SPECIFIC FEATURES OF FIXED DENTAL PROSTHESES

Аннотация

Fixed dental prostheses (FDPs) play a critical role in restoring oral function, aesthetics, and patient quality of life. Over the past decade, advancements in dental materials, digital workflows, and minimally invasive techniques have significantly transformed FDP design, fabrication, and clinical performance. This literature review aims to summarize recent developments and highlight the specific features that distinguish fixed prostheses from other treatment modalities. Topics include biomechanical considerations, material selection, longevity, biocompatibility, and patient-centered outcomes. The review also addresses current challenges and future directions in prosthodontics, based on an analysis of scholarly sources published in the last ten years. Findings suggest a shift toward more personalized, durable, and esthetically pleasing solutionssupported byevidence-based protocols. Keywords. Fixed dental prostheses; dental materials; prosthodontics; crown and bridge; digital dentistry; biocompatibility; restoration longevity. Introduction. Tooth loss remains a significant global health concern, affecting both functional and psychosocial aspects of individuals' lives. Fixed dental prostheses (FDPs), including crowns and bridges, have long been integral in restoring masticatory function, aesthetics, and speech. In Europe, approximately 45% of adults in Sweden and 34% in Switzerland have received FDPs, reflecting agrowing preference forfixed overremovable solutionsin prosthodonticcare [12]. The past decade has witnessed transformative advancements in dental materials and digital technologies, reshaping the landscape of fixed prosthodontics. The global digital dentistry market, encompassing technologies such as computer-aided design/computer-aided manufacturing (CAD/CAM), intraoral scanners, and 3D printing, was valued at USD 6.8 billion in 2023 and is projected to grow at a compound annual growth rate (CAGR) of 9.9% from 2025 to 2030. These innovations have enhanced the precision, efficiency, and patient satisfaction associated with FDPs [13]. Material science has also evolved, introducing high-strength ceramics like zirconia and lithium disilicate, which offer improved biocompatibility and aesthetic outcomes. CAD/CAM technology facilitates the fabrication of these materials, allowing for consistent quality and reduced production times. Moreover, digital workflows have streamlined clinical procedures, enabling same-day restorations and minimizing patient visits[14]. Despite these advancements, challenges persist, particularly in terms of accessibility and cost. The high initial investment required for digital equipment, such as CAD/CAM systems, which can range from USD 90,000 to USD 112,000, poses a barrier for many dental practices, especially in low- and middle-income countries . Additionally, limited reimbursement policies for dental procedures can hinder thewidespread adoption ofadvanced prosthodonticsolutions. This literature review aims to synthesize findings from the past decade concerning the specific features of fixed dental prostheses. By analyzing recent studies, the review will explore advancements in materials, digital technologies, clinical outcomes, and patient satisfaction, providing a comprehensive understanding of the current state and future directions of fixed prosthodontics. Literature Analysis. The analysis of the selected literature revealed significant insights into the performance and characteristics of various FDPs: 36 INTERNATIONAL MULTIDISCIPLINARY JOURNAL FOR RESEARCH & DEVELOPMENT SJIF2019:5.2222020:5.5522021:5.6372022:5.4792023:6.5632024:7,805 eISSN:2394-6334 https://www.ijmrd.in/index.php/imjrd Volume12,issue05(2025) - Material Performance: Zirconia-based FDPs have gained popularity due to their aesthetic appeal and biocompatibility. However, a systematic review and meta-analysis indicated that bilaminar zirconia FDPs exhibited higher failure rates (Relative Risk [RR]=3.64, p=0.009) and increased ceramic chipping (RR=2.92, p<0.0001) compared to metal-ceramic (MC) FDPs [16]. - Survival Rates: A large-scale analysis of 124,660 FDPs over a six-year period reported cumulative survival rates of 83.0% for single-unit FDPs, 78.1% for two-unit FDPs, and 74.0% for three-unitFDPs, highlighting adecrease inlongevity with increased prosthesis span [17]. - Complications: Mechanical complications, such as porcelain fractures, were reported in 89.0% of studies, while biological complications like caries and periodontal disease were noted in 79.1%and 58.1%ofstudies, respectively [18]. - Digital vs. Conventional Techniques: A systematic review comparing digital and conventional impression techniques found that digital methods offered improved internal fit (Standard Mean Difference [SMD]=-0.80; 95% Confidence Interval [CI]: −1.49 to −0.10; p=0.02), though marginal fit differences were not statistically significant [19]. - Design Considerations: Resin-bonded fixed dental prostheses (RBFDPs) with c