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Lampl S, Gurunathan D, Krithikadatta J, Mehta D, Moodley D. Reasons for Crown Failures in Primary Teeth: Protocol for a Systematic Review and Meta-Analysis. JMIR Res Protoc 2023; 12:e51505. [PMID: 37910174 PMCID: PMC10652188 DOI: 10.2196/51505] [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: 08/02/2023] [Revised: 09/28/2023] [Accepted: 10/05/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND There is a tendency nowadays to restore large defects in primary dentition with pediatric crowns instead of conventional restorations. Thus, understanding the factors contributing to the survival or failure of dental crowns in pediatric dentistry is essential for optimizing treatment outcomes. OBJECTIVE The primary objective of this protocol is to outline the methodological approach for analyzing data from observational studies and randomized controlled trials to investigate reasons for the failure of dental crowns in primary teeth and to compute their survival and failure rates. METHODS A comprehensive literature review will be performed in electronic databases, including PubMed (MEDLINE), Cochrane, Embase, and Web of Science. As per predefined inclusion criteria, we will include observational studies (prospective clinical studies) and randomized clinical trials that have an English abstract and involve children aged 1-10 years undergoing crown restorations. Two independent reviewers will independently screen all retrieved records and full-text articles and extract data. The study's methodological quality will be appraised using suitable tools. Assessments of publication bias will be performed using funnel plots. The findings will be described qualitatively for the systematic review. If possible, a meta-analysis will be performed to estimate failure rates by dividing the number of failures by the total exposure time. A Poisson regression model, assuming constant event rates, will be used to compute 3-year and 5-year survival proportions. The Pearson goodness-of-fit statistics will be used to assess the heterogeneity of the model. A P value <.05 will be considered significant. All analyses will be performed using R Statistical software (version 4.1.2; R Core Team). RESULTS This systematic review and synthesis aim to assess the survival and failure rates of dental crowns in pediatric dentistry. By following this rigorous methodology, we seek to provide valuable insights into the factors contributing to the success or failure of these restorations. The results of our full review will have implications for pediatric dentists, researchers, and policy makers, helping to improve dental care for children. CONCLUSIONS This systematic review protocol helps in establishing a thorough approach for reviewing failures in pediatric crowns. By following this methodology, standardization and transparency of the process as well as accountability for the stated methods and outcomes will be ensured. The findings of this review and analysis will provide useful data on the survival of crowns to pediatric dentists and researchers. TRIAL REGISTRATION PROSPERO CRD42023442266; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=442266. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/51505.
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Affiliation(s)
- Stephan Lampl
- Department of Cariology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Deepa Gurunathan
- Department of Pediatric Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Jogikalmat Krithikadatta
- Department of Cariology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Deepak Mehta
- Department of Cariology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
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Silvestri F, Maille G, Mansuy C, Graillon N, Mense C. Prosthetic rehabilitation of a completely edentulous maxilla with a sectioned implant-supported screw-retained prosthesis in a multiamputee patient with microstomia: A clinical report. J Prosthet Dent 2023:S0022-3913(23)00411-0. [PMID: 37442751 DOI: 10.1016/j.prosdent.2023.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 05/26/2023] [Accepted: 05/26/2023] [Indexed: 07/15/2023]
Abstract
Providing fixed implant-supported prostheses for edentulous patients with microstomia or limited mouth opening is challenging. The clinical treatment of a patient who was a multiple amputee with microstomia and a complete loss of lips elasticity is described. A custom half-sectioned prosthesis was fabricated to resolve numerous difficulties. A screw-retained complete implant-supported prosthesis was developed from a monolithic zirconia framework supported by 4 implants and with digital scanning and computer-aided design and computer-aided manufacturing of the prosthesis. The protocol achieved a complete screw-retained implant-supported prosthesis and offered a solution for a patient with microstomia and limited mouth opening, leading to improved quality of life.
