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Jurado CA, Tsujimoto A, Molisani J, Fu CC, Sadid-Zadeh R. Fracture resistance of chairside CAD-CAM lithium disilicate occlusal veneer with various designs after mechanical aging. J Prosthodont 2025; 34:323-328. [PMID: 38706398 DOI: 10.1111/jopr.13852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 03/15/2024] [Indexed: 05/07/2024] Open
Abstract
PURPOSE This study evaluated the fracture resistance of chairside computer-aided design and computer-aided manufacturing (CAD-CAM) lithium disilicate crown, onlay, and non-anatomical occlusal veneer (A-OV) with and without margin fabricated. MATERIALS AND METHODS Sixty-four CAD-CAM lithium disilicate restorations were designed as (1) complete coverage crown (CCC); (2) A-OV with margin; (3) non-A-OV with margin (NA-OV-M); and (4) non-A-OV without margin (NA-OV-NM), 16 of each. Restorations were crystallized and adhesively luted to resin dies using resin cement. Specimens were then subjected to 400,000 cycles of chewing in a mastication simulator. A universal testing machine was used to apply a compressive load at a crosshead speed of 1 mm/min to the long axis of the tooth with a stainless-steel sphere until fracture occurred. One-way ANOVA followed by post hoc tests were used to assess the impact of preparation design on the fracture load of CAD-CAM lithium disilicate restorations. RESULTS The highest fracture load was recorded for CAD-CAM lithium disilicate indirect restorations for non-A-OVs preparation with margin (2549 ± 428 N) and onlay (2549 ± 293 N) and the lowest fracture load was recorded for CCCs (2389 ± 428 N); however, there was no significant (p = 0.640) between groups. CONCLUSIONS CAD-CAM lithium disilicate restorations fabricated for anatomical and non-A-OV preparation display a fracture resistance similar to CCCs. Conservative partial coverage restorations may be considered an acceptable approach for posterior teeth.
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Affiliation(s)
- Carlos A Jurado
- Department of General Dentistry, University of Tennessee Health Science College of Dentistry, Memphis, Tennessee, USA
| | - Akimasa Tsujimoto
- Department of Operative Dentistry, Aichi Gaukin University School of Dentistry, Nagoya, Aichi, Japan
- Department of Operative Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
- Department of General Dentistry, Creighton University School of Dentistry, Omaha, Nebraska, USA
| | - Joseph Molisani
- University of Alabama at Birmingham School of Dentistry, Birmingham, Alabama, USA
| | - Chin-Chuan Fu
- Department of Restorative Sciences, University of Alabama at Birmingham, School of Dentistry, Birmingham, Alabama, USA
| | - Ramtin Sadid-Zadeh
- Department of Restorative Sciences, University of Alabama at Birmingham, School of Dentistry, Birmingham, Alabama, USA
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Krug R, Droste L, Schreiber C, Reichardt E, Krastl G, Hahn B, Soliman S. Long-term performance of ceramic in/-onlays vs. cast gold partial crowns - a retrospective clinical study. Clin Oral Investig 2024; 28:298. [PMID: 38702521 PMCID: PMC11068672 DOI: 10.1007/s00784-024-05682-7] [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: 03/11/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVES To assess the long-term clinical performance of ceramic in-/onlays (CIOs) and cast gold partial crowns (CGPCs) in posterior teeth in terms of success, survival, complications (biological, technical) and quality. MATERIAL AND METHODS In a retrospective study, a total of 325 patients were recorded after up to 24.8 years (mean 13.9 ± 3.8 years) having (pre-)molars restored with CIO (Empress I, Ivoclar Vivadent, n = 161) and CGPC (Degunorm, DeguDent, n = 164) by supervised undergraduate students. A total of 296 restorations were assessed clinically and radiologically in healthy and endodontically treated teeth using modified United States Public Health Service (USPHS) criteria. Cumulative success and survival rates of the restorations were calculated using Kaplan-Meier estimates. Biological and technical complications were recorded. Status of oral health comprising caries risk and localized periodontitis were assessed. RESULTS The cumulative