26 July 2021

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Finishing line for prosthetic restoration: is there any correlation with periodontal behavior?

Alessandra Abbà

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Prosthetic rehabilitation using fixed dental prostheses improves the quality of life and oral health of patients who need replacement of missing teeth or just restoration of teeth.  In order to provide space for the slot of the prostheses, such a restoration requires an adequate tooth preparation which should respect fundamental principles of taper and thickness. Insufficient tooth preparation may lead to a compromised aesthetic outcome or to an overcontoured prostheses with likely periodontal disorder and failure of the treatment. Three different tooth preparation techniques have been documented: horizontal, vertical and preparation without finishing line (bopt). The position of the finishing line is determinant for periodontal tissue health around prostheses  and consequently for the success of the restoration. 

Thus, the present study aimed to determine the periodontal behavior around teeth prepared with horizontal finishing line supporting fixed metal-ceramic and zirconia prostheses.

Materials and methods
An electronic search was conducted in PubMed, Scopus, Embase and Cochrane database following PRISMA guidelines for systematic reviews and meta-analyses and applying strict inclusion and exclusion criteria in the selection process with any restrictions about year of publication. Qualitative and quantitative periodontal analysis recording data such as probing pocket depth (PPD); probing attachment level (PAL); plaque control record (PCR); bleeding on probing (BOP), was conducted. 

Results
A final total of 20 articles were included in the study. Of these, nine underwent meta-analysis.
All the data registered highlighted a higher gingival index in treated teeth but a lower amounts of plaque than untreated control teeth. BOP, PPD, and PAL were higher around teeth prepared with horizontal finishing lines supporting prostheses. The most significant parameter pointing to periodontal disorderin prepared teeth was gingival margin migration. 

Conclusions
Meta-analysis revealed that teeth prepared with horizontal finishing lines supporting crown present more periodontal disorderthan untreated control teeth.

For additional information: Periodontal Behavior Around Teeth Prepared with Finishing Line for Restoration with Fixed Prostheses. A Systematic Review and Meta-Analysis