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Affiliation(s)
- Frédéric Silvestri
- Assistant Professor, Department of Prosthesis and Implantology, School of Dental Medicine, ADES, CNRS, Aix-Marseille University, Marseille, France.
| | - Gérald Maille
- Assistant Professor, Department of Prosthesis and Implantology, School of Dental Medicine, ADES, CNRS, Aix-Marseille University, Marseille, France
| | - Charlotte Mansuy
- Assistant Professor, Department of Prosthesis and Implantology, School of Dental Medicine, ADES, CNRS, Aix-Marseille University, Marseille, France
| | - Nicolas Graillon
- Assistant Professor, School of Medicine, Aix-Marseille University, Marseille, France; and Assistant Professor, Department of Maxillofacial and Oral Surgery, Conception Hospital, Marseille, France
| | - Chloë Mense
- Assistant Professor, Department of Prosthesis and Implantology, School of Dental Medicine, ADES, CNRS, Aix-Marseille University, Marseille, France
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Calheiros-Lobo MJ, Vieira T, Carbas R, da Silva LFM, Pinho T. Effectiveness of Self-Adhesive Resin Luting Cement in CAD-CAM Blocks-A Systematic Review and Meta-Analysis. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2996. [PMID: 37109832 PMCID: PMC10140979 DOI: 10.3390/ma16082996] [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: 02/27/2023] [Revised: 04/07/2023] [Accepted: 04/08/2023] [Indexed: 06/19/2023]
Abstract
Self-adhesive resin cements (SARCs) are used because of their mechanical properties, ease of cementation protocols, and lack of requirements for acid conditioning or adhesive systems. SARCs are generally dual-cured, photoactivated, and self-cured, with a slight increase in acidic pH, allowing self-adhesiveness and increasing resistance to hydrolysis. This systematic review assessed the adhesive strength of SARC systems luted to different substrates and computer-aided design and manufacturing (CAD/CAM) ceramic blocks. The PubMed/MedLine and Science Direct databases were searched using the Boolean formula [((dental or tooth) AND (self-adhesive) AND (luting or cement) AND CAD-CAM) NOT (endodontics or implants)]. Of the 199 articles obtained, 31 were selected for the quality assessment. Lava Ultimate (resin matrix filled with nanoceramic) and Vita Enamic (polymer-infiltrated ceramic) blocks were the most tested. Rely X Unicem 2 was the most tested resin cement, followed by Rely X Unicem > Ultimate > U200, and μTBS was the test most used. The meta-analysis confirmed the substrate-dependent adhesive strength of SARCs, with significant differences between them and between SARCs and conventional resin-based adhesive cement (α < 0.05). SARCs are promising. However, one must be aware of the differences in the adhesive strengths. An appropriate combination of materials must be considered to improve the durability and stability of restorations.
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Affiliation(s)
- Maria João Calheiros-Lobo
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), Rua Central de Gandra 1317, 4585-116 Gandra, Portugal
- Conservative Dentistry, Department of Dental Sciences, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), Rua Central de Gandra 1317, 4585-116 Gandra, Portugal
| | - Tatiana Vieira
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), Rua Central de Gandra 1317, 4585-116 Gandra, Portugal
| | - Ricardo Carbas
- Department of Mechanical Engineering, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
- INEGI—Institute of Science and Innovation in Mechanical and Industrial Engineering, University of Porto, 4200-465 Porto, Portugal
| | - Lucas F. M. da Silva
- Department of Mechanical Engineering, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
- INEGI—Institute of Science and Innovation in Mechanical and Industrial Engineering, University of Porto, 4200-465 Porto, Portugal
| | - Teresa Pinho
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), Rua Central de Gandra 1317, 4585-116 Gandra, Portugal
- IBMC—Instituto Biologia Molecular e Celular, i3S—Instituto de Inovação e Investigação em Saúde, Institute for Molecular and Cell Biology (IBMC), Institute of Innovation and Investigation in Health (i3S), University of Porto, 4200-135 Porto, Portugal
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Ellakany P, Aly NM, Alghamdi MM, Alameer ST, Alshehri T, Akhtar S, Madi M. Effect of Different Scaling Methods on the Surface Topography of Different CAD/CAM Ceramic Compositions. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2974. [PMID: 37109810 PMCID: PMC10143924 DOI: 10.3390/ma16082974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/25/2023] [Accepted: 04/03/2023] [Indexed: 06/19/2023]
