A Case Report and Review on Cross-Arch Fixed Partial Denture with Severely Reduced Periodontal Tissue Support

심하게 감소된 치주지지를 갖는 Cross-Arch Fixed Partial Denture에 대한 고찰 및 증례보고

  • Oh, Sang-Chun (Dept. of Prosthodontics, College of Dentistry, Wonkwang University) ;
  • Kim, Yun-Sang (Dept. of Periodontology, College of Dentistry, Wonkwang University) ;
  • Kim, Yu-Jin (Dept. of Prosthodontics, College of Dentistry, Wonkwang University) ;
  • Kim, Min-Jeong (Dept. of Prosthodontics, College of Dentistry, Wonkwang University)
  • 오상천 (원광대학교 치과대학 보철학교실) ;
  • 김윤상 (원광대학교 치과대학 치주학교실) ;
  • 김유진 (원광대학교 치과대학 보철학교실) ;
  • 김민정 (원광대학교 치과대학 보철학교실)
  • Received : 2012.08.30
  • Accepted : 2012.09.25
  • Published : 2012.09.30


In advanced stages of periodontal disease, a lot of the periodontal tissue support are usually lost. The tissue destruction around some teeth is progressed to a level which requires either spontaneous exfoliation or extraction of several teeth due to their excessive mobility. In such cases, a comprehensive treatment plan encompassing the adequate periodontal and maintenance therapy, as well as perio-prosthetic treatment involving occlusal equilibration, is needed in order to restore health, function, and esthetics. Cross-arch fixed partial dentures(CAFPDs), one of the perio-prosthetic treatments, are used to stabilize the teeth with severely reduced periodontal tissue support. Unfortunately, however, a little is known about the occlusal scheme and biomechanical concept of CAFPDs. This paper will demonstrate summaries of the trauma from occlusion(TFO), Ante's law revisited, the treatment principles, the role of occlusion, and the long-term consequences for CAFPDs, and the possibility of CAFPDs through a case presentation.


Supported by : 원광대학교


  1. Laurell L, Lundgren D. Periodontal ligament areas (PLA) and occlusal forces in dentitions restored with cross-arch bilateral end abutment bridges. J Clin Periodontol 1985;12:850-860.
  2. Laurell L, Lundgren D. Periodontal ligament areas and occlusal forces in dentitions restored with crossarch unilateral posterior two-unit cantilever bridges. J Clin Periodontol 1986;13:33-38.
  3. Yi SW, Carlsson GE, Ericcson I. Prospective 3-year study of cross-arch fixed partial dentures in patients with advanced periodontal disease. J Prosthet Dent 2001;86(5):489-494.
  4. Fardal Q. and Linden GJ. Long-term outcomes for cross-arch stabilizing bridges in periodontal maintenance patients - a retrospective study. J Clin Periodont 2010;37:299-304.
  5. Kourkouta S, et al. Restoration of periodontally compromised dentitions using cross-arch bridges. Principles of perio-prosthetic patient management. British Dent J 2007;203:189-195.
  6. Jacobs R, Steenberghe D. Role of periodontal ligament receptors in tactile function of teeth. J Period Res 1994;29:153-167.
  7. Nyman S, Lindhe J. Prosthetic rehabilitation of patients with advanced periodontal disease. J Clin Periodont 1976;3:135-147.
  8. Nyman S, Lindhe J. A longitudinal study of combined periodontal and prosthodontic treatment of patients with advenced periodontal disease. J Periodontol 1979;50:163-169.
  9. Laurell L, et al. Long-term prognosis of extensive polyunit cantilevered fixed partial dentures. J Prosthet Dent 1991;66:545-552.
  10. Stillman PR. The management of pyorrhea. Dent Cosmo 1917;59:405-413.
  11. Glossary of Periodontic Terms. Chicago: American Academy of Periodontology, 1986.
  12. Lindhe J, et al. Clinical periodontology and implant dentistry. 1998, Munksgaard.
  13. Davies SJ, et al. Occlusal considerations in periodontics. British D J 2001;191:597-604.
  14. Lulic M, et al. Ante's law revisited: a systematic review on survival rates and complications of fixed dental prostheses on severely reduced periodontal tissue support. Clin Oral Impl Res 2007;18:63-72.
  15. Ante IH. The fundamental principles of abutments. Michigan State Dental Society Bulletin 1926;8:14-23.
  16. Tylman SD, Tylman SG. Theory and practice of crown and bridge prosthodontics. 4th edition St. Louis: C.V. Mosby Co, 1960.
  17. Reynolds JM. Abutment selection for fixed prosthodontics. J Prosthet Dent 1968;19:483-488.
  18. Johnston JH et al. Modern Practice of Crown and Bridge Prosthodontics. WB Sounders Co, 1971.
  19. Lundgren D. Prosthetic reconstruction of dentitions seriously compromised by periodontal disease. J Clin Periodontol 1991;18:390-395.
  20. De Boever JA. Fixed restorations of a dentition with reduced periodontal support in partially edentulous patients. Pariodontol 1990;1(2):153-164.
  21. Nyman S, Ericsson I. The capacity of reduced periodontal tissues to support fixed bridgework. J Clin Periodontol 1982;9(5):409-414.
  22. Mohl ND, Davidson RM. Concepts of occlusion. In: A textbook of occlusion (eds Mohl ND, Zarb GA, Carlsson GE, Rugh JD), pp. 161-175. Quintessence Publishing Company, Chicago.
  23. Lundgren D, Laurell L. Biomechanical aspects of fixed bridgework supported by natural teeth and endosseous implants. Periodont 2000 1994;4:23-40.
  24. Nyman S, Lindhe J, Lundgren D. The role of occlusion for the stability of fixed bridges in patients with reduced periodontal tissue support. J Clin Periodontol 1975;2(2):53-66.
  25. Yi SW, et al. Long-term follow-up of cross-arch fixed partial dentures in patients with advanced periodontal destruction: evaluation of occlusion and subjective function. J Oral Rehabil 1996;23:186-196.