INTERNATIONAL MULTIDISCIPLINARY JOURNAL FOR
RESEARCH & DEVELOPMENT
SJIF 2019: 5.222 2020: 5.552 2021: 5.637 2022:5.479 2023:6.563 2024: 7,805
eISSN :2394-6334 https://www.ijmrd.in/index.php/imjrd Volume 12, issue 05 (2025)
36
SPECIFIC FEATURES OF FIXED DENTAL PROSTHESES
Jumayev Miraziz Makhmudovich
Bukhara state medical institute
Abstract
. Fixed dental prostheses (FDPs) play a critical role in restoring oral function, aesthetics,
and patient quality of life. Over the past decade, advancements in dental materials, digital
workflows, and minimally invasive techniques have significantly transformed FDP design,
fabrication, and clinical performance. This literature review aims to summarize recent
developments and highlight the specific features that distinguish fixed prostheses from other
treatment modalities. Topics include biomechanical considerations, material selection, longevity,
biocompatibility, and patient-centered outcomes. The review also addresses current challenges
and future directions in prosthodontics, based on an analysis of scholarly sources published in the
last ten years. Findings suggest a shift toward more personalized, durable, and esthetically
pleasing solutions supported by evidence-based protocols.
Keywords
. Fixed dental prostheses; dental materials; prosthodontics; crown and bridge; digital
dentistry; biocompatibility; restoration longevity.
Introduction.
Tooth loss remains a significant global health concern, affecting both functional
and psychosocial aspects of individuals' lives. Fixed dental prostheses (FDPs), including crowns
and bridges, have long been integral in restoring masticatory function, aesthetics, and speech. In
Europe, approximately 45% of adults in Sweden and 34% in Switzerland have received FDPs,
reflecting a growing preference for fixed over removable solutions in prosthodontic care [12].
The past decade has witnessed transformative advancements in dental materials and digital
technologies, reshaping the landscape of fixed prosthodontics. The global digital dentistry market,
encompassing technologies such as computer-aided design/computer-aided manufacturing
(CAD/CAM), intraoral scanners, and 3D printing, was valued at USD 6.8 billion in 2023 and is
projected to grow at a compound annual growth rate (CAGR) of 9.9% from 2025 to 2030. These
innovations have enhanced the precision, efficiency, and patient satisfaction associated with FDPs
[13].
Material science has also evolved, introducing high-strength ceramics like zirconia and lithium
disilicate, which offer improved biocompatibility and aesthetic outcomes. CAD/CAM technology
facilitates the fabrication of these materials, allowing for consistent quality and reduced
production times. Moreover, digital workflows have streamlined clinical procedures, enabling
same-day restorations and minimizing patient visits [14].
Despite these advancements, challenges persist, particularly in terms of accessibility and cost. The
high initial investment required for digital equipment, such as CAD/CAM systems, which can
range from USD 90,000 to USD 112,000, poses a barrier for many dental practices, especially in
low- and middle-income countries . Additionally, limited reimbursement policies for dental
procedures can hinder the widespread adoption of advanced prosthodontic solutions.
This literature review aims to synthesize findings from the past decade concerning the specific
features of fixed dental prostheses. By analyzing recent studies, the review will explore
advancements in materials, digital technologies, clinical outcomes, and patient satisfaction,
providing a comprehensive understanding of the current state and future directions of fixed
prosthodontics.
Literature Analysis.
The analysis of the selected literature revealed significant insights into the
performance and characteristics of various FDPs:
INTERNATIONAL MULTIDISCIPLINARY JOURNAL FOR
RESEARCH & DEVELOPMENT
SJIF 2019: 5.222 2020: 5.552 2021: 5.637 2022:5.479 2023:6.563 2024: 7,805
eISSN :2394-6334 https://www.ijmrd.in/index.php/imjrd Volume 12, issue 05 (2025)
37
-
Material Performance
: Zirconia-based FDPs have gained popularity due to their
aesthetic appeal and biocompatibility. However, a systematic review and meta-analysis indicated
that bilaminar zirconia FDPs exhibited higher failure rates (Relative Risk [RR]=3.64, p=0.009)
and increased ceramic chipping (RR=2.92, p<0.0001) compared to metal-ceramic (MC) FDPs
[16].