Abstract
This study evaluated the effect of ultrasonic and manual scaling using different scaler materials on the surface topography of computer-aided designing and computer-aided manufacturing (CAD/CAM) ceramic compositions. After scaling with manual and ultrasonic scalers, the surface properties of four classes of CAD/CAM ceramic discs: lithium disilicate (IPE), leucite-reinforced (IPS), advanced lithium disilicate (CT), and zirconia-reinforced lithium silicate (CD) of 1.5 mm thickness were evaluated. Surface roughness was measured before and after treatment, and scanning electron microscopy was used to evaluate the surface topography following the performed scaling procedures. Two-way ANOVA was conducted to assess the association of the ceramic material and scaling method with the surface roughness. There was a significant difference in the surface roughness between the ceramic materials subjected to different scaling methods (p < 0.001). Post-hoc analyses revealed significant differences between all groups except for IPE and IPS where no significant differences were detected between them. CD showed the highest surface roughness values, while CT showed the lowest surface roughness values for the control specimens and after exposure to different scaling methods. Moreover, the specimens subjected to ultrasonic scaling displayed the highest roughness values, while the least surface roughness was noted with the plastic scaling method.
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Affiliation(s)
- Passent Ellakany
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
| | - Nourhan M. Aly
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21527, Egypt
| | - Maram M. Alghamdi
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
| | - Shahad T. Alameer
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
| | - Turki Alshehri
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
| | - Sultan Akhtar
- Department of Biophysics, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Marwa Madi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
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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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Lampl S, Gurunathan D, Krithikadatta J, Mehta D, Moodley D. Reasons for Failure of CAD/CAM Restorations in Clinical Studies: A Systematic Review and Meta-analysis. J Contemp Dent Pract 2023; 24:129-136. [PMID: 37272145 DOI: 10.5005/jp-journals-10024-3472] [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: 06/06/2023]
Abstract
AIM The systematic review presented herein was performed to descriptively analyze the causes for the failure of computer-aided design/computer-aided manufacture (CAD/CAM) restorations. The meta-analysis reported herein was performed to estimate long-term survival and success rates of CAD-CAM fabrications. MATERIALS AND METHODS Using the PICOS paradigm, a systematic search was carried out in the PubMed and Cochrane databases to identify randomized controlled trials (RCTs) and prospective observational studies reporting survival data for CAD/CAM restorations. After selecting studies with a predefined set of selection criteria, data from included prospective clinical studies and RCTs were used for a systematic review aimed at a descriptive analysis of factors associated with failure of CAD-CAM restorations. Data from the included prospective clinical studies were used for meta-analysis, wherein 5-year and 10-year survival and success rates were estimated using Poisson regression models. RESULTS The systematic review included data from 9 RCTs and 6 observational studies, which had a median follow-up of 36 months and 60 months, respectively. About 58 failures and 118 technical/ biological complications were noted in the included RCTs and 9 failures along with 58 technical/biological complications were noted in the prospective clinical studies. Poisson regression indicated an estimated 5-year and 10-year survival rates of 85.55-100 and 71-100, respectively. The estimated 5-year and 10-year success rates were 74.2-92.75 and 33.3-85.5, respectively. CONCLUSION Several technical and biological complications contribute to failure of CAD/CAM restorations. However, CAD/CAM restorations with routine chairside materials might have clinically meaningful success rates in the long term. CLINICAL SIGNIFICANCE The results presented herein indicate that optimal strategies for mitigation of biological and technical complications may augment the success of CAD/CAM fabrications in restorative dentistry. Studies aimed at identification of such strategies are needed to further enhance the long-term success rates of CAD/CAM restorations.
