The Effect of Different Finish Line Designs and Material Types on the Periodontal Response of Single Crown Restoration: A 3-year Follow-up Study

Abstract

Purpose: Different restorative materials and marginal finish lines may contribute to periodontal inflammation, in spite of patients' proper oral hygiene habits. The aim of this study was to evaluate the effect of different finish line designs and restorative materials on periodontal health. Materials and Methods: In this retrospective clinical study, the periodontal clinical parameters of 450 crown restorations fabricated with different finish line designs (chamfer, shoulder, knife-edge) and different materials (Metal-ceramic, Zirconia, Glass-ceramic) were evaluated at baseline and at 12th, 24th and 36th months after the cementation. The data were analyzed with Repeated Measures ANOVA and post hoc least significant difference tests were performed (α=.05). Results: Periodontal clinical parameters significantly increased during the 36-month follow-up period. The marginal finish line and material type had no significant effect on the probing depth and gingival index scores. The highest plaque index scores were observed in zirconia restorations with knife edge finish lines at the 36th month after crown placement. Conclusions: The periodontal health of the prepared tooth was negatively affected by the increased follow-up duration regardless of the marginal finish line design and material type. The clinicians should consider the favorable effect of the glass-ceramic crown restorations with a chamfer finish line on the plaque control for long-term success.

Keywords

• Glass-Ceramic Restoration
• Marginal Finish Line
• Periodontal Health
• Plaque Index
• Prosthetic procedure

References

1. 1. Pjetursson BE, Lang NP. Prosthetic treatment planning on the basis of scientific evidence. J Oral Rehabil. 2008;35 Suppl 1:72-9.
2. 2. Christensen GJ. When is a full-crown restoration indicated? J Am Dent Assoc. 2007;138(1):101-3.
3. 3. Sailer I, Pjetursson BE, Zwahlen M, Hämmerle CH. A systematic review of the survival and complication rates of all-ceramic and metal-ceramic reconstructions after an observation period of at least 3 years. Part II: Fixed dental prostheses. Clin Oral Implants Res. 2007;18 Suppl 3:86-96.
4. 4. Mallineni SK, Nuvvula S, Matinlinna JP, Yiu CK, King NM. Biocompatibility of various dental materials in contemporary dentistry: a narrative insight. J Investig Clin Dent. 2013;4(1):9-19.
5. 5. Rademacher SWH, Zaura E, Kleverlaan CJ, Buijs MJ, Crielaard W, Loos BG, Laine ML. Qualitative and quantitative differences in the subgingival microbiome of the restored and unrestored teeth. J Periodontal Res. 2019;54(4):405-12.
6. 6. Rokaya D, Bohara S, Srimaneepong V, Kongkiatkamon S, Sultan Z, Heboyan A, et al. Metallic Biomaterials for Medical and Dental Prosthetic Applications. 2022.
7. 7. Paul N, Raghavendra Swamy KN, Dhakshaini MR, Sowmya S, Ravi MB. Marginal and internal fit evaluation of conventional metal-ceramic versus zirconia CAD/CAM crowns. J Clin Exp Dent. 2020;12(1):e31-e7.
8. 8. Schley JS, Heussen N, Reich S, Fischer J, Haselhuhn K, Wolfart S. Survival probability of zirconia-based fixed dental prostheses up to 5 yr: a systematic review of the literature. Eur J Oral Sci. 2010;118(5):443-50.

