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Rinke S, Schmidt E, Leha A, Roediger M, Ziebolz D. Multicenter Prospective Clinical Study on Chairside-Fabricated Partial Crowns: 5-Year Results for Lithia-Zirconia Glass-Ceramic Restorations. J ESTHET RESTOR DENT 2024. [PMID: 39381856 DOI: 10.1111/jerd.13328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 09/08/2024] [Accepted: 09/20/2024] [Indexed: 10/10/2024]
Abstract
OBJECTIVES Clinical evaluation of chairside-fabricated lithia-zirconia glass-ceramic (LZGC) partial crowns (CCPCs) in a multicenter practice-based study. MATERIALS AND METHODS Seventy-one patients were restored with 92 adhesively luted CCPCs (Cerec SW 4.2/Cerec MC XL/Celtra Duo) in three private dental clinics (C1-C3). Time-dependent (Kaplan-Meier) survival rates (SVR) and success rates (SCR) were calculated. The following possible covariates of SVRs and SCRs were evaluated in a Cox regression model: Restoration position (premolar/molar), luting material (Variolink/Calibra), and operator (C1-C3). RESULTS Seventy-three CCPCs were placed in 59 patients and were included in the study (mean observational period: 58.0 ± 15 months). Four complete failures (two tooth fractures, one restoration fracture, and one endodontic failure) were recorded. All failures and interventions occurred in one of the three centers (5-year SCR: C1 + C2: 100%; C3: 71%; 95% confidence interval: [0.55; 0.87]). Additionally, three biological, and two technical complications required clinical intervention to maintain function, and all occurred in C3. Restorations placed in C1 and C2 showed a significantly reduced risk for failure/intervention (hazard ratio = 0.103, p = 0.026) compared with restorations placed in C3. CONCLUSIONS LZGC CCPCs showed good five-year clinical performance. However, SVRs and SCRs were significantly influenced by the operator. Additional clinical data are required for a more detailed investigation of this effect.
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Affiliation(s)
- Sven Rinke
- Department of Prosthodontics, University Medical Center, Goettingen, Germany
| | - Emanuel Schmidt
- Department of Prosthodontics, University Medical Center, Goettingen, Germany
| | - Andreas Leha
- Department of Medical Statistics, University Medical Center, Goettingen, Germany
| | - Matthias Roediger
- Department of Prosthodontics, University Medical Center, Goettingen, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University Medical Center, Leipzig, Germany
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2
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Takenaka H, Yoshida K, Sawase T. Wear characteristics of resin-based luting agents used in the bonded CAD-CAM resin blocks. Dent Mater J 2024:2024-137. [PMID: 39313369 DOI: 10.4012/dmj.2024-137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
This study aimed to investigate the wear and microhardness of luting agents and computer-aided design-computer-aided manufacturing (CAD-CAM) resin blocks, and to compare the wear characteristics of resin-based luting agents used in bonded specimens of CAD-CAM resin blocks. After three-body wear test, the amount of wear and Vickers hardness were measured and Pearson's correlation coefficient was calculated. The lowest amount of wear and the highest Vickers hardness values were obtained for Estecem II. Filler loss was observed in five composite resin cements. A strong negative correlation was observed in the luting agents between the amount of wear and Vickers hardness value (r=-0.874, p<0.0001). Additionally, a strong positive correlation was observed between the amount of wear of the bonded specimen and amount of luting agent used alone (r=0.943, p<0.0001). To conclude, the wear resistance of the luting agent used in the bonded specimen was significantly influenced by the bonding between the filler and matrix resin.
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Affiliation(s)
- Hiroto Takenaka
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University
| | - Keiichi Yoshida
- Clinic of Fixed Prosthodontics, Nagasaki University Hospital
| | - Takashi Sawase
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University
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3
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Eggmann F, Orta AL, Abdulmajeed A, Att W, Beuer F, Bergler M, Blatz MB, Brief J, Castro VE, Cooper LF, Han S, Ortiz MA, Paravina RD, Pizzi P, Tholey MJ, Conejo J. Interdisciplinary Delphi study by PROSEC North America: Recommendations on single indirect restorations made from ceramic and nonmetallic biomaterials for posterior teeth. J ESTHET RESTOR DENT 2024. [PMID: 39093128 DOI: 10.1111/jerd.13289] [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: 03/22/2024] [Revised: 07/05/2024] [Accepted: 07/18/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVE This article puts forward consensus recommendations from PROSEC North America regarding single indirect restorations made from ceramic and nonmetallic biomaterials in posterior teeth. OVERVIEW The consensus process involved a multidisciplinary panel and three consensus workshops. A systematic literature review was conducted across five databases to gather evidence. The recommendations, informed by findings from systematic reviews and formulated based on a two-phase e-Delphi survey, emphasize a comprehensive treatment strategy that includes noninvasive measures alongside restorative interventions for managing dental caries and tooth wear. The recommendations advocate for selecting between direct and indirect restorations on a case-by-case basis, favoring inlays and onlays over crowns to align with minimally invasive dentistry principles. The recommendations highlight the critical role of selecting restorative biomaterials based on clinical performance, esthetic properties, and adherence to manufacturer guidelines. They emphasize the importance of precision in restorative procedures, including tooth preparation, impression taking, contamination control, and luting. Regular follow-up and maintenance tailored to individual patient needs are crucial for the longevity of ceramic and nonmetallic restorations. CONCLUSIONS These PROSEC recommendations provide a framework for dental practitioners to deliver high-quality restorative care, advocating for personalized treatment planning and minimally invasive approaches to optimize oral health outcomes. CLINICAL SIGNIFICANCE The PROSEC North America recommendations highlight the importance of minimally invasive techniques in posterior tooth restorations using ceramic and non-metallic biomaterials. These principles prioritize tooth structure conservation and personalized treatment planning, essential for enhancing clinical outcomes and long-term oral health.