success rates of CIOs were 92.1% and of CGPCs 84.2% after mean service times of 14.5 years. The annual failure rates of total service times were 0.5% in teeth restored with CIO (n = 155) and 0.7% in teeth restored with CGPC (n = 163). The cumulative survival rates of CIOs were 93.9% after a mean service time of 15.2 years and decreased to 91.7% after 23.5 years. The cumulative survival rates of CGPCs were 92.6% after a mean service time of 14.9 years and 91.8% after 23.5 years. Complications in CIOs (n = 149) were ceramic fracture (6.7%), secondary caries (4.7%), endodontic complication (2.7%) and tooth fracture (1.3%) compared to CGPCs (n = 147) with endodontic complication (8.8%), secondary caries (4.8%) and decementation (2.0%). Endodontically treated teeth restored with CIO or CGPC revealed significantly less often success compared with corresponding vital teeth (p = .02). CIOs and CGPCs revealed clinically and radiographically good and excellent qualities with 71.8% (107/149) and 68% (100/147) without any significant differences regarding type of restoration. CONCLUSIONS Both CIOs and CGPCs achieved high survival rates up to 24.8 years when performed by supervised undergraduate students. The longevity of the restorations may benefit from the intraoral repair of accessible defects and, in case of pulp infection or necrosis, an adequate endodontic management. CLINICAL RELEVANCE CIOs and CGPCs made by supervised undergraduate students are proper restoration types in posterior teeth in the long-term. An adequate preparation design, meticulous care in the inserting technique and constant biofilm removal due to proper oral hygiene combined with professional maintenance care are substantial. The clinical long-term performance was mostly limited by ceramic fractures in CIOs and endodontic complications in CGPCs.
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Affiliation(s)
- Ralf Krug
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany.
| | | | | | | | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany
| | - Britta Hahn
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany
| | - Sebastian Soliman
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany
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Lindner S, Frasheri I, Hickel R, Crispin A, Kessler A. Retrospective clinical study on the performance and aesthetic outcome of pressed lithium disilicate restorations in posterior teeth up to 8.3 years. Clin Oral Investig 2023; 27:7383-7393. [PMID: 37870592 PMCID: PMC10713824 DOI: 10.1007/s00784-023-05328-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVES Evaluation of cumulative survival and complication rate of monolithic lithium disilicate inlays and partial crowns performed by supervised undergraduate students up to 8.3 years of clinical service. MATERIALS AND METHODS In this retrospective clinical study 143 lithium disilicate posterior restorations (IPS e.max Press) were examined according to the FDI criteria. A standardised questionnaire was used to determine patient satisfaction. The aesthetic outcome was evaluated by dentists and dental technicians using intraoral photographs. Data were descriptively analysed. Cumulative survival and success rates were calculated using Kaplan-Meier estimation. RESULTS The cumulative survival rate of lithium disilicate restorations was 97.5% after a mean service time of 5.9 years and 95.0% after 8.3 years. The cumulative success rate decreased from 94.4% after 5.9 years to 30.7% after 8.3 years. Repairs were required for 7 restorations (4.9%), and 5 (3.5%) were classified as failures. The results of the questionnaire indicate a high level of patient satisfaction. The subjective aesthetics were assessed more critically by dental technicians compared to dentists. CONCLUSION Lithium disilicate posterior restorations survived successfully up to 8.3 years when carried out by undergraduate students. CLINICAL RELEVANCE Pressed lithium disilicate glass ceramic inlays and partial crowns are reliable treatment options in posterior teeth.
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Affiliation(s)
- Stefanie Lindner
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-Universität München, Goethestr 70, 80336, Munich, Germany.
