The placement of prosthetic restoration finish line is the subject of much interest and debate. The aim of this review was to assess the effect of prosthetic margin placement on caries susceptibility of abutment teeth
Searches were conducted in PubMed, Embase, Google Scholar, Cochrane Central Register of Database of Systematic reviews, Cochrane Central Register of Controlled Trials [CENTRAL] and Scopus. Additional had searching of the journals; Journal of Prosthetic Dentistry, International Journal of Prosthodontics, Journal of Dentistry and Caries Research, was also carried out.
Clinical studies (randomised controlled clinical trials, prospective or retrospective studies or case-control observational studies and follow-up studies reporting on caries susceptibility of teeth serving as abutments for prosthetic restorations were considered. Studies with at least 2-years follow-up reporting the number of patients, restorations, abutments and surfaces and restoration margin location were included.
- Twenty-two studies were finally included in a qualitative synthesis. 13 were prospective the remainder retrospective.
- Most of the studies were conducted in a university setting.
- Follow-up time ranged from 2 – 11.4 years.
- The majority reported on the survival of fixed partial dentures (FPDs) and single crowns (SCs).
- Only 5 studies reported that secondary caries had occurred.
The authors concluded
This systematic review and meta-analysis failed to detect a significantly different secondary caries rate of sub-gingivally located prosthetic margins in the short to mid-term (≤10 years). Due to the small number and the limitations of the included studies the results do not provide conclusive evidence as to the effect of prosthetic margin placement on the incidence of secondary caries.
Comment
The question addressed by this review is one that would be clinically useful to answer. The qualitative summary provides some information about secondary caries at prosthetic margins. However, the available evidence is limited by the studies designs and the heterogeneity of the original studies. While a meta-analysis using data from two studies after follow up of 5 years was reported it is of limited value bearing in mind that the GRADE summary of findings rates the quality of evidence as very low. Several databases were searched but only studies in English or with English abstracts were considered which could have a significant impact on the findings, bearing in mind the poor quality of the studies that have been included.
Links
Papageorgiou SN, Papadelli AP, Koidis PT, Petridis HP. The effect of prosthetic margin location on caries susceptibility. A systematic review and meta-analysis. Br Dent J. 2013 Jun 21;214(12):617-24. doi: 10.1038/sj.bdj.2013.582. PubMed PMID: 23787852