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Affiliation(s)
- Stephan Lampl
- Department of Paediatric Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Deepa Gurunathan
- Department of Paediatric Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India, Phone: +91 9994619386, e-mail:
| | - Jogikalmat Krithikadatta
- Department of Paediatric Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Deepak Mehta
- Department of Conservative Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India; Department of Operative Dentistry, Tohoku University Graduate School of Dentistry, Tohoku University, Sendai, Japan
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Carek A, Slokar Benić L, Komar D, Krebelj E. Roughness of the Surface of Zirconia Reinforced Lithium Disilicate Ceramic Treated by Different Procedures. MATERIALS (BASEL, SWITZERLAND) 2022; 16:ma16010265. [PMID: 36614604 PMCID: PMC9822208 DOI: 10.3390/ma16010265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/15/2022] [Accepted: 12/20/2022] [Indexed: 05/27/2023]
Abstract
Lithium disilicate and zirconia are the two most popular materials for aesthetic and dental prosthetic work; however, due to their limitations, a new material is being researched, namely zirconia-reinforced lithium disilicate, the surface of which is treated with different procedures to achieve the best possible surface properties. In this study, the surface of zirconia-reinforced lithium disilicate glass-ceramic was treated using different methods (conventional and laser) to determine the effects of the treatment procedures on the surface properties and surface roughness to achieve a higher strength of adhesion from the self-adhesive resin cement to zirconia-reinforced lithium disilicate. The treated surfaces were investigated using profilometry, X-ray diffraction and energy dispersive X-ray fluorescence. The results obtained were statistically evaluated. The results show that the surface roughness is highest for the samples treated with Er:YAG (erbium-doped yttrium aluminium garnet laser) and silanisation. Furthermore, the surface treatment procedures applied did not change the composition of the surface.
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Affiliation(s)
- Andreja Carek
- School of Dental Medicine, University of Zagreb, Ivana Gundulića 5, 10000 Zagreb, Croatia
| | - Ljerka Slokar Benić
- Faculty of Metallurgy, University of Zagreb, Aleja narodnih heroja 3, 44000 Sisak, Croatia
| | - Daniel Komar
- School of Dental Medicine, University of Zagreb, Ivana Gundulića 5, 10000 Zagreb, Croatia
| | - Ena Krebelj
- School of Dental Medicine, University of Zagreb, Ivana Gundulića 5, 10000 Zagreb, Croatia
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Newaskar PS, Sonkesriya S, Singh R, Palekar U, Bagde H, Dhopte A. Evaluation and Comparison of Five-Year Survival of Tooth-Supported Porcelain Fused to Metal and All-Ceramic Multiple Unit Fixed Prostheses: A Systematic Review. Cureus 2022; 14:e30338. [PMID: 36407172 PMCID: PMC9663878 DOI: 10.7759/cureus.30338] [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: 09/27/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023] Open
Abstract
The prosthesis must have good survival despite being functional for at least 5-10 years. This makes sure that the replacement of missing teeth does not become a repeated expense. Of 579 identified articles, 15 met the inclusion criteria for systematic review. Missing teeth replacement materials are divided into two groups: porcelain fused to metal and all ceramics. Data related to survival rates as well as the most common mode of failure is observed from both groups. It was observed that porcelain fused to metal prostheses had an approximately 99.5% survival rate and an approximately 92% survival rate for all-ceramic tooth-supported prostheses after five years of insertion. Porcelain-fused-to-metal (PFM) prostheses had a better survival rate after five years of insertion as compared to all-ceramic prostheses. Porcelain fused to metal should be the treatment of choice for dentists and patients when missing teeth need to be fixed.