| | - Iris Frasheri
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-Universität München, Goethestr 70, 80336, Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-Universität München, Goethestr 70, 80336, Munich, Germany
| | - Alexander Crispin
- Department of Medical Informatics, Biometry and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-Universität München, Marchioninistr 15, 81377, Munich, Germany
| | - Andreas Kessler
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-Universität München, Goethestr 70, 80336, Munich, Germany
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Masaka N, Yoneda S, Masaka K. An up to 43-year longitudinal study of fixed prosthetic restorations retained with 4-META/MMA-TBB resin cement or zinc phosphate cement. J Prosthet Dent 2023; 129:83-88. [PMID: 34175113 DOI: 10.1016/j.prosdent.2021.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 01/18/2023]
Abstract
STATEMENT OF PROBLEM Adhesive resin cement has been the preferred choice for the placement of prosthetic restorations, but evidence-based studies supporting this selection are sparse. PURPOSE The purpose of this study was to test the hypothesis that restoration placement with the adhesive 4-methacryloxyethyl trimellitate anhydride/methyl methacrylate-tributylborane (4-META/MMA-TBB) resin cement is associated with better longevity of teeth than zinc phosphate cement up to 43 years. MATERIALS AND METHODS Study participants were individuals who had been visiting the clinic regularly for more than 20 years from their first visit between November 1970 and April 1985. The vital teeth with prosthetic restorations (N=454), including cast inlays, onlays, crowns, and fixed partial dentures, of 53 patients were assessed from dental charts and radiographs. Most of the bonding surfaces were precious metal alloy, excluding 4 restorations cemented with zinc phosphate and 6 ceramic crowns cemented with 4-META/MMA-TBB resin cement. The Kaplan-Meier method and log-rank test (α=.05) were used to compare longevity between the 2 materials. Chi-squared tests (α=.001) were also used to examine the occurrence rates of events such as secondary caries, endodontic treatment, and the dislodgement of restorations affecting the longevity of the 2 cements. RESULTS Clinical review examination demonstrated that 55.4% of teeth retained with 4-META/MMA-TBB resin cement had been in service for 30 years compared with 43.5% of those retained with zinc phosphate cement, with a significant difference (P=.006). 4-META/MMA-TBB resin cement also demonstrated lower event occurrence rates than zinc phosphate cement for 3 assessed types of events (P<.001). CONCLUSIONS Within the limitations of this study, 4-META/MMA-TBB resin adhesive cement demonstrated a higher survival rate than conventional zinc phosphate cement in service for 30 years with a lower occurrence of critical events.
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Affiliation(s)
- Nobuo Masaka
- ex-Chairman, General Practitioner, Medical Corporation Shi-Sei-Kai Masaka Dental Clinic, Tokyo, Japan
| | - Satoshi Yoneda
- General Practitioner, Medical Corporation Shi-Sei-Kai Masaka Dental Clinic, Tokyo, Japan.
| | - Kozue Masaka
- General Practitioner, Medical Corporation Shi-Sei-Kai Masaka Dental Clinic, Tokyo, Japan
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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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Rehm P, Derks H, Lesaar W, Spies BC, Beuer F, Böse MWH. Restoration of 1325 teeth with partial-coverage crowns manufactured from high noble metal alloys: a retrospective case series 18.8 years after prosthetic delivery. Clin Oral Investig 2022; 26:849-861. [PMID: 34241707 PMCID: PMC8791919 DOI: 10.1007/s00784-021-04063-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/29/2021] [Indexed: 12/04/2022]
Abstract
OBJECTIVES To evaluate long-term survival and success rates of conventionally cemented partial-coverage crowns (PCCs) manufactured from high noble metal alloys (hn). MATERIAL AND METHODS Restoration-, periodontal- and tooth-related criteria on patients, restored with a single or multiple conventionally cemented hnPCCs in a private dental office were collected from existing patient records. With regard to semi-annual follow-ups, data of the most recent clinical evaluations were considered. Kaplan-Meier and log-rank tests were used for statistical analyses. Level of significance was set at p ≤ .05. RESULTS Between 09/1983 and 09/2009, 1325 hnPCCs were conventionally cemented on 1325 teeth in 266 patients (mean age: 44.5 ± 10.7 years). Due to various reasons, 81 hnPCCs showed complications, documenting a success rate of 93.9% after a mean observation period of 18.8 ± 5.7 years. Of these, additional 14 restorations were counted as survival, resulting in a survival rate of 94.9%. Most frequent complications were periodontal issues (n = 29, 35.8%). Significantly higher success rates were documented for hnPCCs of patients aged between 37 and 51 years (p = .012). CONCLUSION Partial-coverage crowns from high noble metal alloys showed excellent survival and success rates after a mean observation period of 18.8 ± 5.7 years. Higher patient age was one of the risk factors. CLINICAL RELEVANCE According to the results of this study, hnPCCs still represent an excellent therapeutic option-even in modern dentistry.
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Affiliation(s)
- Philipp Rehm
- Private Dental Office Dr. Rehm, Klückenhofstraße 1, 46459, Rees, Germany.
