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Yurdagüven GY, Çiftçioğlu E, Kazokoğlu FŞ, Kayahan MB. 5-Year clinical performance of ceramic onlay and overlay restorations luted with light-cured composite resin. J Dent 2024; 149:105258. [PMID: 39067649 DOI: 10.1016/j.jdent.2024.105258] [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: 06/05/2024] [Revised: 07/17/2024] [Accepted: 07/20/2024] [Indexed: 07/30/2024] Open
Abstract
OBJECTIVES This prospective clinical trial evaluated the clinical performance of ceramic partial coverage indirect adhesive restorations (PCIARs) in posterior teeth luted with a light-cured composite resin. METHODS From April 2016 to January 2017, a total of 60 patients (27 males, 33 females; mean age: 42.2 ± 10.86 years old) received 83 glass-ceramic PCIARs (26 onlay, 57 overlay) made of IPS Emax CAD (Ivoclar Vivadent). All restorations were luted with a light-cured composite resin (Filtek Z250, 3 M ESPE) by two operators. Two independent calibrated examiners blinded to the operators performing the treatment evaluated the restorations at baseline, 1-year, and 5-year following FDI World Dental Federation criteria including esthetic, functional, and biological properties. Data were analyzed with the Friedman test and the Wilcoxon sign test (p < 0.05). RESULTS None of the restorations failed due to fracture or retention loss. One restoration was clinically unsatisfactory because of secondary caries. Marginal staining (p:0.000), marginal adaptation (p:0.018) showed significant differences between 1-year and 5-year recall. CONCLUSIONS The PCIARs demonstrated excellent clinical performance at 1-year period. The degradation parameters appeared as minor staining and minor irregularities after 5-year, without any affect on the clinical performance. CLINICAL SIGNIFICANCE Our findings provide evidence that the clinical performance of PCIARs luted with a light-cured composite resin was clinically acceptable after a five-year evaluation period. Due to secondary caries, only one restoration was considered clinically unsatisfactory. CLINICALTRIALS REGISTRATION NUMBER NCT04838483.
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Affiliation(s)
- Gülşah Yenier Yurdagüven
- Department of Restorative Dentistry, Istanbul Okan University, Faculty of Dentistry, Istanbul, Turkey.
| | - Elif Çiftçioğlu
- Department of Endodontics, Istanbul Okan University Faculty of Dentistry, Istanbul, Turkey
| | - Fatma Şehnaz Kazokoğlu
- Department of Prosthetic Dentistry, Bezmialem University Faculty of Dentistry, Istanbul, Turkey
| | - Mehmet Baybora Kayahan
- Department of Endodontics, Istanbul University-Cerrahpaşa Faculty of Dentistry, Istanbul, Turkey
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Hassan A, Hamdi K, Ali AI, Al-Zordk W, Mahmoud SH. Clinical performance comparison between lithium disilicate and hybrid resin nano-ceramic CAD/CAM onlay restorations: a two-year randomized clinical split-mouth study. Odontology 2024; 112:601-615. [PMID: 37542639 PMCID: PMC10925567 DOI: 10.1007/s10266-023-00841-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/14/2023] [Indexed: 08/07/2023]
Abstract
A total of 20 lithium disilicate glass-ceramics (IPS e.max CAD, Ivoclar Vivadent) and 20 resin nano-ceramic (Voco Grandio Blocks) onlay restorations were performed in 20 patients using a split-mouth design to compare the two-year clinical performance of lithium disilicate and resin nano-ceramic onlay restorations. Both restorations were evaluated at baseline, one-year, and two-year clinical follow-ups based on the modified United States Public Health Service (USPHS) criteria. Chi-square and Fisher's exact tests showed no statistically significant difference between Voco Grandio and IPS e.max ceramic restorations for all evaluated parameters during the different follow-up periods (p > 0.05). Cochrane's and MC-Nemar's tests indicated statistically significant differences regarding color match within the Voco Grandio group. They also indicated statistically significant differences in marginal discoloration, marginal adaptation, surface texture, and postoperative hypersensitivity within both ceramic material groups (p < 0.05). Kaplan-Meier curve indicated that the survival rate of both ceramic materials was 90%. After two years of clinical service, IPS e.max CAD and Voco Grandio onlay restorations exhibited similar clinical performance.
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Affiliation(s)
- Amr Hassan
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Kareem Hamdi
- Operative Dentistry Department, Faculty of Dentistry, Zagazig University, Zagazig, Egypt.
- Kareem Dental Clinic, El Guesh street, Mansoura, 35516, Egypt.