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Affiliation(s)
- Florin Eggmann
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Periodontology, Endodontology, and Cariology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Amelia L Orta
- Department of Advanced Oral Sciences and Therapeutics, Division of Prosthodontics, University of Maryland School of Dentistry, University of Maryland, Baltimore, Maryland, USA
- Department of Restorative Sciences, Advanced Education in Prosthodontics, The Dental College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Awab Abdulmajeed
- Department of General Practice and Prosthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Wael Att
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Michael Bergler
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Markus B Blatz
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jakob Brief
- PROSEC gGmbH, Bad Säckingen, Germany
- VITA Zahnfabrik, Bad Säckingen, Germany
| | | | - Lyndon F Cooper
- School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sean Han
- Master's Arch, Phoenix, Arizona, USA
| | - Miguel A Ortiz
- Department of Restorative Dentistry, University of Illinois College of Dentistry, Chicago, Illinois, USA
| | - Rade D Paravina
- Department of Restorative Dentistry and Prosthodontics, John M. Powers, PhD, Center for Biomaterials and Biomimetics, The University of Texas School of Dentistry at Houston, Houston, Texas, USA
| | - Peter Pizzi
- Pizzi Dental Studio, Staten Island, New York, USA
| | - Michael J Tholey
- PROSEC gGmbH, Bad Säckingen, Germany
- VITA Zahnfabrik, Bad Säckingen, Germany
| | - Julián Conejo
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Jurado CA, Mekled S, Abuhammoud S, Azpiazu-Flores FX, Vegh D, Wang T, Morton D. Fracture resistance of partial and complete coverage veneers and ceramic crowns for maxillary central incisors. J Prosthet Dent 2024; 132:420.e1-420.e6. [PMID: 38729791 DOI: 10.1016/j.prosdent.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/18/2024] [Accepted: 04/20/2024] [Indexed: 05/12/2024]
Abstract
STATEMENT OF PROBLEM Minimally invasive treatments have gained popularity in recent years. However, research comparing the fracture resistance of lithium disilicate partial coverage veneer restorations with that of ceramic crowns is lacking. PURPOSE The purpose of this in vitro study was to evaluate and compare the fracture resistance of lithium disilicate restorations fabricated for preparations of various designs. The designs included veneer preparations with finish lines in the upper, middle, and lower third of the facial surface and ceramic crown preparations with margins in the lower third of the facial surface. All restorations were designed and fabricated using a chairside digital workflow. MATERIAL AND METHODS Four maxillary right central incisor typodont teeth were prepared for partial coverage veneer preparation with the margin in the upper middle third of the facial surface (PU1/3); partial coverage veneer preparation with margin in lower middle third of the facial surface (PL1/3); complete coverage veneer preparation (CV) with margin in the cervical region; and ceramic crown (CC) preparation. Each preparation was scanned, and 15 casts were 3D printed from each scan. A total of 60 lithium disilicate restorations were fabricated (n=15 per group) using a chairside computer-aided design and computer-aided manufacturing (CAD-CAM) system (Primescan and MCXL). The different restorations were cemented to the 3D printed testing dies with a photopolymerizable resin cement. The specimens were artificially aged with 10 000 thermal cycles between 5 and 55 °C with a dwell time of 30 seconds and were loaded to failure using a universal testing machine. The maximum load to fracture was analyzed using a 1-way ANOVA and post hoc Tukey honestly significant difference (HSD) test (α=.05). Additionally, the fracture patterns of the specimens were evaluated with a stereomicroscope for descriptive purposes. RESULTS The mean fracture resistance of the chairside CAD-CAM lithium disilicate veneers and ceramic crowns was statistically different depending on the design of the restoration (P<.05). Group CC demonstrated the highest fracture resistance values (1440.66 N), followed by CV (929.8 N) and PU1/3 (756.13 N). The lowest value was for PL1/3 (532.4 N). CONCLUSIONS The fracture resistance measured for the maxillary central incisor partial coverage veneers with margins in the middle third of the facial surface appear capable of resisting average occlusal forces. However, these veneers demonstrated lower fracture resistance values when compared with complete coverage veneers. Further, lithium disilicate crowns demonstrated higher fracture resistance than veneers, irrespective of their design.