9. 9. Srimaneepong V, Heboyan A, Zafar MS, Khurshid Z, Marya A, Fernandes GVO, Rokaya D. Fixed Prosthetic Restorations and Periodontal Health: A Narrative Review. J Funct Biomater. 2022;13(1).
10. 10. Hao Y, Huang X, Zhou X, Li M, Ren B, Peng X, Cheng L. Influence of Dental Prosthesis and Restorative Materials Interface on Oral Biofilms. Int J Mol Sci. 2018;19(10).
11. 11. Padbury A, Jr., Eber R, Wang HL. Interactions between the gingiva and the margin of restorations. J Clin Periodontol. 2003;30(5):379-85.
12. 12. Weishaupt P, Bernimoulin JP, Lange KP, Rothe S, Naumann M, Hägewald S. Clinical and inflammatory effects of galvano-ceramic and metal-ceramic crowns on periodontal tissues. J Oral Rehabil. 2007;34(12):941-7.
13. 13. Gupta N, Singh KS, Nisha C, Kapoor V. Effects Of Tooth Preparation And Poorly Designed Artificial Crowns On Health Of Periodontium And Esthetics : A Case Report. Indian Journal of Dental Sciences. 2014;6(4):46-8.
14. 14. Shenoy A, Shenoy N, Babannavar R. Periodontal considerations determining the design and location of margins in restorative dentistry. Journal of Interdisciplinary Dentistry. 2012;2:3-10.
15. 15. Donovan T, Prince J. An analysis of margin configurations for metal-ceramic crowns. J Prosthet Dent. 1985;53(2):153-7.
16. 16. Abduo J, Lyons KM. Interdisciplinary interface between fixed prosthodontics and periodontics. Periodontol 2000. 2017;74(1):40-62.
17. 17. Croll BM. Emergence profiles in natural tooth contour. Part II: Clinical considerations. J Prosthet Dent. 1990;63(4):374-9.
18. 18. Silness J, Loe H. PERIODONTAL DISEASE IN PREGNANCY. II. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDTION. Acta Odontol Scand. 1964;22:121-35.
19. 19. Loe H, Silness J. PERIODONTAL DISEASE IN PREGNANCY. I. PREVALENCE AND SEVERITY. Acta Odontol Scand. 1963;21:533-51.
20. 20. Chapple ILC, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018;89 Suppl 1:S74-s84.
21. 21. Goodacre CJ, Campagni WV, Aquilino SA. Tooth preparations for complete crowns: an art form based on scientific principles. J Prosthet Dent. 2001;85(4):363-76.
22. 22. Martinez Galeano G, Palomar L. Selection of dental ceramics in an esthetic area. A case report. Revista Facultad de Odontología. 2018;vol 29.
23. 23. Gautam C, Joyner J, Gautam A, Rao J, Vajtai R. Zirconia based dental ceramics: structure, mechanical properties, biocompatibility and applications. Dalton Trans. 2016;45(48):19194-215.
24. 24. Stappert CF, Dai M, Chitmongkolsuk S, Gerds T, Strub JR. Marginal adaptation of three-unit fixed partial dentures constructed from pressed ceramic systems. Br Dent J. 2004;196(12):766-70; discussion 0, quiz 80.
25. 25. Ramamurthy J. Effect of Restorations on Periodontal health. IOSR Journal of Dental and Medical Sciences. 2014;13:71-3.
26. 26. Avetisyan A, Markaryan M, Rokaya D, Tovani-Palone MR, Zafar MS, Khurshid Z, et al. Characteristics of Periodontal Tissues in Prosthetic Treatment with Fixed Dental Prostheses. Molecules. 2021;26(5).
27. 27. Kosyfaki P, del Pilar Pinilla Martín M, Strub JR. Relationship between crowns and the periodontium: a literature update. Quintessence Int. 2010;41(2):109-26.
28. 28. Chan C, Weber H. Plaque retention on teeth restored with full-ceramic crowns: a comparative study. J Prosthet Dent. 1986;56(6):666-71.
29. 29. Hämmerle CH, Mesaric W, Lang NP. Marginal fit of porcelain crowns with galvanized frames. Schweiz Monatsschr Zahnmed. 1994;104(6):740-5.
30. 30. Kokubo Y, Tsumita M, Ohkubo C, Vult von Steyern P, Murata T, Fukuhsima S. Clinical marginal gap of porcelain fused to electro-formed gold coping crowns. Eur J Prosthodont Restor Dent. 2006;14(2):85-9.
31. 31. Pelaez J, Cogolludo PG, Serrano B, Serrano JF, Suarez MJ. A four-year prospective clinical evaluation of zirconia and metal-ceramic posterior fixed dental prostheses. Int J Prosthodont. 2012;25(5):451-8.
32. 32. Kc Basnyat S, Sapkota B, Shrestha S. Oral Hygiene and Gingival Health in Patients with Fixed Prosthodontic Appliances - A Six Month Follow-up. Kathmandu Univ Med J (KUMJ). 2015;13(52):328-32.
33. 33. Monaco C, Llukacej A, Baldissara P, Arena A, Scotti R. Zirconia-based versus metal-based single crowns veneered with overpressing ceramic for restoration of posterior endodontically treated teeth: 5-year results of a randomized controlled clinical study. J Dent. 2017;65:56-63.
34. 34. Dragomir LP, Nicolae FM, Gheorghe DN, Popescu DM, Dragomir IM, Boldeanu L, et al. The Influence of Fixed Dental Prostheses on the Expression of Inflammatory Markers and Periodontal Status-Narrative Review. Medicina (Kaunas). 2023;59(5).
35. 35. Kawai K, Urano M. Adherence of plaque components to different restorative materials. Oper Dent. 2001;26(4):396-400.
36. 36. Shang LJ, Wu Y, Xu YJ. Effect of the CAD/CAM zirconia all-ceramic crown restoration on periodontal tissue. Chinese Journal of Tissue Engineering Research. 2014;18:4804-9.
37. 37. Ditrichova D, Kapralova S, Tichy M, Ticha V, Dobesova J, Justova E, et al. Oral lichenoid lesions and allergy to dental materials. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2007;151(2):333-9.
38. 38. Ercoli C, Caton JG. Dental prostheses and tooth-related factors. J Clin Periodontol. 2018;45 Suppl 20:S207-s18.
39. 39. Paniz G, Nart J, Gobbato L, Chierico A, Lops D, Michalakis K. Periodontal response to two different subgingival restorative margin designs: a 12-month randomized clinical trial. Clin Oral Investig. 2016;20(6):1243-52.
40. 40. Vojdani M, Safari A, Mohaghegh M, Pardis S, Mahdavi F. The effect of porcelain firing and type of finish line on the marginal fit of zirconia copings. J Dent (Shiraz). 2015;16(2):113-20.
41. 41. Łabno P, Drobnik K. Comparison of horizontal and vertical methods of tooth preparation for a prosthetic crown. Journal of Pre-Clinical and Clinical Research. 2020;14(1):25-8.
42. 42. Contrepois M, Soenen A, Bartala M, Laviole O. Marginal adaptation of ceramic crowns: a systematic review. J Prosthet Dent. 2013;110(6):447-54.e10.
43. 43. Mously HA, Finkelman M, Zandparsa R, Hirayama H. Marginal and internal adaptation of ceramic crown restorations fabricated with CAD/CAM technology and the heat-press technique. J Prosthet Dent. 2014;112(2):249-56.
44. 44. Yu H, Chen YH, Cheng H, Sawase T. Finish-line designs for ceramic crowns: A systematic review and meta-analysis. J Prosthet Dent. 2019;122(1):22-30.e5.