit, inflammation reduction, maintenance, and the restoration of periodontal health and oral hygiene, as compared to constructions made by conventional method and from other alloys. Compared to subgingival margins, the supragingival margins offer better oral hygiene, which can be maintained and does not lead to secondary caries or periodontal disease.