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The Relationship between Fixed Prosthodontics and Gingival Problems: A

Systematic Review

Article · August 2021

DOI: 10.36348/sjodr.2021.v06i08.006

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 Saudi Journal of Oral and Dental Research
Abbreviated Key Title: Saudi J Oral Dent Res
ISSN 2518-1300 (Print) |ISSN 2518-1297 (Online)
Scholars Middle East Publishers, Dubai, United Arab Emirates
Journal homepage: https://saudijournals.com

Original Research Article

The Relationship between Fixed Prosthodontics and Gingival Problems:

A Systematic Review
Dr. Hind Majed E. Alotaibi*, Dr. Laila Mohammad Alanazi, Dr. Waad Mohammed Alghamdi, Dr. Musab Majed E
Alotaibi, Dr. Razan Salem Alzahrani, Dr. Rawan Nasser Almutairi, Dr. Ahmed Bin Sawad, Dr. Dalal Jumah Alturaif, Dr.
Mohammed Ahmed Al Attas, Dr. Fatima Sultana
Department of Dentistry, Riyadh, Kingdom of Saudi Arabia

DOI: 10.36348/sjodr.2021.v06i08.006 | Received: 02.07.2021 | Accepted: 04.08.2021 | Published: 25.08.2021

*Corresponding author: Dr. Hind Majed E. Alotaibi

Abstract
The specialization of dentistry dealing with the replacement of missing teeth is primarily considered as prosthodontics.
Prosthodontics maybe divided into two types: fixed prosthodontics and removable prosthodontics. The fixed
prosthodontics plays a crucial role in restoring the function and mastication of the teeth, restoring aesthetics of the face,
maintaining integrity and health of the dental arch, and support temporomandibular joint (TMJ). Gingivitis, also known
as the gum inflammation is a mild symptom reported after fixing of Fixed Denture Prostheses. Untreated gingivitis over
the period of time with the development of bacteria can lead to periodontitis. Periodontitis is a serious gum disease that
can damage the soft tissue and bone that can cause tooth loss. To search the online databases like MEDLINE, Cochrane
Central Register of Controlled Trials (CENTRAL) and PubMed. All the articles in English language were selected to
review. It was designed in accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analysis
(PRISMA) guidelines. About 10 articles were finalized manually by the investigators for full analysis based on their
eligibility to the present topic of study. Various studies have accounted for the association between fixed prostheses and
the gingival problem. The health of the gingiva can be determined by using the diagnostic tools like Plaque Index (PI)
and Gingival Index (GI). While reviewing all the articles related to the gingival problems associated with the fixed
prostheses, we found that there is lack of knowledge given to the patient related to maintaining the prostheses.
Keywords: Fixed Denture Prostheses, Gingivitis, Periodontitis, Gingival problems, periodontal disease, gum
inflammation, plaque.
Copyright © 2021 The Author(s): This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International
License (CC BY-NC 4.0) which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original
author and source are credited.

buildup, release acid that dissolves the outer shell

INTRODUCTION called enamel. Plaque turns into tartar in approximate
The most common gingival problems that 72 hours, making it difficult to clean the gums and teeth
occur during the fixed prosthodontic treatment are completely [2].
gingivitis and periodontitis. Gingivitis, also known as
the gum inflammation occurs much earlier then Gingivitis is commonly a non-destructive
periodontitis, that's a kind of gum disease. Gingivitis is gingival problem that when left untreated can progress
generally a mild symptom of the gingiva that is often into periodontitis. The gingival disease is basically of
ignored. When untreated, gingivitis can lead to big two types: Plague induced and non-plaque induced. The
problems in the oral cavity. Mostly gingivitis is treated common causes and risk factors associated with the
by following proper oral hygiene, like brushing your development of gingival diseases are: menopause,
teeth twice a day, dental flossing, dental cleaning using menstrual cycle, pregnancy, puberty; and some diseases
mouthwash and dental checkup [1]. like diabetes, cancer and HIV; few anticonvulsant and
anti-angina drugs; chain smokers; old age people;
During the gingivitis at its early stage, bacteria deficiency of vitamin c; and hereditary factors. The
develop in the plaque deposited on the teeth, leading to early signs and symptoms of gingivitis may be halitosis,
to inflammation and bleeding of the gums. At red or purple gums, inflamed gums, bleeding while
this phase, the gums are highly irritated but still planted brushing or flossing; soft and receding gums. If left
inside the socket. The bacteria found in the plague untreated, the gum diseases can lead to several