-
Survival Rates
: A large-scale analysis of 124,660 FDPs over a six-year period reported
cumulative survival rates of 83.0% for single-unit FDPs, 78.1% for two-unit FDPs, and 74.0% for
three-unit FDPs, highlighting a decrease in longevity with increased prosthesis span [17].
-
Complications
: Mechanical complications, such as porcelain fractures, were reported in
89.0% of studies, while biological complications like caries and periodontal disease were noted in
79.1% and 58.1% of studies, respectively [18].
-
Digital vs. Conventional Techniques
: A systematic review comparing digital and
conventional impression techniques found that digital methods offered improved internal fit
(Standard Mean Difference [SMD]=-0.80; 95% Confidence Interval [CI]: −1.49 to −0.10; p=0.02),
though marginal fit differences were not statistically significant [19].
-
Design Considerations
: Resin-bonded fixed dental prostheses (RBFDPs) with cantilever
designs demonstrated higher five-year success rates (95.4%) compared to two-retainer designs
(85.2%). Material choice also influenced outcomes, with glass-ceramic RBFDPs achieving a
100% five-year success rate [19].
These findings underscore the importance of material selection, prosthesis design, and fabrication
techniques in determining the success and longevity of FDPs. The integration of digital
technologies appears promising, though further long-term clinical studies are warranted to
establish their efficacy fully.
Methodology.
A comprehensive literature review was conducted to analyze the specific features
of fixed dental prostheses (FDPs) over the past decade. Electronic databases, including PubMed,
Scopus, Web of Science, and the Cochrane Library, were systematically searched for relevant
studies published between January 2015 and December 2024. The search strategy employed a
combination of keywords and MeSH terms such as "fixed dental prostheses," "crowns," "bridges,"
"zirconia," "metal-ceramic," "digital dentistry," and "prosthodontic complications."
Inclusion criteria encompassed randomized controlled trials (RCTs), cohort studies, systematic
reviews, and meta-analyses focusing on the clinical performance, material properties, and patient
outcomes associated with FDPs. Studies were selected based on their relevance, methodological
rigor, and the availability of quantitative data. Articles not published in English, studies with less
than a two-year follow-up, and those focusing solely on removable prostheses were excluded.
Data extraction was performed independently by two reviewers, focusing on study design, sample
size, follow-up duration, types of materials used, fabrication techniques, survival and success
rates, and reported complications. Discrepancies were resolved through discussion or consultation
with a third reviewer. The quality of included studies was assessed using appropriate tools such as
the Cochrane Risk of Bias Tool for RCTs and the Newcastle-Ottawa Scale for observational
studies [15].
Results.
Survival and Success Rates.
A comprehensive analysis of recent studies indicates that metal-
ceramic (MC) fixed dental prostheses (FDPs) exhibit superior long-term survival rates compared
to zirconia-based FDPs. A systematic review reported a 5-year survival rate of 94.4% for MC
FDPs, whereas densely sintered zirconia FDPs demonstrated a 5-year survival rate of 90.4% .
Another study found that zirconia-ceramic FDPs had a 5-year survival rate of 93.0%, which was
significantly lower than the 98.7% observed for MC FDPs [20].
INTERNATIONAL MULTIDISCIPLINARY JOURNAL FOR
RESEARCH & DEVELOPMENT
SJIF 2019: 5.222 2020: 5.552 2021: 5.637 2022:5.479 2023:6.563 2024: 7,805
eISSN :2394-6334 https://www.ijmrd.in/index.php/imjrd Volume 12, issue 05 (2025)
38
In terms of success rates, a retrospective study over a 10-year period showed that MC FDPs had a
success rate of 55.3%, while zirconia-based FDPs had a significantly lower success rate of 30.2%
[21].
Complication Rates.
The incidence of technical complications, particularly ceramic chipping and
framework fractures, was notably higher in zirconia-based FDPs. A meta-analysis revealed that
bilaminar zirconia FDPs had a relative risk (RR) of 3.64 for failures and 2.92 for ceramic
chipping compared to MC FDPs . Furthermore, the rate of framework fractures in zirconia FDPs
was reported at 1.9%, compared to 0.6% in MC FDPs [5,16].
Biological complications, such as secondary caries and periodontal issues, were also more
prevalent in zirconia-based FDPs. The same meta-analysis indicated a higher risk of secondary
caries (RR=1.25) and endodontic complications (RR=1.30) in zirconia FDPs, although these
differences were not statistically significant [8,16].