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Affiliation(s)
- Carlos A Jurado
- Associate Professor and Director, Operative Dentistry Division, The University of Tennessee Health Science Center, Memphis, Tenn
| | - Salwa Mekled
- Clinical Associate Professor, Restorative Dentistry Department, Temple University Kornberg School of Dentistry, Philadelphia, Pa
| | - Salahaldeen Abuhammoud
- Associate Professor, Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa
| | | | - Daniel Vegh
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Ting Wang
- Prosthodontic Resident, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Ind
| | - Dean Morton
- Professor, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Ind; and Director, Center for Implant, Esthetic and Innovative Dentistry, Indiana University School of Dentistry, Indianapolis, Ind
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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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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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Mahat NS, Shetty NY, Kohli S, Jamayet NB, Patil P. Clinical outcomes of implant-supported and tooth-supported fixed prostheses fabricated from digital versus analogue impression: a systematic review and meta-analysis. Evid Based Dent 2023; 24:142. [PMID: 37369705 DOI: 10.1038/s41432-023-00904-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/15/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVE To analyze the clinical outcomes of implant-supported prostheses and tooth-supported fixed prostheses, fabricated from digital and conventional impression. MATERIALS AND METHODS The literature search was carried out on two electronic databases (PubMed and Cochrane Library). Randomized controlled trials (RCT) published from January 2011 to September 2022 were included. The bias risk was evaluated using Cochrane Risk of Bias Tool 2.0. Further screening was done for meta-analysis according to modified Newcastle-Ottawa scoring criteria. Forest plot was generated using a statistical method of inverse variance of random effect with 95% confidence interval. RESULTS A total of 8 randomized controlled trials were included for systematic review out of which four studies were based on tooth-supported fixed prosthesis and remaining four were based on implant-supported prosthesis. Further screening was conducted and three studies were eligible for meta-analysis. Tooth-supported fixed prosthesis fabricated from digital impression showed no significant difference in the marginal fit in any region measured, except for occlusal region where conventional impression showed more favorable marginal fit. Implant-supported prosthesis fabricated from digital impression showed survival rates ranging from 97.3 to 100% and there was no statistically significant difference in marginal bone loss (p = 0.14). CONCLUSION Implant-supported prostheses fabricated from digital and conventional impressions show no significant differences in their clinical outcomes. Tooth-supported fixed prostheses fabricated from digital impression have shown favorable findings in terms of marginal fit. Despite that, there is still lack of clinical trials with larger sample size and longer follow-up periods. Future studies that fulfill these two criteria are deemed necessary.
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Affiliation(s)
- Nur Safiani Mahat
- School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Naresh Yedthare Shetty
- Associate Professor, Department of Clinical Sciences, Ajman University, Ajman, UAE
- Centre of Medical and Biomedical Allied Health Sciences Research, Deanship of Graduate Studies and Research, Ajman, UAE
| | - Shivani Kohli
- Senior Lecturer, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.
| | - Nafij Bin Jamayet
- Senior Lecturer, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Pravinkumar Patil
- Associate Professor, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
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Ye Z, Jiang J, Yang L, Xu T, Lin Y, Luo F. Research Progress and Clinical Application of All-Ceramic Micro-Veneer. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2957. [PMID: 37109791 PMCID: PMC10141096 DOI: 10.3390/ma16082957] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/11/2023] [Accepted: 03/30/2023] [Indexed: 06/19/2023]
Abstract
Anterior teeth problems affect the patient's daily eating, communication, social activities, self-confidence, and mental health. The trend in dentistry is to address anterior tooth problems with minimally invasive and aesthetic treatments. With the development of adhesive materials and ceramics, micro-veneers have been proposed as an alternative treatment for enhancing the aesthetic appearance and avoiding unnecessary tooth reduction. A micro-veneer is a veneer that can be cemented to the surface without or with minimal tooth preparation. These benefits include no need for anesthesia, postoperative insensitivity, good adhesion to enamel, reversibility of treatment, and higher patient acceptance. However, the micro-veneer repair is suitable only for specific cases and must be strictly controlled regarding indication. Treatment planning is a crucial step to achieving functional and aesthetic rehabilitation, and following the clinical protocol is helpful for the longevity and success of micro-veneer restorations. However, more precise and predictable tooth preparation methods, such as minimally invasive microscopic tooth preparation and digitally guided veneer preparation, are recommended rather than the traditional free-hand method. Therefore, this paper clarifies micro-veneers and compares them with other restorations to gain a deeper and more comprehensive understanding. The authors also review indications, materials, cementation, and effect evaluation of micro-veneers to provide clinicians with valuable information. In conclusion, micro-veneers are minimally invasive treatments that provide good restoration results when used appropriately and are worthy of promotion for the aesthetic restoration of anterior teeth.