Citation: Hind Majed E. Alotaibi et al (2021). The Relationship between Fixed Prosthodontics and Gingival Problems: A 372
Systematic Review. Saudi J Oral Dent Res, 6(8): 372-377.
 Hind Majed E. Alotaibi et al; Saudi J Oral Dent Res, Aug, 2021; 6(8): 372-377
complications like development of infection and The various types of cast restorations are:
formation of abscess in the jaw bone, reoccurring porcelain veneers, inlay, onlay, porcelain fused to metal
gingivitis and trench mouth which is associated with crown, full crown, fixed Bridge, three quarter crown,
ulceration of gums[3]. and resin bonded bridge. The basic components of a
fixed prosthodontic denture contains abutment, pontic,
Periodontitis is a serious gum disease that can retainer and connector [7]. The advantages of using a
damage the soft tissue and the bone that can cause tooth metal crown is that it provides high strength, great
loss. Untreated gingivitis over the period of time with resistance form, good protection for a tooth to be
the development of bacteria can lead to periodontitis. restored, modification of occlusion in case of over
The common symptoms related to periodontitis are: eruption, modification of root in case of open contact,
the gums become tender, swollen, with bright red or great retention and ideal restoration for teeth with
purple coloured gums; with gum bleeding, loss of teeth development defects. A few disadvantages reported by
or loose teeth, formation of pus between teeth and using the fixed prosthodontics restoration is that it can
gums, development of new spaces between the teeth, give bad aesthetic, no detection of pulp vitality and
receding gums, counting of blood while brushing for incipient caries and extensive tooth reduction. In spite
dental floss, pain while chewing. The common causes of the fact that the dental implants are so popular in the
for the development of periodontitis is the formation present day, the removable prosthodontic appliances are
of plaque on the teeth, that may result in the formation commonly used, especially in developing countries.
of tartar or calculus, leading to gingivitis, and untreated Therefore a proper formulation of effective methods to
gingivitis may lead to periodontitis. enhance the dental awareness related to the periodontal
problems associated with the fixed prosthodontics is
The risk factors associated with the required.
development of periodontitis are genetics; obesity; lack
of Nutrition especially Vitamin C deficiency, gingivitis, METHODOLOGY
poor oral hygiene, chain smoking and consumption of Study Protocol: The protocol for the study of
tobacco, conditions like leukaemia, HIV, diseases like association between the fixed prosthodontics and the
rheumatoid arthritis, diabetes and crohn’s disease, gingival health was designed in accordance to Preferred
hormonal imbalance due to pregnancy or Reporting Items for Systematic Reviews and Meta-
menopause, certain medications that can cause Analysis (PRISMA) guidelines.
Xerostomia [4]. The major complication of
periodontitis is losing of permanent teeth or loosening Inclusion Criteria: It is a type of study with
of teeth; periodontitis is often linked with rheumatoid Systematic review of literature related to the association
arthritis, coronary artery disease, respiratory disease and between fixed prosthodontics and gingival problems.
diabetes. The other parts of the body might be affected The articles included in this study need to have a fixed
by the bacteria that cause periodontitis, as it enters into prostheses, it need to be in English language, the
the bloodstream via gum tissue. Periodontitis can be articles need to be peer reviewed, the participants that
prevented by maintaining good oral hygiene and having reported periodontal diseases after the fixed prostheses,
regular dental checkups for every six months and and the participants of the study need to be adults.
treating of gingivitis. In severe cases the treatment can
be done using antibiotics or dental surgery. In a Strategy of Search: To search the online
survey conducted in the United States of America databases like MEDLINE, Cochrane Central Register of
nearly 70% of the the people are affected with Controlled Trials (CENTRAL) and PubMed were used.
periodontitis who are above 65 years of age. Globally, All the articles in English language were selected to
males are more often affected by periodontitis when review. The MeSH terms related to fixed prosthodontics
compared to the females [5]. and gingival diseases were selected.

