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Objectives: Posterior metal ceramic crowns are still widely used as a standard treatment. The aim of this study was to obtain long-term data on their clinical performance.Material and Methods: Ten private practitioners participated in this prospective practice-based study. Patients were provided with two crowns each. Two groups were formed. The single crown group comprised 95 patients with 190 crowns. The retainer crown group comprised 138 patients with fixed dental prostheses and 276 retainer crowns.Results: For the primary outcome "loss of tooth or crown," 20-year survival rates of 78.8% in the single crown group and 67.8% in the retainer crown group were found. Veneering ceramic defects occurred rather frequently, resulting in respective 20-year technical success rates of 74.2% for single crowns and 62.9% for retainer crowns. However, veneering ceramic defects causing crown losses were very rare events.Conclusions: The results contribute to our knowledge on long-term outcomes of treatments with metal ceramic crowns and show high survival and success rates over 20 years.Clinical relevance: Posterior metal ceramic crowns are a highly reliable option in private practice settings. [ABSTRACT FROM AUTHOR]

Objectives: Being a secondary outcome in a multicenter randomized controlled trial, the present analysis focused on interdental spacing in the shortened dental arch (SDA). The aim was to evaluate changes in interdental spacing in dependence of two different treatments after an observation period of up to 5 years. Material and methods: Patients were either treated with a partial removable dental prosthesis (PRDP) for molar replacement (PRDP group) or according to the SDA concept aiming at a premolar occlusion (SDA group) in a randomized manner. Interdental spacing in the anterior region was measured with gauges and categorized as '0' (<0.1 mm), '1' (<0.5 mm), '2' (0.5-1 mm), and '3' (>1 mm). The statistical analysis was performed with analysis of variance models followed by linear contrast. Results: Ninety-one patients (SDA n = 41, PRDP n = 50) were included. Changes of interdental spacing were detected in 70.7 % of all cases. A significant difference between the mean score changes was found in the mandible comparing the PRDP group and the SDA group. The respective mean score changes from baseline to 5 years were 0.23 ( SD 0.49) for the PRDP group and 0.02 ( SD 0.30) for the SDA group ( p = 0.023). Conclusions: Major interdental spacing could be observed in neither of the groups. The SDA concept resulted in a slightly better outcome. Clinical relevance: When deciding whether to replace missing molars, the present results give further support to the SDA concept. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this multi-center, randomized controlled trial was to assess the impact of missing posterior support on the risk for temporomandibular disorder (TMD) pain by comparing patients with either shortened dental arches (SDA) or molar replacement by removable dental prostheses (RDP). Methods: A sample of 215 patients with bilateral molar loss in at least one jaw was consecutively recruited in 14 prosthodontic departments of dental schools in Germany. Of the initial sample, 152 patients (mean age: 59.7 years; 53.9 % female) received randomly allocated interventions (SDA: n = 71; RDP: n = 81). Presence of TMD pain was assessed using patients' self-reports and was verified by physical examination and by pain intensity, as the mean of current pain, worst pain, and average pain in the last 6 months, with 10-point ordinal rating scales. Assessments were performed before treatment and at follow-ups until 60 months after treatment. Impact of interventions on TMD risk and pain intensity was computed by applying logistic and linear random-intercept models. Results: Tooth replacement (RDP) did not significantly change the risk for self-reported (odds ratio [OR]: 1.1; confidence interval [CI]: 0.4 to 3.4) or clinically verified (OR: 0.7; CI: 0.1 to 4.3) TMD pain compared to no tooth replacement (SDA). Mean characteristic pain intensity was virtually identical in both groups (Coeff: 0.01; CI: −0.30 to 0.32). Conclusion: Retaining or preservation of an SDA is not a major risk factor for TMD pain over the course of 5 years when compared to molar replacement with RPDs. Clinical relevance: Seemingly, missing molars do not have to be replaced in order to prevent TMD pain. [ABSTRACT FROM AUTHOR]