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Affiliation(s)
- Zhenwei Ye
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Jiapei Jiang
- Outpatient Department, Sichuan Electrical Power Hospital, Chengdu 610021, China
| | - Linxin Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Tingxiang Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yuanyou Lin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Feng Luo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China
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Aswal GS, Rawat R, Dwivedi D, Prabhakar N, Kumar V. Clinical Outcomes of CAD/CAM (Lithium disilicate and Zirconia) Based and Conventional Full Crowns and Fixed Partial Dentures: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e37888. [PMID: 37213959 PMCID: PMC10199723 DOI: 10.7759/cureus.37888] [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] [Accepted: 04/14/2023] [Indexed: 05/23/2023] Open
Abstract
Although CAD/CAM (computer-aided design/computer-aided manufacturing) restorations act as a favorable alternative to conventional metal-ceramic restorations for fixed dental prostheses, little is known about their intermediate and persistent clinical performance. This systematic review and meta-analysis aimed to assess the clinical performance in terms of biological, technical, and esthetic aspects and the survival and success ratios for single full crowns (SFCs) and fixed partial dentures (FPDs) fabricated by CAD/CAM and conventional techniques and according to the materials used (zirconia {ZC} and lithium disilicate {LD}). The population, intervention, control, outcome, and study design (PICOS) strategy was used to electronically search key terms in the PubMed, Cochrane Library, Embase, and Wiley Online databases for randomized control trials (RCTs) and cohort studies. The bias risks for RCTs and cohort studies were assessed using the Cochrane collaboration tool and the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using Rev5 from Cochrane. A total of 13 studies reporting on 1598 restorations in 1161 patients with a mean observation period of 3.6 years (minimum-maximum: 1-9.3 years) met the inclusion criteria. Meta-analysis of the included studies indicated that CAD/CAM manufacturing resulted in 1.17, 1.14, and 16.88 (95% CI: 0.64-2.17, 0.86-1.52, 7.59-37.56) higher biological, technical, and esthetic complications than conventional manufacturing of restorations. However, the difference was significant for esthetic complications only (p<0.00001). A significant difference was observed for all biological, technical, and aesthetic aspects between SFCs and FPDs (odds ratio {OR} = 2.61 vs. 1.78, 95% CI: 1.92-3.56 vs. 1.33-2.38; p<0.00001). The survival ratio of SFCs was 2.69 (95% CI: 1.98-3.65), significantly higher compared to the 1.76 (95% CI: 1.31-2.36) of FPDs (p<0.00001). The success ratio of FPDs at 1.18 (95% CI: 0.83-1.69) was significantly lower compared to SFCs at 2.36 (95% CI: 1.68-3.33). The clinical performance of LD with 2.42 (CI: 1.16-5.03) was significantly higher compared to ZC with 2.22 (CI: 1.78-2.77) (p<0.00001). The biological, technical, and aesthetic behaviors showed similar clinical outcomes between the CAD/CAM and conventional groups. LD could be a good alternative to zirconia, but its intermediate or persistent clinical performance needs to be evaluated. Overall, zirconia and CAD/CAM techniques must evolve further to outclass the conventional techniques used in the fabrication of SFCs and FPDs.
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Affiliation(s)
- Gunjan S Aswal
- Dentistry, The University of the West Indies, St. Augustine, TTO
| | - Renu Rawat
- Dentistry, The University of the West Indies, St. Augustine, TTO
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Robaian A, Alqahtani A, Alanazi K, Alanazi A, Almalki M, Aljarad A, Albaijan R, Maawadh A, Sufyan A, Mirza MB. Different Designs of Deep Marginal Elevation and Its Influence on Fracture Resistance of Teeth with Monolith Zirconia Full-Contour Crowns. Medicina (B Aires) 2023; 59:medicina59040661. [PMID: 37109619 PMCID: PMC10144512 DOI: 10.3390/medicina59040661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Background and objectives: Even with the demand for high esthetics, the strength of the material for esthetic applications continues to be important. In this study, monolith zirconia (MZi) crowns fabricated using CAD/CAM were tested for fracture resistance (FR) in teeth with class II cavity designs with varying proximal depths, restored through a deep marginal elevation technique (DME). Materials and Methods: Forty premolars were randomly divided into four groups of ten teeth. In Group A, tooth preparation was conducted and MZi crowns were fabricated. In Group B, mesio-occluso-distal (MOD) cavities were prepared and restored with microhybrid composites before tooth preparation and the fabrication of MZi crowns. In Groups C and D, MOD cavities were prepared, differentiated by the depth of the gingival seat, 2 mm and 4 mm below the cemento-enamel junction (CEJ). Microhybrid composite resin was used for DME on the CEJ and for the restoration of the MOD cavities; beforehand, tooth preparations were conducted and MZi crowns were and cemented using resin cement. The maximum load to fracture (in newtons (N)) and FR (in megapascals (MPa)) were measured using the universal testing machine. Results: The average scores indicate a gradual decrease in the load required to fracture the samples from Groups A to D, with mean values of 3415.61 N, 2494.11 N, 2108.25 N and 1891.95 N, respectively. ANOVA revealed highly significant differences between the groups. Multiple group comparisons using the Tukey HSD post hoc test revealed that Group D had greater DME depths and showed significant differences compared with Group B. Conclusions: FR in teeth decreased when more tooth structure was involved, even with MZi crowns. However, DME up to 2 mm below the CEJ did not negatively influence the FR. Strengthening the DME-treated teeth with MZi crowns could be a reasonable clinical option, as the force required to fracture the samples far exceeded the maximum recorded biting force for posterior teeth.