The specialization of dentistry dealing with the RESULTS

replacement of missing teeth is primarily considered as Selection of Articles: About 245 potentially
prosthodontics. Prosthodontics maybe divided into two related articles that studied the gingival problems
types: fixed prosthodontics and removable associated with fixed prosthodontics were selected from
prosthodontics. In case of removable prosthodontics, the electronic data-bases like CENTRAL, MEDLINE
the dental device can be removed for cleaning. and in and PubMed. Applying filters, 102 articles were short
fixed prosthodontics, the replaced teeth are permanently listed. Later only 31 articles were identified according
fixed inside the oral cavity. Mostly the devices used to to the eligibility criteria. Incomplete articles with only
replace the teeth permanently are a non-biological abstracts were removed from the study. About 10
material. The fixed prosthodontics plays a crucial role articles were finalized manually by the investigators for
in restoring the function and mastication of the teeth, full analysis based on their eligibility to the present
restoring aesthetics of the face, maintaining integrity topic of study. Any disagreements between the
and health of the dental arch, and support investigators were resolved by consensus.
temporomandibular joint (TMJ) [6].
© 2021 |Published by Scholars Middle East Publishers, Dubai, United Arab Emirates 373
 Hind Majed E. Alotaibi et al; Saudi J Oral Dent Res, Aug, 2021; 6(8): 372-377

Around 143 articles were removed as they intervention, evaluation and control. Thus only 10
were duplicate copies of research when all the results articles met the eligibility criteria for reviewing the
from the databases were compared. 71 articles had only literature related to gingival problems associated with
abstracts and the complete article was not available for fixed denture prostheses.
study and 21 articles were excluded based on improper

Year of Journal Investigation done

Author’s Name Findings of the Investigation Outcome to the findings
Publication Name on
Adequate oral hygiene are
To avoid an
Interdisciplinary essential for longevity of the
unsatisfactory treatment
Abduo J, Lyons Periodontol interface between prosthesis, and regular reviews
2017 outcome, may require
KM 2000 fixed prosthodontics provide an opportunity for early
extensive and expensive
and periodontics. detection and treatment of
retreatment
failures.
Aesthetical outcome of soft To obtain a maximum
The influence of tissue health could be improved aesthetic effect and
Bluma E, Vidzis
2016 Stomatologija fixed prostheses on in case of mucosa around prostheses strength, the
A, Zigurs G
periodontal health. implants and extraction sites, hygienic possibilities
crown gingival connection may be disregarded
Ercoli C, Tarnow The Relationships To critically evaluate the
Periodontal diagnostic criteria
D, Poggio CE, Between Tooth- findings on the
should be thoroughly reviewed
Tsigarida A, J Supported Fixed periodontal outcomes of
2021 before fixed restorative
Ferrari M, Caton Prosthodont. Dental Prostheses restorations and tooth-
treatments are planned and
JG, Chochlidakis and Restorations and supported fixed
executed.
K. the Periodontium prostheses
These results showed that (i)
masticatory function could be
a systematic review established and maintained in To systematically review
on survival rates and subjects receiving fdps on the impact of severely
Lulic M, Brägger complications of abutment teeth with severely reduced, but healthy
U, Lang NP, Clin Oral fixed dental reduced but healthy periodontal periodontal tissue support
2007
Zwahlen M, Salvi Implants Res. prostheses (FDPs) on tissue support and (ii) fdps on the survival rate and
GE severely reduced survival rates compared complications of fdps
periodontal tissue favourably with those of fdps after a mean follow-up
support. incorporated in subjects without time of at least 5 years.
severely periodontally
compromised dentitions.