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Aßmannshauser Str. 4-6, Berlin, Germany.
| | - Hermann Derks
- Private Dental Office Dr. Hermann Derks, Steinstraße 12, 46446, Emmerich am Rhein, Germany
| | - Wilfried Lesaar
- Private Dental Office Dr. Hermann Derks, Steinstraße 12, 46446, Emmerich am Rhein, Germany
| | - Benedikt Christopher Spies
- Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Aßmannshauser Str. 4-6, Berlin, Germany
| | - Mats Wernfried Heinrich Böse
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Aßmannshauser Str. 4-6, Berlin, Germany
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Longevity of lithium disilicate indirect restorations in posterior teeth prepared by undergraduate students: A retrospective study up to 8.5 years. J Dent 2020; 105:103569. [PMID: 33385535 DOI: 10.1016/j.jdent.2020.103569] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/07/2020] [Accepted: 12/19/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To analyze retrospectively the clinical performance and survival of lithium disilicate inlays, partial crowns and crowns placed by undergraduate students. METHODS 250 lithium disilicate posterior restorations (IPS™Emax Press) were evaluated. Mean service time was 6.6 years (79 months) with a maximum observation time of 8.5 years (102 months). Clinical performance was assessed using FDI Criteria. Descriptive statistics were used to display the distribution of the criteria. Success and survival of the restorations were calculated with the Kaplan Meier method. A Cox regression analysis was performed to detect influencing parameters for the survival or the success of the restorations. RESULTS Survival and success rates of lithium disilicate indirect restorations were calculated at 6.6 years with 96.3 % and 93.8 %, respectively. After 8.5 years the survival rate was calculated with 94 % and the success rate with 83.8 %. 10 out of 250 restorations (4%) failed, while the main reasons for failure were fracture of material, debonding/loss of restoration, endodontic complications as well as recurrence of caries. A Cox regression analysis failed to show a correlation between restoration failure and the experience level of the students, an existing root canal treatment, type of tooth, bruxism or the use of rubber dam. CONCLUSIONS Lithium disilicate indirect posterior restorations demonstrate a high success and survival rate after a mean service of 6.6 years when placed by undergraduate students with different levels of experience. Co-factors influencing the survival or success rate of these restorations could not be identified. CLINICAL SIGNIFICANCE Lithium disilicate restorations show a good clinical performance up to 8.5 years when prepared by undergraduate students.
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Falahchai M, Babaee Hemmati Y, Neshandar Asli H, Neshandar Asli M. Marginal adaptation of zirconia‐reinforced lithium silicate overlays with different preparation designs. J ESTHET RESTOR DENT 2020; 32:823-830. [DOI: 10.1111/jerd.12642] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/21/2020] [Accepted: 07/30/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Mehran Falahchai
- Dental Sciences Research Center, Department of Prosthodontics School of Dentistry, Guilan University of Medical Sciences Rasht Iran
| | - Yasamin Babaee Hemmati
- Dental Sciences Research Center, Department of Orthodontics School of Dentistry, Guilan University of Medical Sciences Rasht Iran
| | - Hamid Neshandar Asli
- Dental Sciences Research Center, Department of Prosthodontics School of Dentistry, Guilan University of Medical Sciences Rasht Iran
| | - Marzieh Neshandar Asli
- Undergraduate student, Dental School Anzali Campus, Guilan University of Medical Sciences Rasht Iran
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Vág J, Nagy Z, Bocklet C, Kiss T, Nagy Á, Simon B, Mikolicz Á, Renne W. Marginal and internal fit of full ceramic crowns milled using CADCAM systems on cadaver full arch scans. BMC Oral Health 2020; 20:189. [PMID: 32631333 PMCID: PMC7339429 DOI: 10.1186/s12903-020-01181-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/29/2020] [Indexed: 11/25/2022] Open
Abstract
Background Chairside systems are becoming more popular for fabricating full-ceramic single restorations, but there is very little knowledge about the effect of the entire workflow process on restoration fit. Therefore, this study aimed to compare the absolute marginal discrepancy (AMD) and the full internal fit (FULL) of all-ceramic crowns made by two chairside systems, Planmeca FIT and CEREC, with detailed and standard mill settings. Methods One upper molar was prepared for an all-ceramic crown in human cadaver maxilla. Full-arch scans were made by Emerald or Omnicam four times each. Twenty-four e.max crowns were designed and milled by the Planmill 30s or 40s or CEREC MCXL mills with either detailed or standard settings. The cadaver tooth was extracted, and each crown was fixed on it and scanned by a high-resolution microCT scanner. The AMD and FULL were measured digitally in mesio-distal and bucco-lingual 2D slices. The actual and predicted times of the milling were also registered. Results No differences were observed between detailed or standard settings in either system. The AMD was significantly higher with CEREC (132 ± 12 μm) than with either Planmill 30s (71 ± 6.9 μm) or 40s (78 ± 7.7 μm). In standard mode, the FULL was significantly higher with CEREC (224 ± 9.6 μm) than with either Planmill 30s (169 ± 8.1 μm) or 40s (178 ± 8.5 μm). There was no difference between actual and predicted time with the two Planmeca models, but with CEREC, the actual time was significantly higher than the predicted time. The 30s had significantly higher actual and predicted times compared to all other models. Across all models, the average milling time was 7.2 min less in standard mode than in detailed mode. Conclusions All fit parameters were in an acceptable range. No differences in fit between Planmeca models suggest no effect of spindle number on accuracy. The detailed setting has no improvement in the marginal or internal fit of the restoration, yet it increases milling time.