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Affiliation(s)
- Prabha Shakya Newaskar
- Department of Prosthodontics, Rural Dental College, Pravara Institute of Medical Sciences - Deemed University (PIMS-DU), Loni, IND
| | - Subhash Sonkesriya
- Department of Prosthodontics, Government Dental College and Hospital, Indore, IND
| | - Rashmi Singh
- Department of Prosthodontics, Mansarovar Dental College, Hospital and Research Centre, Bhopal, IND
| | - Umesh Palekar
- Department of Prosthodontics, Rural Dental College, Pravara Institute of Medical Sciences - Deemed University (PIMS-DU), Loni, IND
| | - Hiroj Bagde
- Periodontology, Rama Dental College and Research Centre, Kanpur, IND
| | - Ashwini Dhopte
- Oral Medicine and Radiology, Rama Dental College and Research Centre, Kanpur, IND
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Frasheri I, Hickel R, Manhart J, Diegritz C, Folwaczny M, Fotiadou C. Longevity of gold restorations in posterior teeth: A retrospective study up to 10-years. J Dent 2022; 124:104235. [PMID: 35870735 DOI: 10.1016/j.jdent.2022.104235] [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: 03/28/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE In this retrospective clinical study, we investigated the long-term survival and success of indirect gold restorations, placed by undergraduate students. MATERIAL AND METHODS The study included 72 gold restorations in 45 patients, placed in a five-year period between 2009 and 2013. Two experienced dentists performed the evaluation following the FDI criteria after 5 to 10 years. Kaplan-Meier test was used for longevity analysis of success and survival. Data were tested for normality with Shapiro-Wilk test. Cox regression analysis, with significance level appointed at p ≤ .05, was performed using success and survival of restorations as dependent variables. Annual failure rates (AFRs) were calculated. RESULTS Overall, 72 indirect gold restorations prepared in posterior teeth were assessed, with an observation time from 63 months to 117 months. The mean service time was 88.1 months and the median 87 months. No failures, but 2 repairs, were observed during the first five years. From 5 to 10 years 1 replacement and 1 more repair occurred. The survival and success rates of gold restorations were calculated at 9 years with 98.6% and 91%, respectively. Restorations placed on premolars had higher survival and success rates compared to molars. Three cases were categorized as repairs: in two cases, a root canal treatment was needed and, in one other, an occlusal perforation of the restoration was observed. CONCLUSIONS Posterior indirect gold restorations placed by dental undergraduate students showed a highly predictable clinical performance in terms of success and survival. These results are comparable with survival rates reported in literature for restorations cemented in general dental practices. CLINICAL SIGNIFICANCE Casted gold restorations placed from dental students in an undergraduate setting show high survival rates, similar to professional dentists.
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Affiliation(s)
- Iris Frasheri
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, Munich 80336, Germany.
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, Munich 80336, Germany
| | - Juergen Manhart
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, Munich 80336, Germany
| | - Christian Diegritz
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, Munich 80336, Germany
| | - Matthias Folwaczny
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, Munich 80336, Germany
| | - Christina Fotiadou
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, Munich 80336, Germany
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Comparative Assessment of the Functional Parameters for Metal-Ceramic and All-Ceramic Teeth Restorations in Prosthetic Dentistry-A Literature Review. BIOLOGY 2022; 11:biology11040556. [PMID: 35453755 PMCID: PMC9024664 DOI: 10.3390/biology11040556] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 03/27/2022] [Accepted: 03/31/2022] [Indexed: 12/16/2022]
Abstract
Simple Summary In the last decades, the science and technology of all-ceramic teeth restorations witnessed the fastest-growing field of restorative materials in research and development for fixed prosthodontics. Due to their properties, characterized by a high level of biocompatibility, excellent optical properties, and high fracture resistance, all-ceramic material can also be used in the posterior areas of the dental arches. However, metal-ceramic fixed partial dentures are still perceived as the golden standard for those restorations, thanks to the positive clinical outcomes. Irrespective of the materials of which fixed partial dentures are performed, their success rates depend on the expected outcome and on how they perform in the oral environment. Such conditions of failure restorations may include biological factors (i.e., secondary decay, loss of vitality, periodontal disease, or