| | - Ashraf I Ali
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Walid Al-Zordk
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Salah Hasab Mahmoud
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
- Operative Department, Faculty of Dentistry, Horus University, New Damietta, Egypt
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Hofsteenge JW, Bresser RA, Buijs GJ, van der Made SA, Özcan M, Cune MS, Gresnigt MM. Clinical performance of bonded partial lithium disilicate restorations: The influence of preparation characteristics on survival and success. J Dent 2024; 142:104828. [PMID: 38159900 DOI: 10.1016/j.jdent.2023.104828] [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: 06/06/2023] [Revised: 12/21/2023] [Accepted: 12/27/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES The aim of this study was to investigate the influence of preparation characteristics on the survival, success, and clinical performance of partial indirect lithium disilicate restorations with immediate dentin sealing. METHODS This retrospective clinical study evaluated partial indirect lithium disilicate restorations placed in conjunction with Immediate Dentin Sealing (IDS) in (pre)molar teeth between March 2018 and May 2021. The restorations were luted using pre-heated composite. The study focused on survival, success, and clinical performance, which was evaluated using the modified United States Public Health Service (USPHS) criteria. Results were analyzed using the Kaplan-Meier estimates, log-rank tests, and Fisher exact tests. RESULTS Partial indirect lithium disilicate restorations (N = 454) were evaluated in 214 patients. The mean evaluation time was 37 months, with a cumulative survival rate of 99.2 % and a cumulative success rate of 97.6 %. Fourteen failures occurred, with endodontic pathology as the predominant failure mode, followed by secondary caries, debonding, and tooth fracture. No statistically significant influence of the preparation variables on survival and success was observed (p > .05). The short-term clinical performance was clinically acceptable in > 90 % of the evaluations. CONCLUSIONS This retrospective study on partial indirect lithium disilicate restorations in conjunction with IDS demonstrates survival and success rates of 99.2 and 96.7 % over a mean evaluation period of 37 months. A marked influence of the studied preparation characteristics on the survival, success and clinical performance of lithium disilicate partial restorations could not be demonstrated. Partial lithium disilicate restorations exhibit good clinical performance in >90 % of the cases. CLINICAL SIGNIFICANCE The results of this study suggest that preparation characteristics had no significant impact on the survival, success, and clinical performance of partial lithium disilicate restorations in conjunction with IDS. Results show good clinical performance and high survival and success rates, regardless of preparation characteristics.
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Affiliation(s)
- Jelte W Hofsteenge
- Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, AV 9713, the Netherlands.
| | - Rijkje A Bresser
- Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, AV 9713, the Netherlands
| | - Gerrit J Buijs
- Private Practice Buijs Tandartsen, Groningen, the Netherlands
| | | | - Mutlu Özcan
- Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, AV 9713, the Netherlands; Center of Dental Medicine, Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Marco S Cune
- Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, AV 9713, the Netherlands; Department of Oral Maxillofacial Surgery, Prosthodontics and Special Dental Care, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - Marco Mm Gresnigt
- Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, AV 9713, the Netherlands; Department of Special Dental Care, Martini Hospital, Groningen, the Netherlands
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Elmoselhy HAS, Hassanien OES, Haridy MF, Salam El Baz MAE, Saber S. Two‑year clinical performance of indirect restorations fabricated from CAD/CAM nano hybrid composite versus lithium disilicate in mutilated vital teeth. A randomized controlled trial. BMC Oral Health 2024; 24:101. [PMID: 38233771 PMCID: PMC10792922 DOI: 10.1186/s12903-023-03847-6] [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: 10/28/2023] [Accepted: 12/31/2023] [Indexed: 01/19/2024] Open
Abstract
TRIAL DESIGN This is a randomized, controlled, superiority, double-blinded, parallel-group, two-arms trial with an allocation ratio of 1:1. The aim of this trial was to compare the two-year clinical performance of partial indirect restorations fabricated from CAD/CAM nano-hybrid composite and ceramic lithium disilicate blocks using the modified USPHS criteria. METHODS In two parallel groups (n = 50 restorations), fifty participants having mutilated vital teeth with a minimum of two remaining walls were randomly enrolled in this trial and received indirect restorations of either nano-hybrid composite resin blocks (Brilliant, Coltene, Switzerland) or Lithium Disilicate (IPS Emax CAD). The restorations were assessed using modified USPHS criteria by two independent blinded assessors at baseline, six months, one-year and two years follow-up visits. Categorical and ordinal data were presented as frequencies and percentages. Categorical data were analyzed using the chi-square test. Ordinal data were analyzed using the Mann-Whitney U test for intergroup comparisons and Freidman's test followed by the Nemenyi post hoc test for intragroup comparisons. Numerical data were presented as mean and standard deviation values. They were analyzed for normality using the Shapiro-Wilk test. Data were found to be normally distributed and were analyzed using the independent t-test. The significance level was set at p ≤ 0.05 within all tests. RESULTS Forty-eight participants received the allocated intervention and completed the follow-up periods. There was a statistically significant difference between both tested materials for all USPHS criteria regarding Marginal integrity and Marginal discoloration at six-months Follow-up, but with no statistically significant difference at one- and two-year follow-up. CONCLUSIONS Both materials showed an acceptable, successful clinical performance along the two-years follow-up period. CLINICAL RELEVANCE The CAD/CAM nano-hybrid composite blocks are as reliable as Lithium disilicate for restoring mutilated vital teeth.
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Affiliation(s)
- Haneen Ahmad Shafik Elmoselhy
- Conservative Dentistry Department, Faculty of Dentistry, The British University in Egypt, Suez Desert Road El Sherouk City, Egypt
| | | | - Mohamed Fouad Haridy
- Conservative Dentistry, Faculty of Dentistry, Cairo University and The British University in Egypt, Suez Desert Road El Sherouk City, Egypt
| | | | - Shehabeldin Saber
- Endodontics, Faculty of Dentistry, Ain Shams University and The British University in Egypt, Suez Desert Road El Sherouk City, Egypt.