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Bonfante EA, Calamita M, Bergamo ETP. Indirect restorative systems-A narrative review. J ESTHET RESTOR DENT 2023; 35:84-104. [PMID: 36688803 DOI: 10.1111/jerd.13016] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The background and clinical understanding of the properties of currently available indirect restorative systems and fabrication methods is, along with manufacturer and evidence-based literature, an important starting point to guide the clinical selection of materials for tooth and/or implant supported reconstructions. Therefore, this review explores most indirect restorative systems available in the market, especially all-ceramic, along with aspects of manufacturing process, clinical survival rates, and esthetic outcomes. OVERVIEW Progressive incorporation of new technologies in the dental field and advancements in materials science have enabled the development/improvement of indirect restorative systems and treatment concepts in oral rehabilitation, resulting in reliable and predictable workflows and successful esthetic and functional outcomes. Indirect restorative systems have evolved from metal ceramics and polymers to glass ceramics, polycrystalline ceramics, and resin-matrix ceramics, aiming to improve not only biological and mechanical properties, but especially the optical properties and esthetic quality of the reconstructions, in attempt to mimic natural teeth. CONCLUSIONS Based on several clinical research, materials, and patient-related parameters, a decision tree for the selection of indirect restorative materials was suggested to guide clinicians in the rehabilitation process. CLINICAL SIGNIFICANCE The pace of materials development is faster than that of clinical research aimed to support their use. Since no single material provides an ideal solution to every case, professionals must continuously seek information from well designed, long-term clinical trials in order to incorporate or not new materials and technological advancements.
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Affiliation(s)
- Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry - University of São Paulo, Bauru, SP, Brazil
| | - Marcelo Calamita
- Department of Restorative Dental Sciences at the University of Florida, Gainesville, Florida, USA
| | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry - University of São Paulo, Bauru, SP, Brazil
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12
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Luo B, Sun X, He L, Zhao L, Liu X, Jiang Q. Impact of different axial wall designs on the fracture strength and stress distribution of ceramic restorations in mandibular first molar. BMC Oral Health 2022; 22:549. [PMID: 36456942 PMCID: PMC9714140 DOI: 10.1186/s12903-022-02577-5] [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: 10/11/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate the fracture strength and stress distribution of four ceramic restorations. METHODS Forty human mandibular first molars were collected and randomized into four groups after establishing the distal defect: full crown group with 4 mm axial wall height (AWH) (FC4); short AWH crown group with 2 mm AWH (SC2); occlusal veneer group with 0 mm AWH (OV0); occlusal distal veneer group with only the distal surface prepared, and 4 mm AWH (OD4). The teeth were prepared according to the groups and the ceramic restorations were completed using celtra duo ceramic blocks. The ceramic thickness of the occlusal surface is about 1.5 mm and the edge is about 1 mm. The failure load values and fracture modes of each group were detected by mechanical test in vitro. According to the groups to establish three-dimensional finite element analysis (FEA) models, a 600 N loading force was applied vertically using a hemispherical indenter with a diameter of 6 mm. and compare the stress distribution under the condition of different restorations. RESULTS In vitro mechanical tests showed that the failure load values were SC2 (3232.80 ± 708.12 N) > OD4 (2886.90 ± 338.72 N) > VO0 (2133.20 ± 376.15 N) > FC4(1635.40 ± 413.05 N). The failure load values of the short AWH crown and occlusal distal veneer were significantly higher than that of occlusal veneer and full crown (P<0.05). The fracture modes of the full crown and occlusal veneer groups were mainly ceramic fractures and some were restorable tooth fractures. The short AWH crown and occlusal distal veneer groups presented with three fracture modes, the proportion of non-restorable tooth fracture was higher. The results of FEA show that under the spherical loading condition, the stress of ceramic was concentrated in the contact area of the loading head, the maximum von Mises stress values were FC4 (356.2 MPa) > VO0 (214.3 MPa) > OD4 (197.9 MPa) > SC2 (163.1 MPa). The stress of enamel was concentrated in the area where the remaining enamel was thinner, the maximum von Mises stress values was OD4 (246.2 MPa) ≈ FC4 (212.4 MPa) > VO0 (61.8 MPa) ≈ SC2 (45.81 MPa). The stress of dentin is concentrated in the root furcation and the upper third region of the root. However, stress concentration was observed at the tooth cervix in the full crown. CONCLUSION Under certain conditions, the occlusal distal veneer shows better performance than the full crown.
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Affiliation(s)
- Bin Luo
- grid.24696.3f0000 0004 0369 153XDepartment of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 100050 Beijing, China
| | - Xiaolu Sun
- grid.479671.a0000 0004 9154 7430Shunyi Hospital, Beijing Traditional Chinese Medicine Hospital, 100010 Beijing, China
| | - Lin He
- grid.24696.3f0000 0004 0369 153XDepartment of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 100050 Beijing, China
| | - Lidan Zhao
- grid.410737.60000 0000 8653 1072Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, 510013 Guangzhou, China
| | - Xinggang Liu
- grid.24696.3f0000 0004 0369 153XDepartment of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 100050 Beijing, China
| | - Qingsong Jiang
- grid.24696.3f0000 0004 0369 153XDepartment of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 100050 Beijing, China
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13
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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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Clinical report of six-month follow-up after cementing PEEK crown on molars. Sci Rep 2022; 12:19070. [PMID: 36351981 PMCID: PMC9646781 DOI: 10.1038/s41598-022-23458-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 10/31/2022] [Indexed: 11/11/2022] Open
Abstract
We conducted a six-month clinical follow-up on computer-aided design/computer-aided manufacturing-fabricated molar polyetheretherketone PEEK crowns to investigate their therapeutic effect. Only the PEEK crowns were examined as our study focused on short-term clinical evaluation of the new PEEK material. Twenty-three cases of PEEK crowns placed on the molars of 20 subjects (7 males and 13 females, mean age: 60.6 ± 14.2 years) were included in the study. The evaluation items were the condition of the crowns at the time of cementation and after six months, patient satisfaction, masticatory ability, and occlusal force. Mann-Whitney U tests with a significance level of 5% were used to examine the difference in glucose concentration by masticatory ability, occlusal pressure, and occlusal force, with and without PEEK crowns. The occlusion, margin fit, and contact of all 23 cases at the time of cementing were good. Six months after cementation, there was no crown desorption, fracture or crack, and prosthodontics was not needed in the 22 cases (one patient dropped out). No wear of the dental antagonist was observed. Patient satisfaction was generally high. There was no significant difference in masticatory ability between the groups with and without PEEK crowns. The subject's occlusal force was within the normal range. PEEK crowns used on molars can replace metal crowns and hold promise for an appropriate and effective treatment.
