Dental prostheses and tooth‐related factors
Abstract
Objectives: This narrative review summarizes the current evidence about the role that the fabrication and presence of dental prostheses and tooth‐related factors have on the initiation and progression of gingivitis and periodontitis. Findings: Placement of restoration margins within the junctional epithelium and supracrestal connective tissue attachment can be associated with gingival inflammation and, potentially, recession. The presence of fixed prostheses finish lines within the gingival sulcus or the wearing of partial, removable dental prostheses does not cause gingivitis if patients are compliant with self‐performed plaque control and periodic maintenance. However, hypersensitivity reactions to the prosthesis dental material can be present. Procedures adopted for the fabrication of dental restorations and fixed prostheses have the potential to cause traumatic loss of periodontal supporting tissues. Tooth anatomic factors, root abnormalities, and fractures can act as plaque‐retentive factors and increase the likelihood of gingivitis and periodontitis. Conclusions: Tooth anatomic factors, such as root abnormalities and fractures, and tooth relationships in the dental arch and with the opposing dentition can enhance plaque retention. Restoration margins located within the gingival sulcus do not cause gingivitis if patients are compliant with self‐performed plaque control and periodic maintenance. Tooth‐supported and/or tooth‐retained restorations and their design, fabrication, delivery, and materials have often been associated with plaque retention and loss of attachment. Hypersensitivity reactions can occur to dental materials. Restoration margins placed within the junctional epithelium and supracrestal connective tissue attachment can be associated with inflammation and, potentially, recession. However, the evidence in several of the reviewed areas, especially related to the biologic mechanisms by which these factors affect the periodontium, is not conclusive. This highlights the need for additional well‐controlled animal studies to elucidate biologic mechanisms, as well as longitudinal prospective human trials. Adequate periodontal assessment and treatment, appropriate instructions, and motivation in self‐performed plaque control and compliance to maintenance protocols appear to be the most important factors to limit or avoid potential negative effects on the periodontium caused by fixed and removable prostheses.
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New data indicate that clinical procedures involved in the fabrication of indirect restorations may cause recession and loss of clinical attachment.
“Clinical procedures involved in the fabrication of indirect restorations was added because of new data indicating that these procedures may cause recession and loss of clinical attachment (Table 4).25”
From A new classification scheme for periodontal and peri‐implant diseases and conditions – Introduction and key changes from the 1999 classification (2018) · cites this paper as [25]
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- Authors
- Ercoli, C., & Caton, J. G.
- Affiliations
- University of Rochester Medicine (US)
- Corresponding author
- Ercoli, Carlo
- Venue
- Journal of Periodontology
- Publisher
- Wiley
- Published
- 2018-06
- Volume
- 89
- Issue
- S1
- Pages
- S223-S236
- ISSN
- 0022-3492 (ISSN-L)
- 1943-3670
- OpenAlex
- W2808766351
- Cited by
- 105
- References
- 194
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 11 · 2023: 20 · 2022: 18 · 2021: 15 · 2020: 22 · 2019: 3 · 2018: 4
- FWCI
- 2.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Periodontology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Dentistry › Orthodontics › Dental materials and restorations
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Dentistry › Oral Surgery › Dental Implant Techniques and Outcomes
- Keywords
- prosthodontics, gingivitis, periodontitis, restoration margins, junctional epithelium, gingival recession, plaque retention, tooth fracture, removable partial dentures, fixed prostheses, plaque control, periodontal maintenance
- MeSH terms
- Dental Plaque, Gingivitis, Humans, Periodontitis, Prospective Studies, Dental Prosthesis
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