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Farouk AT, Hassanein OES, Fahmy OI, Elkady AM, ElNahass H. Biological evaluation of indirect restorations in endodontically treated posterior teeth with deeply located proximal margins following deep margin elevation versus surgical crown lengthening: a randomized controlled trial. Clin Oral Investig 2023; 28:24. [PMID: 38147139 DOI: 10.1007/s00784-023-05434-z] [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: 08/11/2023] [Accepted: 11/20/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE The current clinical trial was conducted to evaluate the effect of proximal indirect restorations in endodontically treated posterior teeth with deeply located margins following deep margin elevation compared to surgical crown lengthening. MATERIAL AND METHODS Deep proximal cavities in endodontically treated posterior teeth were randomly assigned into two groups; deep margin elevation (DME) or crown lengthening (CL). The clinical attachment level (CAL), probing depth (PD), bleeding on probing (BOP), crestal bone level (CBL), and secondary caries were evaluated at the baseline, 1, 3, 6, 9, and 12 months. RESULTS A total of 20 proximal cavities were included in the study; there was no significant difference between the two groups regarding mean CAL values at the baseline and 1 month, while there was a significant difference between the two groups in all other periods. Regarding the PD, there was no statistical significance between the two groups except at 9 and 12 months, where CL showed higher mean PD values than DME. There was no statistically significant difference in BOP or CBL between the two groups. CONCLUSIONS DME and CL are considered clinically successful with favorable biologic responses. CLINICAL RELEVANCE The deep margin elevation approach could provide a more conservative solution when relocating deeply seated cervical margins in a more coronal position. DME reduced the number of visits and time needed for the restoration of endodontically treated teeth. Surgical crown lengthening remains a gold standard procedure in the re-establishment of the supracrestal tissue attachment, especially in cases where cervical margins are beyond the elevation capacity.
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Affiliation(s)
- Ahmed Tarek Farouk
- Department of Conservative Dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt
- Operative Dentistry Department, Faculty of Dentistry, Misr International University, Cairo, Egypt
| | | | - Ola Ibrahim Fahmy
- Operative Dentistry Department, Faculty of Dentistry, Misr International University, Cairo, Egypt
| | - Ahmed M Elkady
- Department of Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Hani ElNahass
- Department of Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt.
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.
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Lempel E, Gyulai S, Lovász BV, Jeges S, Szalma J. Clinical evaluation of lithium disilicate versus indirect resin composite partial posterior restorations - A 7.8-year retrospective study. Dent Mater 2023; 39:1095-1104. [PMID: 37821330 DOI: 10.1016/j.dental.2023.10.017] [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: 02/27/2023] [Revised: 09/26/2023] [Accepted: 10/07/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE To evaluate retrospectively the longevity of lithium disilicate ceramic (LidiSi) vs. laboratory-processed resin-based composite (RBC) inlay/onlay/overlay restorations and risk factors associated with restoration deficiencies and failures. METHODS Patients (n = 91) receiving LidiSi (73.1%) and RBC (36.9%) inlays/onlays/overlays between 2007 and 2017 were selected. The restorations were evaluated using the modified U.S. Public Health Service criteria. The survival of the restorations was analyzed using the Kaplan-Meier method and log rank test. Factors affecting the occurrence of deficiencies were examined by logistic regression analysis. This was performed with the use of the Generalized Estimating Equation model including Repeated measurements (GEER), with the consideration that the same patient had several teeth in the sample. Risk estimation was conducted for each evaluated criterion (p < 0.05). RESULTS The survival of LidiSi and RBC restorations were 96.8% and 84.9%, respectively after a mean observation period of 7.8 ± 3.3 years. The annual failure rate was 0.2% for LidiSi and 1.0% for RBC. The probability of survival was above 98% for both restorations in the first 6 years, however, it dropped to 60% for RBC by the end of the 15th year. For both materials the reasons for failure included secondary caries, restoration fracture, and endodontic complication. In addition, LidiSi also failed due to tooth fracture, while RBC due to marginal gap formation and loss of retention. Among the evaluated risk factors, material of restoration (OR=6.8, CI95%:3.1-14.9), oral hygiene (OR=8.0, CI95%: 2.9-22.1], and bruxism (OR=1.9, CI95%: 1.1-3.3) showed a significant impact on the evaluated criteria. SIGNIFICANCE LidiSi and RBC restorations showed similarly excellent 6-year survival, however, in the long term significantly more failures should be expected for RBCs.
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Affiliation(s)
- Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, Pécs 7623, Hungary.