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Chotiwutthiphatthana D, Angwaravong O, Angwarawong T. Effect of Different Indirect Composite Onlay and Core Materials on Fracture Resistance of Endodontically Treated Maxillary Premolars. J Prosthodont Res 2022. [PMID: 35979556 DOI: 10.2186/jpr.jpr_d_22_00049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To compare and evaluate the effects of different indirect composite onlay and/or core buildup materials on the fracture resistance and fracture mode of restored endodontically treated premolars. METHODS Two conventional handmade indirect composite resins (SR Nexco (NC) and Ceramage (CM)) and two core buildup materials, dual-cure composite resin (MultiCore Flow (MC)), and short fiber-reinforced composite resin (EverX Posterior (EXP)), were selected. Sixty maxillary premolars were randomly divided into six groups (n=10). Group 1 included intact teeth (INT; negative control). Mesio-occluso-distal cavity preparation and endodontic treatment was performed on the remaining premolars. Group 2 was restored with polymer-reinforced zinc oxide eugenol intermediate restorative material (IRM; positive control), whereas the experimental groups (groups 3-6) were restored with core buildup material and indirect composite onlay (MC_NC, MC_CM, EXP_NC, and EXP_CM). The specimens received compressive loading using a universal testing machine, at 45° to the long axis with a crosshead speed of 0.5 mm/min until fracture. Fracture modes were visually analyzed. Fracture resistance was measured and statistically analyzed using two-way and one-way ANOVA (α=0.05). RESULTS Only the type of indirect composite onlay affected the fracture resistance of the experimental groups (P=0.009). The MC_CM group showed the highest fracture resistance, which was significantly higher than that of the MC_NC group (P=0.031). No statistically significant differences were found between the INT group and other experimental groups(P>0.05). All groups had a greater incidence of restorable than unrestorable failures. CONCLUSION The type of indirect composite onlay affected the fracture resistance of restored endodontically treated maxillary premolars.
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Affiliation(s)
| | - Onauma Angwaravong
- Division of Pediatric Dentistry, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Thidarat Angwarawong
- Department of Prosthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
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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] [MESH Headings] [Grants] [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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17
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Javed F, Haji Z, Khan FR. Comments on Pulpal and Periapical Status of the Vital Teeth Used as Abutment for Fixed Prosthesis: A Systematic Review and Meta-Analysis. J Prosthodont 2021; 31:93. [PMID: 34967990 DOI: 10.1111/jopr.13466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Faizan Javed
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Zainab Haji
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Farhan Raza Khan
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
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18
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Kohli S, Bhatia S, Al-Haddad A, Pulikkotil SJ, Jamayet NB. Reply to Javed et al, 'Comments on Pulpal and Periapical Status of the Vital Teeth Used as Abutment for Fixed Prosthesis-A Systematic Review and Meta-Analysis'. J Prosthodont 2021; 31:94-95. [PMID: 34967986 DOI: 10.1111/jopr.13465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Shivani Kohli
- Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Shekhar Bhatia
- Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Afaf Al-Haddad
- Department of Conservative Dentistry, Faculty of Dentistry, MAHSA University, Selangor, Malaysia
| | - Shaju Jacob Pulikkotil
- Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Nafij Bin Jamayet
- Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
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Galiatsatos A, Galiatsatos P, Bergou D. Clinical Longevity of Indirect Composite Resin Inlays and Onlays: An Up to 9-Year Prospective Study. Eur J Dent 2021. [DOI: https://doi.org/10.1055/s-0041-1735420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Objective This clinical study evaluated the clinical performance of composite resin inlays and onlays over 9 years.
Materials and Methods Sixty composite resin inlays and onlays were placed in 32 patients, aged 20 to 60 years, by a single operator using the same clinical procedure. The restorations were examined for fracture rate; esthetics; and patient acceptance and marginal integrity, including caries, marginal discoloration, tooth integrity, and surface texture. All restorations were evaluated at the time of placement and 3, 6, and 9 years after placement by using the modified U.S. Public Health Service criteria.