© 2021 |Published by Scholars Middle East Publishers, Dubai, United Arab Emirates 374
 Hind Majed E. Alotaibi et al; Saudi J Oral Dent Res, Aug, 2021; 6(8): 372-377
The most common implant
complications (those with a
greater than a 15% incidence)
were loosening of the
overdenture retentive
mechanism (33%), implant loss
To identify the types of
in irradiated maxillae (25%),
complications that have
Goodacre CJ, Clinical hemorrhage-related
been reported in
Bernal G, J Prosthet complications with complications (24%), resin
2003 conjunction with
Rungcharassaeng Dent implants and implant veneer fracture with fixed
endosseous root form
K, Kan JY prostheses partial dentures (22%), implant
implants and associated
loss with maxillary
implant prostheses.
overdentures (21%),
overdentures needing to be
relined (19%), implant loss in
type iv bone (16%), and
overdenture clip/attachment
fracture (16%).
To critically evaluate
Periodontal tissue published evidence on the
Clinically deficient restorations,
responses after effects of artificial
Knoernschild KL, J Prosthet as well as clinically acceptable
2000 insertion of artificial crowns and fixed partial
Campbell SD Dent restorations, can contribute to
crowns and fixed dentures (fpds) on
gingival inflammation.
partial dentures adjacent periodontal
tissue health
In cases of single unit bridges
with very narrow pontics, even
in patients with a very good
oral hygiene and metal-ceramic
restorations, we can still find
To highlight the presence
Pontic morphology micro-organisms that can
Dina MN, Rom J and the types of the
as local risk factor in potentially generate decay or
Mărgărit R, 2013 Morphol microorganisms that can
root decay and periodontal disease on the
Andrei OC. Embryol. be found under the pontic
periodontal disease. abutments, located in the
even in an ideal situation
gingival area underneath these
pontics. These bacteria can
have negative implications on
the long-term prognosis of
prosthetic restorations.
If optimum prospects for oral The inter-relationships
hygiene have been created by between the periodontal
The role of the
good coordination between the situation of a patient and
prosthodontist in the
Erpenstein H. 1986 Int Dent J. periodontist and the a prosthetic appliance
treatment of
prosthodontist, the prognosis in should be regarded in
periodontal disease
the maintenance phase is particular from the aspect
considerably improved. of oral hygiene.
The newer concepts and
techniques that have been
It is probably true that developed to treat a
Periodontal
prosthodontists are more problem that has been of
considerations in
Seibert JS, Cohen Dent Clin sensitive to the emotional major concern to the
1987 preparation for fixed
DW. North Am. concerns and needs of patients prosthodontist: The
and removable
that have sustained ridge-jaw problem of favorable
prosthodontics.
deformities. periodontal support and
poor or deformed
edentulous ridges.
Relationship between To evaluate the influence
prosthodontic status, Indicates the importance of oral of prosthodontic status on
Mojon P, Rentsch
Int J caries, and hygiene instruction and regular caries a and periodontal
A, Budtz- 1995
Prosthodont. periodontal disease in recalls among removable partial disease in a hospitalized
Jørgensen E
a geriatric denture wearers. population of elderly
population. people.

Abduo J, Lyons KM; studied about aesthetical outcome of soft tissue health could be
Interdisciplinary interface between fixed prosthodontics improved in case of mucosa around implants and
and periodontics and reported that adequate oral extraction site [9]. Ercoli C, Tarnow D, Poggio CE,
hygiene are essential for longevity of the prosthesis [8]. Tsigarida A, Ferrari M, Caton JG, Chochlidakis K,
Bluma E, Vidzis A, Zigurs G; studied the influence of studied the relationships between tooth-supported fixed
fixed prostheses on periodontal health, and reported that dental prostheses, restorations, periodontium; and
© 2021 |Published by Scholars Middle East Publishers, Dubai, United Arab Emirates 375
 Hind Majed E. Alotaibi et al; Saudi J Oral Dent Res, Aug, 2021; 6(8): 372-377
confirmed Periodontal diagnostic criteria should be health of the oral tissues, fixed prostheses is the best
thoroughly reviewed before fixed restorative treatments known dental clinical practice used.
are planned and executed [10]. Lulic M, Brägger U,
Lang NP, Zwahlen M, Salvi GE carried out a The fixed prostheses appliance is made up of