| | - Sarolta Gyulai
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, Pécs 7623, Hungary; Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Tüzér Street 1, Pécs 7623, Hungary
| | - Bálint Viktor Lovász
- Oral and Maxillofacial Department, Manchester University Foundation Trust, Manchester Royal Infirmary Hospital, Oxford Rd, Manchester M13 9WL, United Kingdom
| | - Sára Jeges
- Faculty of Health Sciences, University of Pécs, Vörösmarty M. Street 4, Pécs 7621, Hungary
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Tüzér Street 1, Pécs 7623, Hungary
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Bresser RA, Hofsteenge JW, Wieringa TH, Braun PG, Cune MS, Özcan M, Gresnigt MMM. Clinical longevity of intracoronal restorations made of gold, lithium disilicate, leucite, and indirect resin composite: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:4877-4896. [PMID: 37597003 PMCID: PMC10492736 DOI: 10.1007/s00784-023-05050-x] [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: 02/15/2023] [Accepted: 04/28/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis is to assess the comparative clinical success and survival of intracoronal indirect restorations using gold, lithium disilicate, leucite, and indirect composite materials. MATERIAL AND METHODS This systematic review and meta-analysis were conducted following the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. The protocol for this study was registered in PROSPERO (registration number: CRD42021233185). A comprehensive literature search was conducted across various databases and sources, including PubMed/Medline, Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, and gray literature. A total of 7826 articles were screened on title and abstract. Articles were not excluded based on the vitality of teeth, the language of the study, or the observation period. The risk difference was utilized for the analyses, and a random-effects model was applied. All analyses were conducted with a 95% confidence interval (95% CI). The calculated risk differences were derived from the combined data on restoration survival and failures obtained from each individual article. The presence of heterogeneity was assessed using the I2 statistic, and if present, the heterogeneity of the data in the articles was evaluated using the non-parametric chi-squared statistic (p < 0.05). RESULTS A total of 12 eligible studies were selected, which included 946 restorations evaluated over a minimum observation period of 1 year and a maximum observation period of 7 years. Results of the meta-analysis indicated that intracoronal indirect resin composite restorations have an 18% higher rate of failure when compared to intracoronal gold restorations over 5-7 years of clinical service (risk difference = - 0.18 [95% CI: - 0.27, - 0.09]; p = .0002; I2 = 0%). The meta-analysis examining the disparity in survival rates between intracoronal gold and leucite restorations could not be carried out due to methodological differences in the studies. CONCLUSIONS According to the currently available evidence, medium-quality data indicates that lithium disilicate and indirect composite materials demonstrate comparable survival rates in short-term follow-up. Furthermore, intracoronal gold restorations showed significantly higher survival rates, making them a preferred option over intracoronal indirect resin-composite restorations. Besides that, the analysis revealed no statistically significant difference in survival rates between leucite and indirect composite restorations. The short observation period, limited number of eligible articles, and low sample size of the included studies were significant limitations. CLINICAL SIGNIFICANCE Bearing in mind the limitations of the reviewed literature, this systematic review and meta-analysis help clinicians make evidence-based decisions on how to restore biomechanically compromised posterior teeth.
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Affiliation(s)
- R A Bresser
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| | - J W Hofsteenge
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - T H Wieringa
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - P G Braun
- Central Medical Library, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M S Cune
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
- Prosthodontics and Special Dental Care, Department of Oral Maxillofacial Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - M Özcan
- Clinic for Reconstructive Dentistry, Division of Dental Biomaterials, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - M M M Gresnigt
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
- Department of Special Dental Care, Martini Hospital, Groningen, The Netherlands
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Clinical reliability of self-adhesive luting resins compared to other adhesive procedures: A systematic review and meta-analysis. J Dent 2023; 129:104394. [PMID: 36566829 DOI: 10.1016/j.jdent.2022.104394] [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: 10/21/2022] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES This systematic review aimed to collect and interpret the randomized clinical trials (RCTs) that investigated the outcome of the self-adhesive luting resins (SA) compared to total-etch (TE), selective etch with dentin adhesives (Sle), selective etch without dentin adhesives (SleSA) or self-etch adhesives (SE). DATA SOURCES A thorough search of Internet databases was conducted without language restrictions, and the search ran up to and including April 2022. The illegible records citations were checked for more relevant clinical studies. STUDY SELECTION/RESULTS The inclusion criteria were randomized controlled trials (RCTs) that compared self-adhesive luting resins with total-etch, selective-etch, or self-etch adhesives regarding postoperative sensitivity, incidences of debonding, and survival rates of indirect restorations. From 1732 records, 9 RCTs met the eligibility criteria. Three RCTs compared total-etch adhesive to self-adhesive luting resin for intracoronal restorations, one RCT compared selective etch to self-adhesive luting resin for inlays, and 5 RCTs compared self-adhesive to other protocols for partial ceramic crowns. Postoperative sensitivity showed a non-statistically significant difference between SA and other adhesive protocols, SA revealed a non-statistically significant difference in debonding and survival to TE, but a lower statistically significant difference to Sle, SleSA, and SE. CONCLUSIONS Postoperative sensitivity might not be affected by the adhesive protocol. In relatively short observation, TE revealed comparable survival to SA for intracoronal restorations. SE and Sle exhibited the best clinical outcomes, followed by SleSA. Selective etch, and self-etch adhesives are preferable to self-adhesive resins. CLINICAL SIGNIFICANCE The significance of enamel etching and the superiority of self-etching adhesives over self-adhesive luting resins for reliable and durable bonding and improved clinical outcomes. However, long-term RCTs, particularly for total-etch comparison to self-adhesive luting resins, might be recommended to derive further evidence.
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Cui H, You Y, Cheng GW, Lan Z, Zou KL, Mai QY, Han YH, Chen H, Zhao YY, Yu GT. Advanced materials and technologies for oral diseases. SCIENCE AND TECHNOLOGY OF ADVANCED MATERIALS 2023; 24:2156257. [PMID: 36632346 PMCID: PMC9828859 DOI: 10.1080/14686996.2022.2156257] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/15/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
Oral disease, as a class of diseases with very high morbidity, brings great physical and mental damage to people worldwide. The increasing burden and strain on individuals and society make oral diseases an urgent global health problem. Since the treatment of almost all oral diseases relies on materials, the rapid development of advanced materials and technologies has also promoted innovations in the treatment methods and strategies of oral diseases. In this review, we systematically summarized the application strategies in advanced materials and technologies for oral diseases according to the etiology of the diseases and the comparison of new and old materials. Finally, the challenges and directions of future development for advanced materials and technologies in the treatment of oral diseases were refined. This review will guide the fundamental research and clinical translation of oral diseases for practitioners of oral medicine.
