Efficacy and risks of tooth‐supported prostheses in the treatment of partially edentulous patients with stage IV periodontitis. A systematic review and meta‐analysis

Abstract Aim The aim was to evaluate the efficacy and effectiveness of tooth‐supported fixed prostheses in partially edentulous patients with stage IV periodontitis. Material and Methods Randomized and controlled clinical trials (RCTs and CCTs) and prospective/retrospective cohort studies or case series were searched in three databases. Survival rate of abutment teeth was considered the primary outcome. Meta‐analyses were performed whenever possible. Results Twenty‐four publications were included. No RCTs or CCTs compared the efficacy of tooth‐supported fixed prostheses between patients with severe periodontitis or non‐periodontitis patients. Most of the data retrieved were derived from case series. The incidence of abutment‐tooth loss after a follow‐up period from 2 to 35.4 years was low ( n = 17 studies; weighted mean incidence (WMI) = 4.8%; confidence interval (CI) [3.2, 6.5]). The corresponding figure for prostheses failure was WMI = 6.9% (n = 18; 95% CI [4.1, 9.7]). Technical complications seemed to be more frequent than biological complications (caries, endodontic failure, root fracture, etc.). Periodontal outcomes tended to remain stable over time. Conclusion Tooth‐supported fixed prostheses seemed to be a valid treatment approach to restore masticatory function in patients with stage IV periodontitis once periodontal therapy has been accomplished. However, the comparative efficacy of this treatment among periodontitis and non‐periodontitis patients is unclear due to the absence of clinical trials.