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Xiang F, Shi K, Hua H, Zhao J, Zheng Y. Restoration of teeth lacking complete ferrules using cast precious metal alloy post-and-cores and knife-edged crowns: A retrospective clinical study. J Prosthet Dent 2024:S0022-3913(24)00367-6. [PMID: 38942716 DOI: 10.1016/j.prosdent.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/30/2024]
Abstract
STATEMENT OF PROBLEM While the presence of a ferrule has been reported to be essential for post-and-core restorations, many extensively damaged teeth lack complete ferrules. The outcome of post-and-core restorations for these teeth remains uncertain. PURPOSE The purpose of this retrospective clinical study was to assess the outcome of cast alloy post-and-cores and knife-edged crowns for the restoration of teeth lacking complete ferrules. MATERIAL AND METHODS A total of 106 participants with endodontically treated teeth with 2 or fewer walls with ferrules who had received cast precious metal alloy post-and-cores along with knife-edged crowns between 2013 and 2022 were recalled for a clinical examination. The minimum follow-up time was 5 months after restoration, and restoration failure and the periodontal status difference between restored teeth and reference teeth were determined. Kaplan-Meier analysis was performed to obtain success curves. The influence of age, sex, jaw position, tooth type, and antagonistic dentition upon the success function was analyzed with the log-rank or Breslow test (α=.05). RESULTS A total of 100 participants with 130 restorations were studied. The success rate of the restorations was 93.85% in a mean ±standard deviation period of 48.3 ±26.1 months. The estimated 5-year cumulative success probability was 91.61%. No significant effect on the success of restorations was found regarding age, sex, jaw position, tooth type, or antagonistic dentition (P>.05). The main failure types were post debonding, root fracture, and apical periodontitis. No statistical difference in tooth mobility (Z=-1.265, P=.206) was found between the restored and the reference teeth, but the plaque index and calculus index of the restored teeth were significantly lower than of the reference teeth (Z=-7.216, P<.001; Z=-7.044, P<.001). Teeth that had received cast post-and-cores and knife-edged crowns were found to have no significant correlation with periodontal disease (χ²=1.131, P=.288) or bleeding on probing (χ²=3.436, P=.064). CONCLUSIONS The clinical outcomes for the restoration of teeth with 2 or fewer walls with ferrules using cast precious metal alloy post-and-cores and knife-edged crowns were favorable, exhibiting a high 5-year cumulative success probability and no increased periodontal health risk.
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Affiliation(s)
- Fangyue Xiang
- Graduate student, Graduate Prosthodontics, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Keying Shi
- Graduate student, Graduate Prosthodontics, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Haoyang Hua
- Graduate student, Graduate Prosthodontics, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Jing Zhao
- Attending Physician, Department of General Dentistry, Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Yuanna Zheng
- Professor, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Ningbo Dental Hospital/Ningbo Oral Health Research Institute, Ningbo, PR China.
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Wierichs RJ, Kramer EJ, Meyer-Lueckel H, Abou-Ayash S. Success and complication rates of non-precious alloy telescopic crowns in a general dental practice. Clin Oral Investig 2023; 27:7605-7624. [PMID: 37910235 PMCID: PMC10713787 DOI: 10.1007/s00784-023-05350-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/18/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVES This retrospective, single-center, practice-based cohort study aimed to analyze factors associated with the success of removable partial dentures retained by telescopic crowns (TRPD). MATERIALS AND METHODS TRPD which were placed in a single practice of a practice-based research network were analyzed. Data from 139 patients (age (SD): 66 (11) years; 66 female) with 174 TRPD including 488 non-precious alloy telescopic crowns (TC) between 2004 and 2016 were included. TC without any technical complication were considered as successful, and as survived, if they were still in function at the last check-up. Multilevel Cox proportional hazard models were used to evaluate the association between clinical factors and time until failure. RESULTS Within a mean follow-up period (SD) of 4.2 (3.3) years (min-max: 1 day-12 years), 372 (76%) TC (AFR5years,TC-level: 5.0%) as well as 136 (87%) TRPD (AFR5years,TRPD-level: 5.1%) ("worst-case scenario") and 150 (86%) TRPD (AFR5years,TRPD-level: 3.4%) ("best-case scenario") were considered as successful. The main failure types were recementation (n = 39), endodontic treatment (n = 36), and extraction (n = 35). TC in male patients showed 1.6 times higher risk for failure than in female patients (95%CI: 1.1-2.4; p = 0.023). TC on premolars showed 2.2 times higher risk for failure than on incisors (95%CI: 1.1-5.0; p = 0.023) and TC in dentures with ≤ 3TC showed 2.1 times higher risk for failure than TC in dentures with > 3TC (1.3-3.4; p = 0.042). Furthermore, TC on the most distal tooth in an arch showed 2.4 times higher risk for failure than TC on a more mesial tooth (1.5-3.8; p < 0.001). CONCLUSION For removable partial dentures retained by telescopic crowns, high success rates could be found after up to 12 years. Patient-level and tooth-level factors were significantly associated with failure. CLINICAL RELEVANCE For removable partial dentures retained by telescopic crowns, high success rates could be found after up to 12 years. Patient-level and tooth-level factors were significantly associated with failure.