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Affiliation(s)
- Hao Cui
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Yan You
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Guo-Wang Cheng
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhou Lan
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Ke-Long Zou
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Qiu-Ying Mai
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yan-Hua Han
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hao Chen
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Yu-Yue Zhao
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Guang-Tao Yu
- Stomatological Hospital, Southern Medical University, Guangzhou, China
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Zhu X, Shi J, Ye X, Ma X, Zheng M, Yang Y, Tan J. Influence of Cold Atmospheric Plasma on Surface Characteristics and Bond Strength of a Resin Nanoceramic. MATERIALS (BASEL, SWITZERLAND) 2022; 16:44. [PMID: 36614395 PMCID: PMC9821266 DOI: 10.3390/ma16010044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/07/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
The purpose of this study was to investigate the effect of cold atmospheric plasma (CAP) treatment on resin nanoceramic (RNC) surface state and its bond strength with resin cement. RNC with different surface treatments were prepared: control, sandblasting treatment (SB), hydrofluoric acid etching (HF) and plasma treatment of helium gas (CAP-He) and argon gas (CAP-Ar). The prepared samples were measured by SEM, Ra, Rz, contact angle goniometer, and XPS for surface characteristics. The shear bond test of RNC was examined in nine groups: SB + saline coupling agent (SL), HF + SL, CAP-He/Ar, CAP-He/Ar + SL, SB + CAP-He/Ar + SL, and control. The bond strength between RNC and resin cement was compared using shear bond strength test, before and after thermocycling. After CAP irradiation, the surface topography maintained, while the surface water contact angle was significantly reduced to 10.18° ± 1.36° (CAP-He) and 7.58° ± 1.79° (CAP-Ar). The removal of carbon contamination and inducing of oxygen radicals was detected after CAP treatment. The bond strength was improved by CAP treatment, but varied on CAP gas species and combination methods. CAP of Ar gas had better SBS than He gas. After thermocycling, CAP-Ar + SL showed the maximized shear bond strength (32.38 ± 1.42 MPa), even higher than SB + SL group (30.08 ± 2.80 MPa, p < 0.05). In conclusion, CAP treatment of helium and argon can improve the bonding properties of RNC by improving surface wettability, and CAP of argon gas combined with silane coupling agent shows the highest bond strength.
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Affiliation(s)
- Xiaoming Zhu
- Second Clinical Division, Peking University School and Hospital of Stomatology, Beijing 100101, China
- National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Jiamin Shi
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China
| | - Xinyi Ye
- National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Xinrong Ma
- Department of Stomotology, Peking University Third Hospital, Beijing 100191, China
| | - Miao Zheng
- Department of Stomotology, Peking University Third Hospital, Beijing 100191, China
| | - Yang Yang
- National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Jianguo Tan
- National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China
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Wang B, Fan J, Wang L, Xu B, Wang L, Chai L. Onlays/partial crowns versus full crowns in restoring posterior teeth: a systematic review and meta-analysis. Head Face Med 2022; 18:36. [PMID: 36411462 PMCID: PMC9677648 DOI: 10.1186/s13005-022-00337-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/20/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Tooth-colored onlays and partial crowns for posterior teeth have been used increasingly in clinics. However, whether onlays/partial crowns could perform as well as full crowns in the posterior region was still not evaluated thoroughly. METHODS A literature search was conducted without language restrictions in Pubmed, Embase, Cochrane Central Register of Controlled Trial and Web of science until September 2021. RCTs, prospective and retrospective observational studies with a mean follow-up of 1 year were selected. Cochrane Collaboration's tool was adopted for quality assessment of the RCT. The quality of observational studies was evaluated following Newcastle-Ottawa scale. The random-effects and fixed-effects model were employed for meta-analysis. RESULTS Four thousand two hundred fifty-seven articles were initially searched. Finally, one RCT was identified for quality assessment and five observational studies for qualitative synthesis and meta-analysis. The RCT was of unclear risk of bias while five observational studies were evaluated as low risk. The meta-analysis indicated no statistically significant difference in the survival between onlays/partial crowns and full crowns after 1 year (OR = 0.55, 95% CI: 0.02-18.08; I2 = 57.0%; P = 0.127) and 3 years (OR = 0.65, 95% CI: 0.20-2.17; I2 = 0.0%; P = 0.747). For the success, onlays/partial crowns performed as well as crowns (OR = 0.58, 95% CI: 0.20-1.72; I2 = 0.0%; P = 0.881) at 3 years. No significant difference of crown fracture existed between the two methods (RD = 0.00, 95% CI: - 0.03-0.03; I2 = 0.0%; P = 0.972). CONCLUSIONS Tooth-colored onlays/partial crowns performed as excellently as full crowns in posterior region in a short-term period. The conclusions should be further consolidated by RCTs with long-term follow-up.