abutment fracture) or technical factors (i.e., chipping, ceramic fracture, framework fracture, or loss of retention). Our aim is to provide the current evidence for the efficacy of metal-ceramics and all-ceramics in the treatment of multiple posterior edentulous spaces. Moreover, we aim to compare the survival rates of metal-ceramic and all-ceramic fixed partial dentures in terms of functionality and biocompatibility in all the aforementioned clinical situations. Our results have shown that all all-ceramic systems, especially densely sintered zirconia and reinforced glass ceramics, have a promising future to satisfy both practitioners and patients. However, technical and biological complications need to be taken into account when planning multi-unit fixed partial dentures for the posterior areas. Abstract The metal-ceramic fixed partial prosthesis is the golden standard for posterior tooth restorations. Following the demands of patients and clinicians for metal-free restorations, all-ceramic materials were developed as they offer an adequate alternative with better optical qualities and good mechanical properties. This study aims to carry out a bibliographic review to assess the survival rate and the biological and technical complications of all-ceramic and metal-ceramic fixed partial dentures. An electronic search for articles in the English language literature was performed using PubMed (MEDLINE). This literature review focused on research studies between 2010 and 2020 that performed clinical studies on tooth-supported fixed partial dentures with a mean follow-up of at least 3 years. All the studies, which analyzed the survival and complications of tooth-supported fixed partial dentures, were included. Thus, 14 studies reporting on 756 all-ceramic and 160 metal-ceramic fixed partial dentures met the inclusion criteria. A comparative analysis was carried out based on all the data existing in the studies included in this review. The metal-ceramic fixed partial dentures showed survival rates of 95% to 100% at 3-, 5-, and 10-year follow-up periods. Zirconia fixed partial dentures were reported to have survival rates of 81% to 100% at 3-, 5-, 9-, 10-year follow-up evaluations. The reinforced glass-ceramic fixed partial dentures showed survival rates of 70% to 93.35% at 5 years, while the alumina FPDs showed a survival rate of 68% at 3 years follow-up. The incidence of caries and loss of vitality were reported as higher for all-ceramic prostheses as compared to the metal-ceramic ones. A significant framework fracture was reported for glass-infiltrated alumina fixed partial dentures in comparison to metal-ceramic fixed partial dentures. All-ceramic and metal-ceramic restorations showed similar survival rates after 3 years, although all-ceramic restorations have problems with technical complications such as chipping, which can lead to framework fractures over time.
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Blatz MB, Hariton‐Gross K, Anadioti E, Mante F, Zhang Y, Saleh N. Prospective 5-year clinical evaluation of posterior zirconia fixed dental prostheses veneered with milled lithium disilicate (CADon). J ESTHET RESTOR DENT 2022; 34:136-144. [PMID: 35083844 PMCID: PMC9934977 DOI: 10.1111/jerd.12877] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Bi-layer zirconia-based posterior fixed dental prostheses (FDPs) have reportedly a high incidence of veneering ceramic fractures. The CADon technique employs zirconia frameworks veneered with milled lithium disilicate glass-ceramic to overcome these shortcomings but long-term clinical studies are missing. This study evaluated the clinical efficacy of posterior 3-unit CADOn FDPs over a 5-year period. MATERIALS AND METHODS A total of 25 patients, 16 male and 9 female with a mean age of 55.6 years, received a total of 25 posterior three-unit CADOn FDPs. Patients were recalled for baseline and for follow-up visits at 6, 12, 24, and 60 months. Parameters evaluated were fracture, marginal adaptation, marginal discoloration, wear, polish, color match, surface staining, and retention of these restorations as well as secondary caries of the abutment teeth. RESULTS A total of 21 FDPs evaluated at 60-months revealed a 100% survival rate. All evaluated clinical parameters were satisfactory (alpha or bravo) and there was no statistically significant difference at different time points, except for surface staining, which was also worse at 60 months compared to baseline (p ≤ 0.001). CONCLUSIONS CADOn three-unit posterior FDPs demonstrate excellent fracture resistance after 5 years of clinical function. All evaluated clinical parameters were satisfactory, except for surface stain, which also increased over time. CLINICAL SIGNIFICANCE Conventionally veneered bi-layer zirconia-based posterior FDPs have limited clinical success. Based on this study, alternative methods such as zirconia frameworks veneered with milled lithium disilicate glass-ceramic provide a viable alternative with excellent long-term clinical outcomes.