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Affiliation(s)
- R J Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
| | | | - H Meyer-Lueckel
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - S Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Urkande NK, Mankar N, Nikhade PP, Chandak M. Understanding the Complexities of Cast Post Retention: A Comprehensive Review of Influential Factors. Cureus 2023; 15:e51258. [PMID: 38288201 PMCID: PMC10823198 DOI: 10.7759/cureus.51258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 12/27/2023] [Indexed: 01/31/2024] Open
Abstract
This comprehensive review delves into the intricate landscape of cast post retention in restorative dentistry, encompassing historical perspectives, contemporary techniques, and future directions. Examining factors ranging from tooth-related considerations to prosthesis-related dynamics, the review provides a detailed analysis of clinical techniques, including step-by-step procedures, common challenges, and innovative advancements. Technological breakthroughs, such as digital impressions, computer-aided design and computer-aided manufacturing (CAD/CAM) technology, three-dimensional (3D) printing, and finite element analysis, are explored for their transformative impact on precision and customization. The discussion extends to the promising future of cast post retention, emphasising emerging materials, the integration of artificial intelligence in treatment planning, and patient-specific approaches. Implications for clinical practice underscore the importance of individualised treatment planning and the adoption of advanced technologies. Recommendations for future research advocate for comprehensive long-term clinical studies, investigations into AI-driven treatment planning, and a focus on patient outcomes and satisfaction. This review consolidates existing knowledge and anticipates a future marked by enhanced precision, individualised care, and improved long-term success in cast post-retained restorations.
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Affiliation(s)
- Neha K Urkande
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Nikhil Mankar
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Pradnya P Nikhade
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Manoj Chandak
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Hassouneh L, Matoug-Elwerfelli M, Al-Omari T, Setzer FC, Nagendrababu V. Assessment of biomechanical behavior of immature non-vital incisors with various treatment modalities by means of three-dimensional quasi-static finite element analysis. Sci Rep 2023; 13:17491. [PMID: 37840093 PMCID: PMC10577137 DOI: 10.1038/s41598-023-44609-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/10/2023] [Indexed: 10/17/2023] Open
Abstract
The objectives of this study were to evaluate the stress distribution and risk of fracture of a non-vital immature maxillary central incisor subjected to various clinical procedures using finite element analysis (FEA). A three-dimensional model of an immature central incisor was developed, from which six main models were designed: untreated immature tooth (C), standard apical plug (AP), resin composite (RC), glass-fibre post (GFP), regeneration procedure (RET), and regeneration with induced root maturation (RRM). Mineral trioxide aggregate (MTA) or Biodentine® were used as an apical or coronal plug. All models simulated masticatory forces in a quasi-static approach with an oblique force of 240 Newton at a 120° to the longitudinal tooth axis. The maximum principal stress, maximum shear stress, risk of fracture, and the strengthening percentage were evaluated. The mean maximum principal stress values were highest in model C [90.3 MPa (SD = 4.4)] and lowest in the GFP models treated with either MTA and Biodentine®; 64.1 (SD = 1.7) and 64.0 (SD = 1.6) MPa, respectively. Regarding the shear stress values, the dentine tooth structure in model C [14.4 MPa (SD = 0.8)] and GFP models [15.4 MPa (SD = 1.1)] reported significantly higher maximum shear stress values compared to other tested models (p < 0.001), while no significant differences were reported between the other models (p > 0.05). No significant differences between MTA and Biodentine® regarding maximum principal stress and maximum shear stress values for each tested model (p > 0.05). A maximum strain value of 4.07E-03 and maximum displacement magnitude of 0.128 mm was recorded in model C. In terms of strengthening percentage, the GFP models were associated with the highest increase (22%). The use of a GFP improved the biomechanical performance and resulted in a lower risk of fracture of a non-vital immature maxillary central incisor in a FEA model.