Results At the 3-year follow-up, an Alpha score was given to 88.4% of restorations, while a Bravo score was given to the remaining 11.6%. There was not any failure. At the 6-year follow-up, the success rate of the restorations was 100% without failure. None of the restorations was scored with Delta (D). An Alpha score was given to 60% of the restorations, a Bravo score was assigned to 35%, and a Charlie score was 5% of the restorations. Overall, the success rate of the restorations at 9-year follow-up was 85% and the failure rate was 15%. An Alpha score was given to 15% of the restorations, a Bravo score was given to 50%, a Charlie score was assigned to 20%, and a D score was given to 15% of the restorations.
Conclusion Indirect resin composite inlays and onlays showed acceptable long-term clinical results. The success rate of the restorations at 9-year follow-up was 85% and the failure rate was 15%.
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Affiliation(s)
- Aristidis Galiatsatos
- Division of Dental Technology, Department of Biomedical Sciences, University of West Attica, Athens, Greece
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Galiatsatos A, Galiatsatos P, Bergou D. Clinical Longevity of Indirect Composite Resin Inlays and Onlays: An Up to 9-Year Prospective Study. Eur J Dent 2021; 16:202-208. [PMID: 34749421 PMCID: PMC8890907 DOI: 10.1055/s-0041-1735420] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE This clinical study evaluated the clinical performance of composite resin inlays and onlays over 9 years. MATERIALS AND METHODS Sixty composite resin inlays and onlays were placed in 32 patients, aged 20 to 60 years, by a single operator using the same clinical procedure. The restorations were examined for fracture rate; esthetics; and patient acceptance and marginal integrity, including caries, marginal discoloration, tooth integrity, and surface texture. All restorations were evaluated at the time of placement and 3, 6, and 9 years after placement by using the modified U.S. Public Health Service criteria. RESULTS At the 3-year follow-up, an Alpha score was given to 88.4% of restorations, while a Bravo score was given to the remaining 11.6%. There was not any failure. At the 6-year follow-up, the success rate of the restorations was 100% without failure. None of the restorations was scored with Delta (D). An Alpha score was given to 60% of the restorations, a Bravo score was assigned to 35%, and a Charlie score was 5% of the restorations. Overall, the success rate of the restorations at 9-year follow-up was 85% and the failure rate was 15%. An Alpha score was given to 15% of the restorations, a Bravo score was given to 50%, a Charlie score was assigned to 20%, and a D score was given to 15% of the restorations. CONCLUSION Indirect resin composite inlays and onlays showed acceptable long-term clinical results. The success rate of the restorations at 9-year follow-up was 85% and the failure rate was 15%.
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Affiliation(s)
- Aristidis Galiatsatos
- Division of Dental Technology, Department of Biomedical Sciences, University of West Attica, Athens, Greece
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Longevity of Polymer-Infiltrated Ceramic Network and Zirconia-Reinforced Lithium Silicate Restorations: A Systematic Review and Meta-Analysis. MATERIALS 2021; 14:ma14175058. [PMID: 34501148 PMCID: PMC8434158 DOI: 10.3390/ma14175058] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/22/2021] [Accepted: 08/31/2021] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to systematically review the existing literature to assess the clinical survival and success of PICN and ZLS indirect restorations as the clinical evidence for them remains lacking. PubMed, SCOPUS, Embase, Cochrane Library, Web of Science, LILACs, and SciElo databases were searched from 1 January 2000 to 1 February 2021. Clinical trials and cohort studies published in English were included while case studies, case series, and in vitro studies were excluded. Results were analyzed qualitatively and a meta-analysis using a random effects model was performed. A strength of recommendation taxonomy (SORT) analysis was conducted and risk of bias (RoB) was assessed using the Newcastle-Ottawa scale and Cochrane RoB tools. An electronic search through the databases yielded 2454 articles, of which 825 remained after duplicate removal. Five studies investigating PICN and four investigating ZLS indirect restorations remained after assessing for eligibility. The overall survival rate of PICN over 1 year was 99.6% and 99.2% over 2 years. The overall survival rate of ZLS over 1 year was 99%. The main mode of failure for both materials was catastrophic fracture. One study had a high RoB, four had a moderate RoB, and four had a low RoB. Both materials demonstrated moderate strength of recommendation at a level 2 evidence for all studies based on SORT analysis. PICN and ZLS show promising short-term clinical performance as full and partial coverage indirect restorations, but longer follow-up studies are required to confirm their long-term performance.