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Affiliation(s)
- Bingjie Wang
- grid.203507.30000 0000 8950 5267Department of Stomatology, The Affiliated People’s Hospital of Ningbo University (Ningbo Yinzhou People’s Hospital), No.251, Baizhang Road(E), Ningbo, 315000 China
| | - Jiayan Fan
- grid.459833.00000 0004 1799 3336Department of Stomatology, Ningbo No.2 Hospital, Ningbo, 315000 China
| | - Lutao Wang
- grid.459833.00000 0004 1799 3336Department of Stomatology, Ningbo No.2 Hospital, Ningbo, 315000 China
| | - Bin Xu
- grid.459833.00000 0004 1799 3336Department of Stomatology, Ningbo No.2 Hospital, Ningbo, 315000 China
| | - Liang Wang
- grid.459833.00000 0004 1799 3336Department of Stomatology, Ningbo No.2 Hospital, Ningbo, 315000 China
| | - Luyi Chai
- grid.203507.30000 0000 8950 5267Department of Stomatology, The Affiliated People’s Hospital of Ningbo University (Ningbo Yinzhou People’s Hospital), No.251, Baizhang Road(E), Ningbo, 315000 China
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McGrath CE, Bonsor SJ. Survival of direct resin composite onlays and indirect tooth-coloured adhesive onlays in posterior teeth: a systematic review. Br Dent J 2022:10.1038/s41415-022-4395-3. [PMID: 35725911 DOI: 10.1038/s41415-022-4395-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/06/2022] [Indexed: 11/08/2022]
Abstract
Objective To compare the survival of direct resin-composite used as onlays and indirect tooth-coloured adhesive onlays in posterior teeth, along with modes of failure, deterioration and variables affecting survival.Materials and methods PubMed, Embase, The Cochrane Library, Web of Science and Scopus were searched systematically up to 16 October 2020. In total, 3,768 studies were screened, with their results for survival, failure mode, deterioration and variables affecting survival.Results In total, 30 studies were selected. Survival rates in included studies greater than three years in length were 73.1-100%, with a median survival of 92.5% and median follow-up length of 5.1 years. The most prevalent failure mode was fracture, followed by pulpal episodes, debonding and caries. The most prevalent deterioration criteria were loss of marginal integrity and discolouration.Conclusions Survival of direct resin composite onlays and indirect tooth-coloured adhesive onlays in posterior teeth is acceptable (73.1-100%) in the medium-term. There is a need for more studies on direct cusp covering resin composite restorations, zirconia onlays and studies comparing material types. Fracture was the most prevalent failure mode. Restoration margins were the most prevalent area of deterioration.Clinical significance Direct and indirect tooth-coloured adhesive onlays can be a reliable and more conservative way to restore posterior teeth across a range of material options.
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Affiliation(s)
- Colin E McGrath
- Tier 2 Practitioner, DPHC Restorative Managed Clinical Network, Dental Centre Leconfield, HU17 7LX, UK.
| | - Stephen J Bonsor
- Dental Surgeon, The Dental Practice, 21 Rubislaw Terrace, Aberdeen, UK; Online Tutor and Clinical Lecturer, University of Edinburgh, UK; Senior Clinical Lecturer, Institute of Dentistry, University of Aberdeen, UK
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Canatan S, Oz FD, Bolay S. A randomized, controlled clinical evaluation of two resin cement systems in the adhesion of CAD/CAM-fabricated resin nanoceramic restorations: 18-month preliminary results. J ESTHET RESTOR DENT 2022; 34:1005-1014. [PMID: 35388956 DOI: 10.1111/jerd.12910] [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: 11/04/2021] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this clinical study was to evaluate the performance of two different adhesive resin cement systems in the cementation of inlay/onlay restorations produced from resin nanoceramic blocks using the CAD/CAM system. MATERIALS AND METHODS A total of 70 inlay/onlay restorations made from Cerasmart (GC, Tokyo, Japan) resin nanoceramic blocks using CEREC Omnicam (Sirona Dental, Bensheim, Germany) were placed in 53 patients. The restorations were cemented with RelyX U200 Automix (3M ESPE, Seefeld, Germany) self-adhesive resin cement (RXU) after selective enamel etching or with G-CEM LinkForce (GC, Tokyo, Japan) adhesive resin cement (GCL) in combination with a universal adhesive (G-Premio Bond) in selective etch mode. At baseline and after 6, 12, and 18 months, restorations were examined by two calibrated clinicians according to modified USPHS criteria. The data were analyzed using Chi-square (χ2 ) test and Friedman test (p < 0.05). RESULTS After 18 months, two teeth at RXU group were endodontically treated due to hypersensitivities. At GCL group, three restorations were lost due to debondings (2) and ceramic fracture (1). The survival rates of RXU (94.3%) and GCL group (91.4%) exhibited no statistically significant difference (p = 0.661). No significant differences were detected for surface texture, secondary caries, anatomic form, color match, marginal discoloration, marginal integrity, interproximal contacts, and patient satisfaction (p > 0.05). CONCLUSIONS The two resin cement systems showed acceptable clinical performance for the cementation of resin nanoceramic CEREC Omnicam inlay/onlay restorations. CLINICAL SIGNIFICANCE Resin nanoceramic restorations fabricated using CEREC Omnicam and cemented with either a self-adhesive or a universal adhesive/resin cement system demonstrated clinically acceptable results for posterior teeth in a single visit.