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Affiliation(s)
- Layla Hassouneh
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Taher Al-Omari
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Frank C Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
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Ñaupari-Villasante R, Ocampo JB, Cardenas A, Muniz LP, Siqueira F, Moreira A, Feitosa VP, Loguercio AD. Effect of the Viscosity and Application Time of Different Phosphoric Acids on the Bond Strength and Nanoleakage of Fiber Posts to Root Dentin. Oper Dent 2022; 47:E253-E263. [PMID: 36322381 DOI: 10.2341/21-118-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2022] [Indexed: 02/28/2024]
Abstract
PURPOSE To evaluate the effect of application time and viscosity of meta-phosphoric acid (MPA) and ortho-phosphoric acid (OPA) on the push-out resin-dentin bond strength (PBS) and nanoleakage (NL) at the adhesive-root dentin interface. METHODS AND MATERIALS Ninety-six roots of premolars were endodontically prepared and randomly assigned into groups according to the (i) acid (OPA and MPA), (ii) viscosity (gel and liquid), and (iii) application time (7 and 15 seconds). Fiber posts were cemented to the roots, which were then transversally sectioned into serial slices. The slices (cervical, medium, and apical) were subjected to PBS or NL. Analysis of the dentin etching pattern was performed using scanning electron microscopy (SEM). The PBS (MPa) and NL (%) data were subjected to three-way repeated-measures analysis of variance (ANOVA) and Tukey's test (α=0.05). RESULTS The cross-product interaction was significant for both PBS and NL (p<0.001). No significant difference in the PBS was observed with the use of OPA compared to MPA (p>0.05). Higher PBS values were observed in the groups etched for 15 seconds compared to 7 seconds, regardless of the acid, viscosity, or root third (p<0.05). Lower NL was observed for MPA etching when compared to OPA etching (p<0.05), and these values were not affected by increasing the application time or acid viscosity (p>0.05). A more pronounced etching pattern was observed with OPA than MPA regardless of the acid viscosity. CONCLUSION The use of 40% meta-phosphoric acid promoted adequate bond strength without increasing dentin demineralization or void spaces in the hybrid layer.
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Affiliation(s)
- R Ñaupari-Villasante
- Romina Ñaupari-Villasante, DDS, MS student, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - J B Ocampo
- Jessica B Ocampo, DDS, MS, Department of Restorative Dentistry, School of Dentistry, Santiago de Cali University, Cali, Colombia
| | - Afm Cardenas
- Andres Felipe M Cardenas, DDs, MS, PhD, Department of Postgraduate Program in Dentistry,CEUMA University, São Luís, Maranhão, Brazil
| | - L P Muniz
- Luana P Muniz, DDS, MS student, Department of Postgraduate Program in Dentistry, CEUMA University, Sáo Luis, Maranháo, Brazil
| | - Fsf Siqueira
- Fabiana SF Siqueira, DDs, MS, PhD, Department of Postgraduate Program in Dentistry, CEUMA University, Sáo Luís, Maranháo, Brazil
| | - Acl Moreira
- Ana Carolina L Moreira, DDS, MS student, Paulo Picanço School of Dentistry, Fortaleza, Ceará, Brazil
| | - V P Feitosa
- Victor P Feitosa, DDs, MS, PhD, Paulo Picanço School of Dentistry, Fortaleza, Ceará, Brazil
| | - A D Loguercio
- *Alessandro D Loguercio, DDS, MS, PhD, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
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Long-term outcome of nonvital immature permanent teeth treated with apexification and corono-radicular adhesive restoration - a case series. J Endod 2022; 48:1191-1199. [PMID: 35750220 DOI: 10.1016/j.joen.2022.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/03/2022] [Accepted: 06/14/2022] [Indexed: 12/26/2022]
Abstract
INTRODUCTION This study aims to evaluate the long-term outcome of sixteen permanent maxillary central incisors with nonvital pulps and open apices treated with apexification and corono-radicular adhesive restorations, within a follow-up span of 5 to 22 years. METHODS Fourteen patients providing a total of sixteen teeth treated with MTA (n = 12), Biodentine (n = 3) or β-tricalcium phosphate (n = 1) apical barrier and corono-radicular restoration, with or without fiberglass post, were included. Clinical and radiographic criteria were defined for assessment at recall. Restoration and periapical tissues' status evaluation were performed according to FDI World Dental Federation's esthetic, functional and biological criteria and Ørstavik Periapical Index (PAI). Outcome was dichotomized in "healed" (PAI ≤ 2, asymptomatic with absence of signs of infection) or "not healed" (PAI ≥ 3, presence of clinical signs and/or symptoms). RESULTS Fourteen out of twenty-four patients were available for the present study (recall rate = 58%). Within a follow-up of 5 to 22 years, ten (62.5%) teeth were considered "healed", fulfilling both strict clinical and radiographic success criteria. Only one tooth was missing due to root resorption and one patient was presenting with clinical signs and symptoms at recall, resulting in a survival rate of 93.8%. CONCLUSIONS Adhesive corono-radicular restoration in nonvital permanent immature teeth treated with apexification allows for favorable long-term outcomes, by ensuring structural reinforcement and coronal microleakage prevention. Teeth sustaining a substantial loss of coronal structure may require post/core placement. In the case of failure, this endodontic-restorative combination assured teeth survival until growth phase conclusion, thus allowing for proper prosthetic rehabilitation approaches.