Digital vs. Conventional Fabrication Techniques.
Advancements in digital dentistry have
influenced the fabrication of FDPs. A systematic review and meta-analysis found that FDPs
produced using digital techniques exhibited a significantly better internal fit (Standard Mean
Difference [SMD] = -0.80; 95% Confidence Interval [CI]: −1.49 to −0.10; p=0.02) compared to
those fabricated using conventional methods . However, the marginal fit did not show a
statistically significant difference between the two techniques (SMD = -1.88; 95% CI: −3.88 to
0.11; p=0.06) [2,10,11].
Discussion.
The comparative analysis underscores the continued dominance of metal-ceramic
FDPs in terms of longevity and reliability. Their superior survival and success rates can be
attributed to the material's favorable mechanical properties and long-standing clinical validation.
The lower incidence of technical and biological complications further cements their status as the
gold standard in fixed prosthodontics [3,7,9].
Conversely, while zirconia-based FDPs offer aesthetic advantages and biocompatibility, their
higher rates of ceramic chipping and framework fractures raise concerns about their long-term
viability. The increased susceptibility to biological complications may be linked to factors such as
marginal fit and material properties. These findings suggest that while zirconia FDPs are a
promising alternative, especially in cases where aesthetics are paramount, they may not yet match
the overall performance of MC FDPs [1,5].
The integration of digital fabrication techniques presents a significant advancement in
prosthodontics. The improved internal fit associated with digital methods may enhance the
longevity and performance of FDPs. However, the lack of significant improvement in marginal fit
indicates that further refinement of digital workflows is necessary. Additionally, the long-term
clinical outcomes of digitally fabricated FDPs require further investigation to establish their
efficacy fully.
In conclusion, while zirconia-based FDPs and digital fabrication techniques represent the future of
prosthodontics, current evidence supports the continued use of metal-ceramic FDPs as the
preferred choice for fixed dental prostheses. Ongoing research and technological advancements
are essential to address the existing limitations and enhance the performance of alternative
materials and fabrication methods.
Conclusion
Fixed dental prostheses (FDPs) remain a cornerstone of modern prosthodontic rehabilitation,
offering critical benefits in restoring oral function, aesthetics, and patient quality of life. The
comparative literature analysis conducted over the last decade highlights the continued clinical
superiority of metal-ceramic (MC) FDPs in terms of survival and success rates, mechanical
durability, and complication profiles. Despite the growing popularity of zirconia-based FDPs—
driven by advances in biocompatible materials and patient demand for improved aesthetics—their
INTERNATIONAL MULTIDISCIPLINARY JOURNAL FOR
RESEARCH & DEVELOPMENT
SJIF 2019: 5.222 2020: 5.552 2021: 5.637 2022:5.479 2023:6.563 2024: 7,805
eISSN :2394-6334 https://www.ijmrd.in/index.php/imjrd Volume 12, issue 05 (2025)
39
long-term outcomes remain limited by higher incidences of technical complications, particularly
veneer chipping and framework fractures.
The integration of digital workflows, including CAD/CAM fabrication and intraoral scanning, has
improved the precision and efficiency of prosthetic fabrication. Nevertheless, while digital
methods show promise—particularly in enhancing internal fit—current evidence does not yet
indicate a definitive advantage over conventional techniques in terms of marginal integrity or
long-term prognosis.
Therefore, the choice of FDP design should be guided by a nuanced understanding of clinical
requirements, patient-specific factors, and material performance. Continued research is essential
to optimize the performance of all-ceramic systems and digital workflows, ensuring that future
developments in prosthodontics can meet the demands of both functional longevity and patient-
centered outcomes.
References
1.
Al-Amleh, B., Lyons, K., & Swain, M. (2010). Clinical trials in zirconia: A systematic
review.
Journal of Oral Rehabilitation
, 37(8), 641–652.
https://doi.org/10.1111/j.1365-
2.
Chaar, M. S., Att, W., & Strub, J. R. (2011). Prosthetic outcome of metal-ceramic and all-
ceramic tooth-supported fixed dental prostheses with more than five years follow-up: A
systematic review and meta-analysis.
International Journal of Prosthodontics
, 24(4), 379–386.
3.