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Affiliation(s)
| | - Fatma Dilsad Oz
- Department of Restorative Dentistry, Hacettepe University, Ankara, Turkey
| | - Sukran Bolay
- Department of Restorative Dentistry, Hacettepe University, Ankara, Turkey
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Dimensional changes of CAD/CAM polymer crowns after water aging – An in vitro experiment. J Mech Behav Biomed Mater 2022; 128:105109. [DOI: 10.1016/j.jmbbm.2022.105109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/23/2022] [Accepted: 01/29/2022] [Indexed: 11/18/2022]
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15
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Fathy H, Hamama HH, El-Wassefy N, Mahmoud SH. Clinical performance of resin-matrix ceramic partial coverage restorations: a systematic review. Clin Oral Investig 2022; 26:3807-3822. [PMID: 35320383 PMCID: PMC9072524 DOI: 10.1007/s00784-022-04449-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/12/2022] [Indexed: 11/30/2022]
Abstract
Objective To evaluate clinical performance of the new CAD/CAM resin-matrix ceramics and compare it with ceramic partial coverage restorations. Materials and methods An electronic search of 3 databases (The National Library of Medicine (MEDLINE/PubMed), Scopus, and the Cochrane Central Register of Controlled Trials) was conducted. English clinical studies published between 2005 and September 2020 that evaluated the clinical performance of CAD/CAM resin-matrix ceramics inlays, onlays, or overlays were selected. The primary clinical question was applied according to PICOS strategy (Population, Intervention, Comparison, Outcome, Study design). The included studies were individually evaluated for risk of bias according to the modified Cochrane Collaboration tool criteria. Results A total of 7 studies were included according to the established inclusion and exclusion criteria. From the included studies, 6 were randomized clinical trials while one study was longitudinal observational study without control group. According to the results of the included studies, the success rate of CAD/CAM resin-based composite ranged from 85.7 to 100% whereas the success rate reported for ceramic partial coverage restorations ranged from 93.3 to 100%. Fractures and debondings are found to be the most common cause of restorations failure. Conclusion CAD/CAM resin-based composite can be considered a reliable material for partial coverage restorations with clinical performance similar to glass ceramic restorations. However, this result needs to be confirmed in long-term evaluations. Clinical relevance CAD/CAM resin-based composites provide a potential alternative to ceramic indirect restorations. However, clinicians must be aware of the lake of knowledge regarding long-term outcome.
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Affiliation(s)
- Hanan Fathy
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Algomhoria St, Mansoura City, 35516, Egypt
| | - Hamdi H Hamama
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Algomhoria St, Mansoura City, 35516, Egypt.
| | - Noha El-Wassefy
- Dental Biomaterials Science Dept, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Salah H Mahmoud
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Algomhoria St, Mansoura City, 35516, Egypt
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Chairside CAD/CAM Materials: Current Trends of Clinical Uses. BIOLOGY 2021; 10:biology10111170. [PMID: 34827163 PMCID: PMC8614873 DOI: 10.3390/biology10111170] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 12/26/2022]
Abstract
Simple Summary The interest in chairside Computer-aided design/computer-assisted manufacturing (CAD/CAM) restorations has increased the diversity of the restorative material. The promise of accurate, esthetic restorations delivered rapidly to the patient has manly benefits for clinicians in the light of minimally invasive dentistry dictates. New materials have been developed by the industry in order to offer ceramic, composite, and hybrid materials with optimized properties, suitable mechanical and aesthetic features. However, this comes at the expense of making the application more complicated. This article is aimed at providing an overview regarding the main advantages and disadvantages of the CAD/CAM chairside materials. Abstract Restorative materials are experiencing an extensive upgrade thanks to the use of chairside Computer-aided design/computer-assisted manufacturing (CAD/CAM) restorations. Therefore, due to the variety offered in the market, choosing the best material could be puzzling for the practitioner. The clinical outcome of the restoration is influenced mainly by the material and its handling than by the fabrication process (i.e., CAD/CAM). Information on the restorative materials performances can be difficult to gather and compare. The aim of this article is to provide an overview of chairside CAD/CAM materials, their classification, and clinically relevant aspects that enable the reader to select the most appropriate material for predictable success.