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Wierichs RJ, Weilenmann W, Jeganathan S, Perrin P. Longevity of immediate rehabilitation with direct metal-wire reinforced composite fixed partial dentures. Dent Mater 2022; 38:e257-e265. [PMID: 35718596 DOI: 10.1016/j.dental.2022.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/04/2022] [Accepted: 06/05/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study aimed to analyze the longevity of direct metal-wire reinforced composite fixed partial dentures (MRC-FPD) and factors influencing their survival and success. METHODS Within one private practice 513 MRC-FPD were directly applied. The preparation of a proximal cavity in abutment teeth was not limited. MRC-FPD were reinforced by one to three metal-wires. At the last follow-up MRC-FPD were considered successful, if they were still in function without any need of therapy. MRC-FPD were considered as survived, if they were repaired or replaced. Multi-level Cox proportional hazard models were used to evaluate the association between clinical factors and time. RESULTS Mean follow-up period (range) was 59(2-249) months. Seventy-three bridges did not survive (cumulative survival rate(CSR):86%) and further 129 bridges had received a restorative follow-up treatment (CSR:61%). AFR was 2.2% for survival and 8.6% for success. In multivariate analysis MRC-FPD with> 1 wire showed a up to 2.3x higher failure rate than MRC-FPD with one wire(p ≤ 0.023). Dentist's experience in designing MRC-FDP (p ≤ 0.017), patient's caries risk (p ≤ 0.040) and bruxism (p = 0.033) significantly influenced the failure rate: the more experience, the lower caries risk and bruxism, the lower the failure rate. SIGNIFICANCE For directly prepared metal-wire reinforced composite bridges high survival and moderate success rates were observed. MRC-FPD might, thus, be an immediate, short- and medium-term solution for replacing missing teeth. However, several factors on the levels of practice (dentist's experience in designing MRC-FDP), patient (bruxism, caries risk) and restoration (number of wires) were identified as significant predictors for the failure rate. The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00021576).
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Affiliation(s)
- R J Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland.
| | | | - S Jeganathan
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - P Perrin
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland; Private clinic, Schaffhausen, Switzerland
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Usta SN, Cömert-Pak B, Karaismailoğlu E, Eymirli A, Deniz-Sungur D. Patterns of Post-Endodontic Restoration: A Nationwide Survey of Dentists in Turkey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031794. [PMID: 35162816 PMCID: PMC8834666 DOI: 10.3390/ijerph19031794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/17/2022] [Accepted: 02/01/2022] [Indexed: 02/05/2023]
Abstract
Developments in materials and techniques, geographical locations, age, specialty, and affiliations of dental practitioners affect the preference of post-endodontic restoration. Thus, this survey aimed to evaluate the trends of dentists in Turkey in terms of post-endodontic restorations. An anonymous survey containing 10 questions regarding demographics, post-endodontic restoration patterns, and factors affecting restoration selection was electronically delivered to the dentists registered in the database of the Turkish Dental Association. The data were analyzed using by a chi-square test and ordinal logistic regression analysis. A total of 1093 surveys from 20,564 participants were collected with a response rate of 5.3%. Half of the participants (52%) preferred composite resins for post-endodontic restorations. Usage of posts was less prevalent amongst prosthodontists and dentists with clinical experience of more than 20 years compared to endodontists (p < 0.001) and dentists with clinical experience of less than 5 years (p = 0.004). More than half of the participants (56%) utilized fiber posts. Composite resins and fiber posts were the most common preferences in post-endodontic restoration. Endodontists had a higher tendency to use posts than prosthodontists and general dental practitioners.
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Affiliation(s)
- Sıla Nur Usta
- Department of Endodontics, Faculty of Dentistry, University of Hacettepe, Ankara 06230, Turkey; (B.C.-P.); (A.E.); (D.D.-S.)