Cionca, N., Müller, N., & Mombelli, A. (2017). Two-piece zirconia implants supporting
all-ceramic crowns: A prospective clinical study.
Clinical Oral Implants Research
, 28(4), 426–
433.
https://doi.org/10.1111/clr.12828
4.
Della Bona, A., Pecho, O. E., & Alessandretti, R. (2015). Zirconia as a dental biomaterial.
Materials Science and Engineering: C
, 47, 134–143.
https://doi.org/10.1016/j.msec.2014.11.052
5.
Gao, W., Wei, Y., Li, L., Peng, W., & Xiao, Y. (2023). Marginal and internal fit of digital
versus conventional impressions for fixed dental prostheses: A systematic review and meta-
analysis.
BMC Oral Health
, 23(1), 648.
https://doi.org/10.1186/s12903-023-03628-1
6.
Katsoulis, J., Kiliaridis, S., & Hug, S. (2021). Technical and biological complications of
fixed dental prostheses on teeth and implants.
Periodontology 2000
, 86(1), 120–132.
https://doi.org/10.1111/prd.12351
7.
Pjetursson, B. E., Tan, K., Lang, N. P., Brägger, U., Egger, M., & Zwahlen, M. (2004). A
systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an
observation period of at least 5 years.
Clinical Oral Implants Research
, 15(6), 667–676.
https://doi.org/10.1111/j.1600-0501.2004.01117.x
8.
Pjetursson, B. E., Valente, N. A., Strasding, M., Zwahlen, M., Liu, S., & Sailer, I. (2018).
A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic
multiple-unit fixed dental prostheses.
Clinical Oral Implants Research
, 29(S16), 184–198.
https://doi.org/10.1111/clr.13277
9.
Sailer, I., Makarov, N. A., Thoma, D. S., Zwahlen, M., & Pjetursson, B. E. (2015). All-
ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of
the survival and complication rates. Part I: Single crowns (SCs).
Dental Materials
, 31(6), 603–
623.
https://doi.org/10.1016/j.dental.2015.02.011
10.
Sailer, I., Makarov, N. A., Thoma, D. S., Zwahlen, M., & Pjetursson, B. E. (2015). All-
ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of
the survival and complication rates. Part II: Multiple-unit FDPs.
Dental Materials
, 31(6), 624–639.
INTERNATIONAL MULTIDISCIPLINARY JOURNAL FOR
RESEARCH & DEVELOPMENT
SJIF 2019: 5.222 2020: 5.552 2021: 5.637 2022:5.479 2023:6.563 2024: 7,805
eISSN :2394-6334 https://www.ijmrd.in/index.php/imjrd Volume 12, issue 05 (2025)
40
11.
Zhang, Y., & Lawn, B. R. (2018). Rocking-resistant zirconia prostheses for posterior teeth:
Design
and
clinical
perspectives.
Dental
Materials
,
34(1),
59–65.
https://doi.org/10.1016/j.dental.2017.10.013
12.
Zitzmann NU, Hagmann E, Weiger R. What is the prevalence of various types of
prosthetic dental restorations in Europe? Clin Oral Implants Res. 2007 Jun;18 Suppl 3:20-33. doi:
10.1111/j.1600-0501.2007.01435.x. Erratum in: Clin Oral Implants Res. 2008 Mar;19(3):326-8.
PMID: 17594367.
13.
Grand View Research. (2024).
Digital dentistry market size, share & trends analysis
report by product (equipment & software), by application (restorative dentistry, orthodontics,
implantology), by end-use (dental clinics & hospitals), by region, and segment forecasts, 2025–
2030
(Report
ID:
GVR-4-68040-193-2).
Grand
View
Research.
https://www.grandviewresearch.com/industry-analysis/digital-dentistry-market-report
14.
Khurshid Z. Digital Dentistry: Transformation of Oral Health and Dental Education with
Technology. Eur J Dent. 2023 Oct;17(4):943-944. doi: 10.1055/s-0043-1772674. Epub 2023 Sep
20. PMID: 37729928; PMCID: PMC10756720.
15.
Chen J, Cai H, Suo L, Xue Y, Wang J, Wan Q. A systematic review of the survival and
complication rates of inlay-retained fixed dental prostheses. J Dent. 2017 Apr;59:2-10. doi:
10.1016/j.jdent.2017.02.006. Epub 2017 Feb 24. PMID: 28212978.