systematic review on survival rates and complications various materials like, ceramics, metal and metal fused
of fixed dental prostheses (FDPs) on severely reduced to porcelain [18]. Many risks factor may account for the
periodontal tissue support and stated that FDPs survival failure of the fixed prostheses. One of the commonly
rates is favourable with those of FDPs incorporated in reported biological complications are the gingival
subjects without severely periodontally compromised diseases or periodontal diseases.
dentition's [11]. Goodacre CJ, Bernal G,
Rungcharassaeng K, Kan JY studied the Clinical Mostly the periodontal/gingival diseases occur
complications with implants and implant prostheses, due to the development of bacteria in the plaque
and reported the conjunction of endosseous root form deposited on the teeth, poor oral hygiene and infrequent
implants and associated implant prostheses with visits to the dentist for maintenance therapy [19]. Apart
gingival problems [12]. Knoernschild KL, Campbell from the bacterial plaque accumulated on the teeth, the
SD, reviewed Periodontal tissue responses after other factor for the failure of the fixed prostheses may
insertion of artificial crowns and fixed partial dentures be ill-fitted prostheses and over-hanging crowns.
and stated that Clinically deficient restorations, as well
as clinically acceptable restorations, can contribute to Various studies have accounted for the
gingival inflammation [13]. association between fixed prostheses and the gingival
problem. The health of the gingiva can be determine by
Dina MN, Mărgărit R, studied Andrei OC. using the diagnostic tools Plaque Index (PI) and
Pontic morphology as local risk factor in root decay and Gingival Index (GI). The Plaque Index and Gingival
periodontal disease and confirmed that the bacteria Index between 0 and 1 is considered to be satisfactory.
developing in the pontics can have negative It was also reported in other studies that taking
implications on the long-term prognosis of prosthetic professional advice from the dental doctor with
restorations [14]. Erpenstein H. did a study on the role instructions and re-instructions contribute to the overall
of the prosthodontist in the treatment of periodontal good health of the gums [20].
disease and reported that if optimum prospects for oral
hygiene have been created by good coordination Also a study reported that galvanoceramic
between the periodontist and the prosthodontist, the crowns have good stabilizing effect and is more
prognosis in the maintenance phase is considerably favourable to the gingival health of the oral cavity.
improved [15]. Periodontal diseases and the formation of dental abscess
is attributed to the poor oral hygiene after the fixed
Seibert JS, Cohen DW did research on prosthodontics appliances [21]. In a study carried out in
Periodontal considerations in preparation for fixed and Saudi Arabia, it was reported that 47% of the patients
removable prosthodontics and stated that It is probably did not receive any oral hygiene instructions after
true that prosthodontists are more sensitive to the placement of the Fixed Denture prostheses from their
emotional concerns and needs of patients that have dental specialist [22].
sustained ridge-jaw deformities [16]. Mojon P, Rentsch
A, Budtz-Jørgensen E had reviewed the literature Thus it is very crucial to evaluate
related to relationship between prosthodontic status, the complications and success of the the fixed
caries, and periodontal disease in a geriatric population prosthesis. Hence the present topic was selected to
and concluded the importance of oral hygiene understand the relationship between the fixed
instructions and regular recalls among removable partial prosthodontics and gingival problems by carrying out a
denture wearer [17]. Thus with the systematic review of systematic review of the literature available online.
all the above mentioned articles, we can state that there With this, we can improve doctors ability to plan the
is an association of Fixed denture prostheses with most suitable treatment, realistic expectations and
gingival disease in patients lack knowledge about oral formulation to maintain fixed prosthesis in the patient.
hygiene, dental flossing and use of an antiseptic mouth Scurria reported the survival rate of fixed prostheses to
wash. 92% for 10 years and 75% for 15 years.

