Long-term comparison of acrylic vs. ceramic All-on-4® fixed dentures

Long-term comparison of acrylic vs. ceramic All-on-4® fixed dentures

Dental implants have improved a lot in recent
years. People who have lost their natural teeth can
now get fixed dentures, and with the All-on-4® approach, dentists can replace the entire
top or bottom set of teeth with just four screws in one visit. But few studies have investigated the long-term
success of these fixed dentures, and whether the cheaper acrylic versions work as well
as the more expensive ceramic ones. Researchers in Germany and Turkey have now
compared both options over a five-year period, offering an unprecedented look at how these
dentures hold up over time. The dentists recruited 29 patients who opted
for either acrylic or ceramic fixed dentures, and evaluated them before and after surgery
on a variety of measures. Overall, both types of dentures performed
similarly in patients. Bone loss, for instance, increased in both
groups over the years, as expected, but was relatively minimal, and low enough to easily
be considered successful. Patients’ oral health-related quality of
life also went up. As measured by the Oral Health Impact Profile,
in which higher scores indicate problems, the both dentures essentially eliminated any
impairment as soon as they were installed, and over time relatively few issues developed. Bite force, which was measured for the first
time with pressure film, also increased, and remained strong over time, although by the
fifth year the ceramic dentures had a slight edge. These results are consistent with previous
reports suggesting that both fixed dentures are highly effective, and that if costs are
a concern, acrylic dentures are a fine choice. But the team also identified a concerning
increase in sulcus flow in the acrylic dentures after about 3 years. Higher rates of flow are linked to more inflammation
and eventual bone degradation. The findings suggest that given more time,
acrylic dentures may prematurely fail. The acrylic dentures also showed more abrasion,
and in a quarter of patients, veneers cracked, while the ceramic ones remained intact. These problems indicate that the lower cost
of the acrylic dentures may not be worth it long-term. Even longer follow-up in future studies may
help answer whether ceramic dentures are the superior choice.

Author: Kevin Mason

4 thoughts on “Long-term comparison of acrylic vs. ceramic All-on-4® fixed dentures

  1. I am interested in what you mean by ceramic. Do you consider porcelain fused to metal as ceramic or do you mean a product like Zirconia.
    I presently have acrylic temporary teeth but I would like my permanent teeth to be less bulky and more like natural teeth.

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