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Affiliation(s)
- Markus B. Blatz
- Department of Preventive and Restorative Sciences University of Pennsylvania School of Dental Medicine Philadelphia Pennsylvania USA
| | - Karina Hariton‐Gross
- Department of Preventive and Restorative Sciences University of Pennsylvania School of Dental Medicine Philadelphia Pennsylvania USA
| | - Evanthia Anadioti
- Department of Preventive and Restorative Sciences University of Pennsylvania School of Dental Medicine Philadelphia Pennsylvania USA
| | - Francis Mante
- Department of Preventive and Restorative Sciences University of Pennsylvania School of Dental Medicine Philadelphia Pennsylvania USA
| | - Yu Zhang
- Department of Preventive and Restorative Sciences University of Pennsylvania School of Dental Medicine Philadelphia Pennsylvania USA
| | - Najeed Saleh
- Department of Preventive and Restorative Sciences University of Pennsylvania School of Dental Medicine Philadelphia Pennsylvania USA
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Su S, Dudley J. The marginal gaps of lithium disilicate crowns constructed by different scanner and milling unit combinations. Aust Dent J 2021; 67:125-131. [PMID: 34855210 DOI: 10.1111/adj.12891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The purpose of this study was to compare the marginal gaps of CAD/CAM lithium disilicate (LDS) crowns constructed using three different scanner and milling unit combinations. METHODS Twenty-four Columbia model lower left molars were prepared for LDS crowns by undergraduate students in a simulated environment. One LDS crown was constructed for each crown preparation using each of the following intraoral scanner/milling unit combinations: TRIOS 3 scanner/E4D milling unit (TRIO/E4DM); TRIOS 3 scanner/Sirona inLab MC X5 milling unit (TRIO/MCX5); E4D scanner/E4D milling unit (E4DS/E4DM). The crowns were seated onto the original crown preparations and three vertical marginal gap measurements taken at four locations (mid-buccal, mid-lingual, mid-mesial and mid-distal) using a stereomicroscope. The mean marginal gap (MMG) was calculated for each crown and each individual tooth surface. RESULTS The TRIO/MCX5 scanner/milling unit combination produced the smallest MMG of 63.73 ± 47.38 μm followed by E4DS/E4DM (88.64 ± 106.51 μm) and TRIO/E4DM (107.41 ± 76.47 μm). There was a significant effect of milling unit (p < 0.0001) on MMG but no significant effect of scanner (p = 0.070) or location (p = 0.182). CONCLUSIONS The newer scanner/milling unit combination produced LDS crowns with the smallest MMG. All scanner/milling unit combinations produced LDS crowns within a clinically acceptable MMG.
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Affiliation(s)
- Sinclair Su
- Adelaide Dental School, Adelaide Health & Medical Sciences, The University of Adelaide, South Australia, Australia
| | - James Dudley
- Adelaide Dental School, The University of Adelaide, South Australia, Australia
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Bernauer SA, Zitzmann NU, Joda T. The Use and Performance of Artificial Intelligence in Prosthodontics: A Systematic Review. SENSORS 2021; 21:s21196628. [PMID: 34640948 PMCID: PMC8512216 DOI: 10.3390/s21196628] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/01/2021] [Accepted: 10/01/2021] [Indexed: 12/15/2022]
Abstract
(1) Background: The rapid pace of digital development in everyday life is also reflected in dentistry, including the emergence of the first systems based on artificial intelligence (AI). This systematic review focused on the recent scientific literature and provides an overview of the application of AI in the dental discipline of prosthodontics. (2) Method: According to a modified PICO-strategy, an electronic (MEDLINE, EMBASE, CENTRAL) and manual search up to 30 June 2021 was carried out for the literature published in the last five years reporting the use of AI in the field of prosthodontics. (3) Results: 560 titles were screened, of which 30 abstracts and 16 full texts were selected for further review. Seven studies met the inclusion criteria and were analyzed. Most of the identified studies reported the training and application of an AI system (n = 6) or explored the function of an intrinsic AI system in a CAD software (n = 1). (4) Conclusions: While the number of included studies reporting the use of AI was relatively low, the summary of the obtained findings by the included studies represents the latest AI developments in prosthodontics demonstrating its application for automated diagnostics, as a predictive measure, and as a classification or identification tool. In the future, AI technologies will likely be used for collecting, processing, and organizing patient-related datasets to provide patient-centered, individualized dental treatment.
