Clinical Complications of Fixed Anterior Prostheses After Traumatic Premature Loss of Primary Maxillary Incisors: A Retrospective Cohort Study.

BACKGROUND/AIM: Premature loss of primary maxillary incisors after traumatic dental injuries may require secondary rehabilitation in preschool children. Evidence on complications associated with fixed anterior prostheses in this context remains limited. This retrospective cohort study evaluated recorded complications of fixed anterior prostheses supported by preformed crowns for prematurely lost primary maxillary incisors, with emphasis on trauma-related tooth loss and recurrent traumatic episodes. MATERIAL AND METHODS: In this retrospective cohort study, clinical records of children treated consecutively with fixed anterior prostheses supported by preformed metal crowns on primary molars were reviewed. Variables included sex, age at treatment onset, aetiology of tooth loss, oral habits, number of replaced teeth, anchorage type, treatment duration, new traumatic episodes during appliance use, and clinical complications. The primary outcome was the presence of any recorded complication. Bivariate analyses and multivariable logistic regression were performed. Complication incidence was also expressed per 100 patient-years to account for variable follow-up duration. RESULTS: The final sample included 123 children. Trauma was the main aetiology (112/123; 91.1%). The prostheses were supported by maxillary first primary molars in 107 cases (87.0%) and by maxillary second primary molars in 16 cases (13.0%). Mean treatment duration was 28.0 ± 12.43 months (range: 8-85), corresponding to approximately 287.0 patient-years of follow-up. Overall, 30 patients (24.4%) experienced at least one recorded complication, with an incidence rate of 10.5 complications per 100 patient-years (95% CI: 7.1-14.9). New traumatic episodes during appliance use were independently associated with complications (adjusted odds ratio = 3.62; 95% confidence interval: 1.37-9.59; p = 0.010). CONCLUSIONS: In this retrospective cohort, fixed anterior prostheses supported by preformed crowns showed a low-to-moderate frequency of recorded complications after premature loss of primary maxillary incisors, most frequently of traumatic origin. Recurrent trauma was the main independent factor associated with complications. Overall treatment effectiveness, survival, and patient-centred outcomes were not assessed.