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Affiliation(s)
- János Vág
- Department of Conservative Dentistry, Semmelweis University, Szentkirályi utca 47, Budapest, H-1088, Hungary.
| | - Zsolt Nagy
- Department of Conservative Dentistry, Semmelweis University, Szentkirályi utca 47, Budapest, H-1088, Hungary
| | - Christopher Bocklet
- College of Dental Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Tamás Kiss
- János Szentágothai Research Centre & Department of Pharmacology and Pharmacotherapy, Medical School, University of Pecs, Ifjúság útja 20, Pécs, H-7624, Hungary
| | - Ákos Nagy
- Department of Dentistry, Oral and Maxillofacial Surgery, University of Pecs, Pecs, Hungary
| | - Botond Simon
- Department of Conservative Dentistry, Semmelweis University, Szentkirályi utca 47, Budapest, H-1088, Hungary
| | - Ákos Mikolicz
- Department of Conservative Dentistry, Semmelweis University, Szentkirályi utca 47, Budapest, H-1088, Hungary
| | - Walter Renne
- Department of Oral Rehabilitation, College of Dental Medicine, Medical University of South Carolina, Charleston, SC, USA
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Mulic A, Svendsen G, Kopperud S. A retrospective clinical study on the longevity of posterior Class II cast gold inlays/onlays. J Dent 2018; 70:46-50. [DOI: 10.1016/j.jdent.2017.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 12/08/2017] [Accepted: 12/16/2017] [Indexed: 10/18/2022] Open
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Patel DR, O'Brien T, Petrie A, Petridis H. A systematic review of outcome measurements and quality of studies evaluating fixed tooth-supported restorations. J Prosthodont 2014; 23:421-33. [PMID: 24947268 PMCID: PMC4491372 DOI: 10.1111/jopr.12160] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2013] [Indexed: 02/04/2023] Open
Abstract
PURPOSE The purpose of this systematic review was to review clinical studies of fixed tooth-supported prostheses, and to assess the quality of evidence with an emphasis on the assessment of the reporting of outcome measurements. Multiple hypotheses were generated to compare the effect of study type on different outcome modifiers and to compare the quality of publications before and after January 2005. MATERIALS AND METHODS An electronic search was conducted using specific databases (MEDLINE via Ovid, EMBASE via Ovid, Cochrane Library) through July 2012. This was complemented by hand searching the past 10 years of issues of the Journal of Oral Rehabilitation, Journal of Prosthetic Dentistry, Journal of Prosthodontics, and the International Journal of Prosthodontics. All experimental and observational clinical studies evaluating survival, success, failure, and complications of tooth-supported extracoronal fixed partial dentures, crowns, and onlays were included. No restrictions on age or follow-up time were placed. RESULTS The electronic search generated 14,869 papers, of which 206 papers were included for full-text review. Hand-searching added 23 papers. Inclusion criteria were met by 182 papers and were included for the review. The majority were retrospective studies. Only 8 (4.4%) were randomized controlled trials. The majority of the studies measured survival and failure, and few studies recorded data on success; however, more than 60% of the studies failed to define survival, success, and failure. Many studies did not use any standardized criteria for assessment of the quality of the restorations and, when standardized criteria were used, they were modified, thereby not allowing for comparisons with other studies. There was an increase of 21.8% in the number of studies evaluating outcome measurements of all-ceramic restorations in past 8 years. CONCLUSIONS Prosthodontic literature presents with a reduced percentage of RCTs compared to other disciplines in dentistry. The overall quality of recording prosthodontic outcome measurements has not improved greatly in the past 8 years.
