Speakers - 2027

Title: Beyond esthetics: the impact of fixed prosthodontic restorations on periodontal health

Abstract

Background: The long-term success of fixed prosthodontic restorations relies not only on mechanical and esthetic outcomes but also on the preservation of periodontal health. The relationship between fixed prostheses and periodontal tissues remains a subject of ongoing debate due to the influence of multiple prosthetic and biological factors. This review aimed to evaluate the available evidence regarding the impact of fixed prosthodontic restorations on periodontal health and to identify the main prosthetic risk factors associated with periodontal complications.

Materials and Methods: A structured literature review was conducted following PRISMA-based recommendations. Relevant studies were selected according to predefined eligibility criteria and critically appraised using the French National Authority for Health (HAS) methodological guidelines. Data regarding study characteristics, periodontal outcomes, and prosthetic risk factors were extracted and analyzed.

Results: The reviewed studies consistently reported that periodontal outcomes are strongly influenced by prosthetic design and clinical execution. The most frequently observed complications included increased plaque accumulation, gingival inflammation, bleeding on probing, deeper periodontal probing depths, and clinical attachment loss. The main risk factors were subgingival restoration margins, poor marginal adaptation, inadequate crown contours, deficient oral hygiene, and violation of the supracrestal tissue attachment. Conversely, well-designed restorations fabricated with biocompatible materials, combined with meticulous clinical procedures and regular periodontal maintenance, were associated with favorable periodontal outcomes.

Conclusion: Fixed prosthodontic restorations are not inherently detrimental to periodontal health. Their long-term success depends on respecting biological principles, achieving precise restorative execution, and implementing continuous periodontal maintenance. A multidisciplinary approach remains essential for ensuring predictable functional and biological outcomes.