DISCUSSION With this study we could conclude that one of

In the present study, a search strategy using the the common complication or risk factor associated with
MeSH terms for the systematic review was done. the fixed prostheses is the periodontal diseases or
During this research, the studies with participants less gingival diseases. Despite many investigations carried
than 18 years was excluded because there were very out to examine the failure and complications of fixed
few or almost negligible cases of prosthodontics and prosthesis, the present topic of studying the relationship
gingival disease in small children. For restoring the between the fixed prosthodontics and gingival problems
was not done and much research is required in this
© 2021 |Published by Scholars Middle East Publishers, Dubai, United Arab Emirates 376
 Hind Majed E. Alotaibi et al; Saudi J Oral Dent Res, Aug, 2021; 6(8): 372-377
field. Various studies in this systematic review reported 10. Ercoli, C., Tarnow, D., Poggio, C. E., Tsigarida, A.,
the high prevalence of the gingival or periodontal Ferrari, M., Caton, J. G., & Chochlidakis, K. (2021).
problems associated with fixed prosthodontics to poor The Relationships Between Tooth‐ Supported Fixed
oral hygiene and lack of professional maintenance Dental Prostheses and Restorations and the
therapy. Periodontium. Journal of Prosthodontics, 30(4), 305-
317.
11. Lulic, M., Brägger, U., Lang, N. P., Zwahlen, M., &
CONCLUSION Salvi, G. E. (2007). Ante's (1926) law revisited: a
While reviewing all the articles related to the systematic review on survival rates and complications of
gingival problems associated with the fixed prostheses, fixed dental prostheses (FDPs) on severely reduced
we found that there is lack of knowledge given to the periodontal tissue support. Clinical Oral Implants
patient related to maintaining the prostheses. Proper Research, 18, 63-72.
instructions need to be given by the dental practitioner 12. Goodacre, C. J., Bernal, G., Rungcharassaeng, K., &
to the patient for tooth cleaning using electronic Kan, J. Y. (2003). Clinical complications with implants
and implant prostheses. The Journal of prosthetic
brushes, dental floss and use of antiseptic mouth
dentistry, 90(2), 121-132.
washes. The patients using the Fixed denture prostheses
13. Knoernschild, K. L., & Campbell, S. D. (2000).
need to be made aware about the super floss in order to Periodontal tissue responses after insertion of artificial
reduce the gingival problems. The dental practitioners crowns and fixed partial dentures. The Journal of
need to be emphasized about following the proper prosthetic dentistry, 84(5), 492-498.
guidelines to instruct the patient after applying fixed 14. Dina, M. N., Mărgărit, R., & Andrei, O. C. (2013).
prostheses. Follow-up, re-examination and re- Pontic morphology as local risk factor in root decay and
instructions by the doctor had to be improved to reduce periodontal disease. Rom J Morphol Embryol, 54(2),
the incidence of gingival problems after FDP. The 361-364.
doctor also needs to keep a track of other medical 15. Erpenstein, H. (1986). The role of the prosthodontist in
conditions of the patients for better results of dental the treatment of periodontal disease. International
treatment. dental journal, 36(1), 18-29.
16. Seibert, J. S., & Cohen, D. W. (1987). Periodontal
considerations in preparation for fixed and removable
More workshops and training need to be given prosthodontics. Dental Clinics of North America, 31(3),
in this field to the doctor for better understanding of 529-555.
post-operative care in case of FDP. 17. Mojon, P., Rentsch, A., & Budtz-Jørgensen, E. (1995).
Relationship between prosthodontic status, caries, and
REFERENCES periodontal disease in a geriatric
1. Øzhayat, E. B., & Gotfredsen, K. (2019). Patient‐ population. International Journal of
reported effect of oral rehabilitation. Journal of oral Prosthodontics, 8(6).
rehabilitation, 46(4), 369-376. 18. Alrumyyan, A., Quwayhis, S., Meaigel, S., Almedlej,
2. Saito, T., & Shimazaki, Y. (2007). Metabolic disorders R., Alolaiq, R., Nafesah, R. B., ... & Alzamil, S. (2020).
related to obesity and periodontal Oral health–related quality of life and oral hygiene
disease. Periodontology 2000, 43(1), 254-266. practice of adults with fixed dental prostheses in
3. Valderhaug, J., & Heloe, L. A. (1977). Oral hygiene in a Riyadh, Saudi Arabia. Journal of International Society
group of supervised patients with fixed of Preventive & Community Dentistry, 10(1), 62.
prostheses. Journal of periodontology, 48(4), 221-224. 19. Alkahtani, F. H., Baseer, M. A., Ingle, N. A., Assery,
4. Ferencz, J. L. (1991). Maintaining and enhancing M. K., Al Sanea, J. A., AlSaffan, A. D., & Al-
gingival architecture in fixed prosthodontics. The Shammery, A. (2019). Oral Health Status, Treatment
Journal of prosthetic dentistry, 65(5), 650-657. Needs and Oral Health Related Quality of Life among
Hearing Impaired Adults in Riyadh City, Saudi
5. Silness, J. (1980). Fixed prosthodontics and periodontal
Arabia. The journal of contemporary dental
health. Dental Clinics of North America, 24(2), 317-
practice, 20(6), 744.
329.
6. Wunderlich, R. C., & Caffesse, R. G. (1985). 20. Alkhadra, T. (2017). Prevalence of dental caries and
Periodontal aspects of porcelain restorations. Dental oral hygiene status among juvenile prisoners in the
kingdom of Saudi Arabia. The journal of contemporary
clinics of North America, 29(4), 693-703.
dental practice, 18(11), 991-5.
7. Bral, M. (1989). Periodontal considerations for
provisional restorations. Dental Clinics of North
21. Özhayat, E. B., & Gotfredsen, K. (2012). Effect of
treatment with fixed and removable dental prostheses.
America, 33(3), 457-477.
An oral health‐ related quality of life study. Journal of
8. Abduo, J., & Lyons, K. M. (2017). Interdisciplinary
oral rehabilitation, 39(1), 28-36.
interface between fixed prosthodontics and
periodontics. Periodontology 2000, 74(1), 40-62.
22. Özhayat, E. B., & Gotfredsen, K. (2013). Oral health-
related quality-of-life in patients to be treated with fixed
9. Bluma, E., Vidzis, A., & Zigurs, G. (2016). The in.
or removable partial dental prostheses. Acta
fluence of fixed prostheses on periodontal
Odontologica Scandinavica, 71(1), 113-119.
health. Stomatologija, 18(4), 112-21.

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