- Correspondence:
| | - Begüm Cömert-Pak
- Department of Endodontics, Faculty of Dentistry, University of Hacettepe, Ankara 06230, Turkey; (B.C.-P.); (A.E.); (D.D.-S.)
| | - Eda Karaismailoğlu
- Department of Medical Informatics, Gulhane Faculty of Medicine, University of Health Sciences, Ankara 06018, Turkey;
| | - Ayhan Eymirli
- Department of Endodontics, Faculty of Dentistry, University of Hacettepe, Ankara 06230, Turkey; (B.C.-P.); (A.E.); (D.D.-S.)
| | - Derya Deniz-Sungur
- Department of Endodontics, Faculty of Dentistry, University of Hacettepe, Ankara 06230, Turkey; (B.C.-P.); (A.E.); (D.D.-S.)
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Bruhnke M, Wierichs RJ, von Stein-Lausnitz M, Meyer-Lückel H, Beuer F, Naumann M, Sterzenbach G. Long-term survival of adhesively post-endodontically restored teeth. J Endod 2022; 48:606-613. [DOI: 10.1016/j.joen.2022.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/25/2022] [Accepted: 02/08/2022] [Indexed: 01/04/2023]
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10
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Clinical performance of posterior resin composite restorations after up to 33 years. Dent Mater 2022; 38:680-688. [DOI: 10.1016/j.dental.2022.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/24/2022] [Accepted: 02/19/2022] [Indexed: 12/20/2022]
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Wierichs RJ, Kramer EJ, Reiss B, Schwendicke F, Krois J, Meyer-Lueckel H, Wolf TG. A prospective, multi-center, practice-based cohort study on all-ceramic crowns. Dent Mater 2021; 37:1273-1282. [PMID: 33972099 DOI: 10.1016/j.dental.2021.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/07/2021] [Accepted: 04/24/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aim of this prospective, multi-center, practice-based cohort study was to analyze factors associated with the success of all-ceramic crowns. METHODS All-ceramic crowns placed in a practice-based research network ([Ceramic Success Analysis, AG Keramik) were analyzed. Data from 1254 patients with (mostly in-office CAD/CAM) all-ceramic crowns placed by 101 dentists being followed up for more than 5 years were evaluated. At the last follow-up visit crowns were considered as successful (not failed) if they were sufficient, whereas crowns were considered as survived (not lost) if they were still in function. Multi-level Cox proportional hazards models were used to evaluate the association between a range of predictors and time of success or survival. RESULTS Within a mean follow-up period (SD) of 7.2(2)years [maximum:15years] 776 crowns were considered successful (annual failure rate[AFR]:8.4%) and 1041 crowns survived (AFR:4.9%). The presence of a post in endodontically treated teeth resulted in a risk for failure 2.7 times lower than that of restorations without a post (95%CI:1.4-5.0;p = 0.002). Regarding the restorative material and adhesive technique, hybrid composite ceramics and single-step adhesives showed a 3.4 and 2.2 times higher failure rate than feldspathic porcelain and multi-step adhesives, respectively (p < 0.001). Use of an oxygen-blocking gel as well as an EVA instrument resulted in a 1.5-1.8 times higher failure rate than their non-use (p ≤ 0.001). SIGNIFICANCE After up to 15years AFR were rather high for all-ceramic crowns. Operative factors, but no patient- or tooth-level factors were significantly associated with failure. The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00020271).
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Affiliation(s)
- R J Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland; Department of Biohybrid & Medical Textiles, Institute of Applied Medical Engineering, RWTH Aachen University, Aachen, Germany.
| | | | - B Reiss
- German Society of Computerized Dentistry, Berlin, Germany
| | - F Schwendicke
- Department of Oral Diagnosis, Digital Health and Health Services Research, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - J Krois
- Department of Oral Diagnosis, Digital Health and Health Services Research, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - H Meyer-Lueckel
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland
| | - T G Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland; Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Germany
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Aminoshariae A, Azarpazhooh A, Diogenes AR, Fouad AF, Glickman GN, Kishen A, Letra AM, Levin L, Roda RS, Setzer FC, Tay FR, Hargreaves KM. Insights into the April 2021 Issue of the Journal of Endodontics. J Endod 2021; 47:555-557. [PMID: 33662436 DOI: 10.1016/j.joen.2021.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Amir Azarpazhooh
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Anibal R Diogenes
- University of Texas Health San Antonio School of Dentistry, San Antonio, Texas
| | | | | | - Anil Kishen
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Ariadne M Letra
- University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
| | | | | | - Frank C Setzer
- Diplomate, American Board of Endodontics; Assistant Professor, Clinic & Predoctoral Program and Director, Department of Endodontics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Franklin R Tay
- The Dental College of Georgia, Augusta University, Augusta, Georgia
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