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Rinke S, Zuck T, Hausdörfer T, Leha A, Wassmann T, Ziebolz D. Prospective clinical evaluation of chairside-fabricated zirconia-reinforced lithium silicate ceramic partial crowns-5-year results. Clin Oral Investig 2021; 26:1593-1603. [PMID: 34415434 PMCID: PMC8816527 DOI: 10.1007/s00784-021-04132-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 08/06/2021] [Indexed: 10/31/2022]
Abstract
OBJECTIVES A university-based randomized clinical study evaluated the 5-year performance of chairside-fabricated zirconia-reinforced lithium silicate (ZLS)-ceramic partial crowns. MATERIAL AND METHODS Forty-five patients were restored with 61 chairside-fabricated ZLS-restorations (Cerec SW 4.2, Dentsply Sirona, Germany; Vita Suprinity, Vita Zahnfabrik, Germany). Deviating from the manufacturers' recommendations, restorations with reduced minimum material thicknesses (MMT) were fabricated: group 1, MMT = 0.5-0.74 mm (n = 31); group 2, MMT = 0.75-1.0 mm (n = 30). For luting, a self-adhesive cement (SAC) or a total-etch technique with a composite cement (TEC) was applied. Statistical evaluation was performed by time-to-event analysis (Kaplan-Meier). Possible covariates of the survival (SVR) and success rates (SCR), evaluated in a Cox regression model, were MMT, restoration position (premolar/molar), and cementation technique (SAC vs. TEC). RESULTS Forty patients (54 restorations, premolars, n = 23; molars, n = 31) participated in the 5-year follow-up. Five losses due to ceramic fractures occurred in group 1 (n = 28) (SVR: 83.0% [95% confidence interval (CI): 0.71-0.96]). Group 2 (n = 26) showed no losses (SVR: 100%). The success rate for partial crowns placed on premolars was 100% and 69% (95% CI: 0.54-0.84) for molar restorations. Recementation was required in 4 restorations with SAC (SCR: 86% [95% CI: 0.73-0.99]; SCR-DC: 100%). Restorations in group 2 showed a significantly reduced risk of material fracture hazard ratio (HR) = 0.09, p = 0.0292) compared with the restorations in group 1. Molar partial crowns showed an increased risk for a clinical intervention (HR = 5.26, p = 0.0222) compared to premolar restorations. CONCLUSIONS Material thickness and position of the restoration are risk factors influencing the survival and success rate of ZLS-ceramic partial crowns. CLINICAL RELEVANCE Observation of an MMT of at least 0.75-1.0 mm for ZLS-ceramics is essential to avoid material-related fractures. CLINICAL TRIAL REGISTRATION German Clinical Trails Register (trial number: DRKS00005611).
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Affiliation(s)
- Sven Rinke
- Department of Prosthodontics, University Medical Center, Robert-Koch-Str. 40, 37075, Goettingen, Germany.
| | - Tanja Zuck
- Department of Prosthodontics, University Medical Center, Robert-Koch-Str. 40, 37075, Goettingen, Germany
| | - Tim Hausdörfer
- Department of Preventive Dentistry, Periodontology, and Cariology, University Medical Center, Goettingen, Germany
| | - Andreas Leha
- Department of Medical Statistics, University Medical Center, Goettingen, Germany
| | - Torsten Wassmann
- Department of Prosthodontics, University Medical Center, Robert-Koch-Str. 40, 37075, Goettingen, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University Medical Center, Leipzig, Germany
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Clinical Evaluation of Resin Composite CAD/CAM Restorations Placed by Undergraduate Students. J Clin Med 2021; 10:jcm10153269. [PMID: 34362055 PMCID: PMC8348683 DOI: 10.3390/jcm10153269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/17/2021] [Accepted: 07/22/2021] [Indexed: 12/03/2022] Open
Abstract
To evaluate the clinical outcomes of resin composite CAD/CAM restorations in a prospective cohort study, and to assess patient and operator satisfaction after restoration placement, 59 indirect resin composite were placed by supervised undergraduate students, of which 43 restorations were followed over a mean period of 28 months (14–44 months) and evaluated using USPHS criteria. Patient and operator satisfaction levels were assessed using a visual analogue scale (VAS) after restoration placement. A total of 37 patients and 47 restorations were included for further study. Four teeth were extracted—three due to extensive drug-induced secondary caries in the same patient, and one tooth due to large periapical periodontitis after 44 months of service. The overall survival rate was 91.4%, and success rate was 87.2%. Differences between baseline and endpoint scores were significant for marginal discoloration (p < 0.05) and adaptation (p < 0.001). Color match (p < 0.05) and surface texture (p < 0.001) differed significantly, affecting all restoration types. VAS scores for patient and operator satisfaction showed a significant rank correlation (p < 0.01), and pairwise comparison showed significant differences for mean overall patient and operator VAS scores (p < 0.001). Lava Ultimate CAD/CAM may be considered a suitable material for overlays and endocrown restorations when combined with IDS, air abrasion, and MDP-containing adhesive systems. Marginal disintegration may present in inlays and onlays over time.
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Clinical Behavior of Ceramic, Hybrid and Composite Onlays. A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207582. [PMID: 33086485 PMCID: PMC7589045 DOI: 10.3390/ijerph17207582] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/11/2020] [Accepted: 10/16/2020] [Indexed: 12/28/2022]
Abstract
A systematic review and meta-analysis was performed to analyze the survival of onlay restorations in the posterior region, their clinical behavior according to the material used (ceramic reinforced with lithium disilicate, conventional feldspathic ceramic or reinforced with leucite; hybrid materials and composite), possible complications, and the factors influencing restoration success. The systematic review was based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, without publication date or language restrictions. An electronic search was made in the PubMed, Scopus, Embase, and Cochrane databases. After discarding duplicate publications and studies that failed to meet the inclusion criteria, the articles were selected based on the population, intervention, comparison, outcome (PICO) question. The following variables were considered in the qualitative and quantitative analyses: restoration survival rate (determined by several clinical parameters), the influence of the material used upon the clinical behavior of the restorations, and the complications recorded over follow-up. A total of 29 articles were selected for the qualitative analysis and 27 for the quantitative analysis. The estimated restoration survival rate was 94.2%. The predictors of survival were the duration of follow-up (beta = −0.001; p = 0.001) and the onlay material used (beta = −0.064; p = 0.028). Composite onlays were associated with a lower survival rate over time. Onlays are a good, conservative, and predictable option for restoring dental defects in the posterior region, with a survival rate of over 90%. The survival rate decreases over time and with the use of composite as onlay material.
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