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Zandinejad A, Das O, Barmak AB, Kuttolamadom M, Revilla-León M. The Flexural Strength and Flexural Modulus of Stereolithography Additively Manufactured Zirconia with Different Porosities. J Prosthodont 2021; 31:434-440. [PMID: 34580962 DOI: 10.1111/jopr.13430] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/01/2021] [Accepted: 09/09/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Additive manufacturing (AM) technologies are capable of fabricating complex geometries with different porosities. However, the effect of such porosities on mechanical properties of stereolithography (SLA) AM zirconia with different porosities is unclear. The purpose of this in vitro study was to investigate the mechanical properties namely flexural strength, and flexural modulus of AM zirconia with different porosities. MATERIALS AND METHODS A bar (25 × 4 × 3 mm) for flexural strength test (ISO standard 6872/2015) was designed by CAD software program and standard tessellation language (STL) file was obtained. The STL file was used to fabricate a total of 80 bars in four groups. Three experimental groups each containing 20 samples were manufactured using an SLA ceramic printer (CeraMaker 900; 3DCeram Co) and zirconia material (3DMix ZrO2 paste; 3DCeram Co) with different sintering post processing to achieve different porosities including 0%-porosity (AMZ0), 20%-porosity (AMZ20), and 40%-porosity (AMZ40). The same STL file was used for subtractive manufacturing or milling of 20 zirconia bars as control group (CNCZ) with the same dimensions using a commercial zirconia. Three-point bending tests were performed for all groups following ISO standard 6872/2015 specification using a universal testing machine. Outcomes measured included load at fracture, mean flexural strength, and flexural modulus and they were compared across the experimental groups using a one-way ANOVA. Post hoc pair wise comparison between each pair of the groups were performed using Tukey test. RESULTS There was a significant difference between the four groups, in terms of fracture load, flexural strength and flexural modulus using one-way ANOVA. AM zirconia with 0% porosity (AMZ0) showed the highest value for fracture load (1132.7 ± 220.6 N), flexural strength (755.1 ± 147.1 MPa) and flexural modulus (41,273 ± 2193 MPa) and AM zirconia with 40% porosity (AMZ40) showed the lowest fracture load (72.13 ± 13.42 N), flexural strength (48.09 ± 8.95 MPa) and flexural modulus (7177 ± 506 MPa). Tukey's pairwise comparisons detected a significant difference between all the possible pairs for all variables except flexural modulus between AMZ0 and CNCZ. The Weibull moduli presented the lowest value for AMZ20 (4.4) followed by AMZ40 (6.1), AMZ0 (6.1), and the highest value was for CNCZ (8.1). CONCLUSION AM zirconia with 0% porosity showed significantly higher flexural strength and flexural modulus when compared to milled and AM zirconia with 20% and 40% porosities.
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Affiliation(s)
| | - Omprakash Das
- College of Engineering, Texas A&M University, College Station, TX
| | | | | | - Marta Revilla-León
- College of Dentistry, Texas A&M University, Dallas, TX.,School of Dentistry, University of Washington, Seattle, WA.,Revilla Research Center, Madrid, Spain
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The Frequency of Dental Materials Use for Fixed Prostheses in a General Dental Practice. CURRENT HEALTH SCIENCES JOURNAL 2021; 47:393-397. [PMID: 35003771 PMCID: PMC8679156 DOI: 10.12865/chsj.47.03.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 08/18/2021] [Indexed: 11/04/2022]
Abstract
This retrospective study aimed to evaluate the frequency of dental materials use for fixed prosthesis depending on the location of the teeth, the restorative prosthetic type, the age and sex of the patients from a dental practice in Essen, Germany. The analysis of the collected data showed that zirconia is currently the most common material for making dental fixed prostheses, a larger number of prosthetic elements for women and a significant increase for these restorations at ages over 40 years. Most of the prosthetic elements were made in the mandibular molar area, with an increased frequency of zirconia bridges in the mandible, while for the upper jaw the number of crowns was higher. Zirconia was more frequent used in female patients and in the age group 60-69.
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