A Retrospective Study of Stabilizing Bridges in Patients With Stages III and IV Periodontitis: Up to 35 Years of Clinical Audit.

Background/aim: Studies on large cross-arch bridges in patients with severe periodontitis show that such bridges can stabilize the periodontal condition. However, it is not known if these bridges will reduce long-term tooth loss and what factors are important for their long-term survival. The aim of the study was to study all patients with Stages III/IV periodontitis who received cross-arch bridges for up 35 years in a private practice.

Materials and methods: All patients referred for periodontal treatment from 1986 who received cross-arch bridges with observation period of minimum 7 years were assessed. All dropouts were accounted for.

Results: Ninety-eight patients (1.7% of the patient population) with 111 bridges were observed (57 females and 37 males). Age at bridge construction was 55.4 years (SD = 7.1, range 39-79). Failure rate was 14.4% at 16.1 years (SD = 4.0 range 10-22). Reasons for failure were poor oral hygiene (p = 0.0093) and complications such as caries, endontics, porcelain fractures and gingival retractions during maintenance therapy (p = 0.0059). Fewer abutment teeth were lost from the bridges than teeth from the same and opposing arches (8.8% vs. 34.4% and 25.4%) (p < 0.0001).

Conclusion: Cross-arch bridges constructed for patients with Stages III and IV periodontitis were successful in terms of longevity, low failure rates, tooth preservation and patient satisfaction.