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Saravi B, Vollmer A, Hartmann M, Lang G, Kohal RJ, Boeker M, Patzelt SBM. Clinical Performance of CAD/CAM All-Ceramic Tooth-Supported Fixed Dental Prostheses: A Systematic Review and Meta-Analysis. MATERIALS 2021; 14:ma14102672. [PMID: 34065202 PMCID: PMC8161295 DOI: 10.3390/ma14102672] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/16/2021] [Accepted: 05/18/2021] [Indexed: 12/29/2022]
Abstract
Although CAD/CAM ceramics present a promising alternative to metal-ceramic fixed dental prostheses, little is known about their mid- and long-term clinical performance. This systematic review aims to estimate the survival and success rates and describes the underlying complication characteristics for CAD/CAM tooth-supported zirconia- and lithium disilicate-based fixed dental prostheses (FDPs). We systematically searched MEDLINE and Web of Science to find relevant prospective studies with a follow-up of at least one year. We estimated pooled 1-, 5-, and 10-year survival and success rates by combining the collected data in a Poisson regression model. Descriptive statistics were conducted to evaluate the distribution of failures and complications in the included studies. Risk of bias for the included studies was assessed with an adapted checklist for single-arm trials. Pooled estimated 1-, 5-, and 10-year survival rates ranged from 93.80% to 94.66%, 89.67% to 91.1%, and 79.33% to 82.20%, respectively. The corresponding success rates excluding failures, but including any other types of intervention were 94.53% to 96.77%, 90.89% to 94.62%, and 81.78% to 89.25%. Secondary caries was the most frequent cause of failure, followed by chipping of the veneering. The most common cause of complication excluding failures but requiring intervention was chipping of the veneering. Risk of bias was generally acceptable for the included studies, with seven studies associated with low risk of bias, eight studies with a moderate risk of bias, and three studies with serious risk of bias. The current meta-analysis on CAD/CAM-supported FDPs revealed satisfying survival and success rates for up to 10 years of exposure. More prospective studies focusing on long-term performance are needed to strengthen the evidence currently available in the literature.
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Affiliation(s)
- Babak Saravi
- Medical Center—University of Freiburg, Department of Orthopedics and Trauma Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany;
- Correspondence:
| | - Andreas Vollmer
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany;
| | - Maja Hartmann
- Private Practice, Kantstraße 10, 60316 Frankfurt am Main, Germany;
| | - Gernot Lang
- Medical Center—University of Freiburg, Department of Orthopedics and Trauma Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany;
| | - Ralf-Joachim Kohal
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany; (R.-J.K.); (S.B.M.P.)
| | - Martin Boeker
- Medical Center—University of Freiburg, Institute of Medical Biometry and Medical Statistics, Faculty of Medicine, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany;
| | - Sebastian B. M. Patzelt
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany; (R.-J.K.); (S.B.M.P.)
- Private Practice, Am Dorfplatz 3, 78658 Zimmern o.R., Germany
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23
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Influence of Cavity Geometry on the Fracture Strength of Dental Restorations: Finite Element Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11094218] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The main purpose of this work was to analyze the stress distribution in premolars restored with indirect IPS Empress® CAD onlays or inlays. The three-dimensional geometry of a human first premolar was created using modeling software. The tooth fixation system was simulated through box geometry, comprising a cortical bone layer with 2 mm of thickness over a layer of trabecular bone with 15 mm of thickness. The tooth had the following approximated crown dimensions: 10.35 mm buccolingual length; 7.1 mm mesiodistal width; and 7.0 mm cervico-occlusal height. The mesio-occluso-distal (MOD) cavity preparations followed the suggestions available in the literature. The cement geometry was modified to include cohesive zone models (CZM) to perform the adhesive joint’s strength prediction. The loading body was created assuming contact between the food bolus and the tooth surface. Numerical solutions were obtained by performing static analysis and damage analysis using the finite element method. Von Mises stress values generated in the ceramic inlay restoration ranged from 1.39–181.47 MPa, which were on average 4.4% higher than those of the onlay ceramic restoration. The fracture strength of the onlay restoration was about 18% higher than that of the inlay restoration. The onlay design seems to contribute to higher homogenization of the adhesive resin cement strain and higher tooth structure protection.
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Oouchi H, Takamizawa T, Tamura T, Ishii R, Tsujimoto A, Miyazaki M, Kitahara N. Flexural properties and wear behavior of computer-aided design/computer-aided manufacturing resin blocks. Dent Mater J 2021; 40:979-985. [PMID: 33883355 DOI: 10.4012/dmj.2020-381] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study investigates the flexural properties, Knoop hardness number (KHN), and wear behavior of computer-aided design and computer-aided manufacturing (CAD/CAM) resin blocks and compares these values with those of conventional resin composites for direct restoration (RCDs). Four CAD/CAM resin blocks and two RCDs are compared. Ten specimens per material are used to obtain the flexural properties according to ISO 6872 specifications, and five specimens per material are used for KHN measurement. For sliding impact wear testing, twelve specimens are prepared. Confocal laser scanning microscopy (LSM) is used to determine maximum facet depth and volume loss. Polished material surfaces and worn surfaces after wear testing are observed using scanning electron microscopy and LSM. While measured flexural properties and KHN are found to be material-dependent, CAD/CAM resin blocks exhibit higher wear resistance than RCDs. CAD/CAM resin blocks polymerized at high-pressure and high-temperature are found to exhibit wear behaviors far superior to those of RCDs.
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Affiliation(s)
- Hajime Oouchi
- Department of Operative Dentistry, Nihon University School of Dentistry
| | | | - Tomohiko Tamura
- Department of Operative Dentistry, Nihon University School of Dentistry
| | - Ryo Ishii
- Department of Operative Dentistry, Nihon University School of Dentistry
| | - Akimasa Tsujimoto
- Department of Operative Dentistry, Nihon University School of Dentistry
| | - Masashi Miyazaki
- Department of Operative Dentistry, Nihon University School of Dentistry
| | - Nobuya Kitahara
- Department of Operative Dentistry, Nihon University School of Dentistry.,Team Tokyo
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