Longevity of Fiber-Reinforced Composite Fixed Partial Dentures (FRC FPD) - Systematic Review

Abstract

Objectives: to assess the longevity of Fiber-Reinforced Composite Fixed Partial Dentures (FRC FPDs) through systematically reviewing contemporary clinical evidence. Population investigated comprised patients requiring replacement of a single missing anterior/posterior tooth. Intervention was FRC FPDs. No control/ comparison selected. Outcome was longevity of FRC FPDs. The focus question was: ‘What is the longevity of FRC FPDs used to replace one anterior or posterior tooth in patients?’Methods: PubMed, MEDLINE, and Web of Science databases were searched between January 2007 and December 2015. Randomised, non-randomised, controlled, prospective and retrospective clinical studies were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were applied. The Overall Strength of Clinical Recommendation (OSCR) was assessed using the Strength of Recommendation Taxonomy system. Survival of FPDs was assessed using the Kaplan-Meier method. Analysis of FPD-survival according to location and occurrence of different failures was performed using Logrank and Chi-square testing.Results: Nine clinical studies were included, involving placement of 592 FRC FPDs in 463 patients. Follow-up periods ranged between 2 months and 8 years. Kaplan-Meier overall survival probability was 94.5% (95% C.I: 92.5%- 96.5%) at 4.8 years. There was no significant difference in survival probability of anterior versus posterior FRC FPDs (P = 0.278). Veneering material fracture/delamination occurred significantly more than other types of failures (Ps < 0.05). A meta-analysis could not be performed. OSCR was moderate.Conclusions: FRC FPDs demonstrated high overall survival with predictable performance outcomes. Consequently, FRC FPDs can be considered as viable medium-term management alternatives for replacing single anterior or posterior teeth in patients. However, long-term performance remains unclear.