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Affiliation(s)
| | - Tim O'Brien
- Prosthodontics Unit, Department of Restorative Dentistry, UCL Eastman Dental InstituteLondon, UK
| | - Aviva Petrie
- Biostatistics Unit, UCL Eastman Dental InstituteLondon, UK
| | - Haralampos Petridis
- Prosthodontics Unit, Department of Restorative Dentistry, UCL Eastman Dental InstituteLondon, UK
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Marginal and internal fit of heat pressed versus CAD/CAM fabricated all-ceramic onlays after exposure to thermo-mechanical fatigue. J Dent 2013; 42:199-209. [PMID: 24161516 DOI: 10.1016/j.jdent.2013.10.002] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 09/21/2013] [Accepted: 10/01/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES The aim of the study was to evaluate the marginal and internal fit of heat-pressed and CAD/CAM fabricated all-ceramic onlays before and after luting as well as after thermo-mechanical fatigue. MATERIALS AND METHODS Seventy-two caries-free, extracted human mandibular molars were randomly divided into three groups (n=24/group). All teeth received an onlay preparation with a mesio-occlusal-distal inlay cavity and an occlusal reduction of all cusps. Teeth were restored with heat-pressed IPS-e.max-Press* (IP, *Ivoclar-Vivadent) and Vita-PM9 (VP, Vita-Zahnfabrik) as well as CAD/CAM fabricated IPS-e.max-CAD* (IC, Cerec 3D/InLab/Sirona) all-ceramic materials. After cementation with a dual-polymerising resin cement (VariolinkII*), all restorations were subjected to mouth-motion fatigue (98 N, 1.2 million cycles; 5°C/55°C). Marginal fit discrepancies were examined on epoxy replicas before and after luting as well as after fatigue at 200× magnification. Internal fit was evaluated by multiple sectioning technique. For the statistical analysis, a linear model was fitted with accounting for repeated measurements. RESULTS Adhesive cementation of onlays resulted in significantly increased marginal gap values in all groups, whereas thermo-mechanical fatigue had no effect. Marginal gap values of all test groups were equal after fatigue exposure. Internal discrepancies of CAD/CAM fabricated restorations were significantly higher than both press manufactured onlays. CONCLUSIONS Mean marginal gap values of the investigated onlays before and after luting as well as after fatigue were within the clinically acceptable range. Marginal fit was not affected by the investigated heat-press versus CAD/CAM fabrication technique. Press fabrication resulted in a superior internal fit of onlays as compared to the CAD/CAM technique. CLINICAL RELEVANCE Clinical requirements of 100 μm for marginal fit were fulfilled by the heat-press as well as by the CAD/CAM fabricated all-ceramic onlays. Superior internal fit was observed with the heat-press manufacturing method. The impact of present findings on the clinical long-term behaviour of differently fabricated all-ceramic onlays warrants further investigation.
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Clausen JO, Abou Tara M, Kern M. Dynamic fatigue and fracture resistance of non-retentive all-ceramic full-coverage molar restorations. Influence of ceramic material and preparation design. Dent Mater 2010; 26:533-8. [PMID: 20181388 DOI: 10.1016/j.dental.2010.01.011] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Revised: 10/15/2009] [Accepted: 01/27/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The purpose of the study was to evaluate the influence of preparation design, and ceramic material, masticatory fatigue and fracture resistance of non-retentive all-ceramic full-coverage restorations luted on human mandibular molars. METHODS Full-coverage occlusal restorations were laboratory fabricated from leucite reinforced glass-ceramic (IPS Empress Esthetic) or lithium disilicate glass-ceramic (IPS e.max Press). For each ceramic material four groups with eight specimens each were randomly assigned. Groups had either a non-retentive, occlusal preparation with chamfer finishing line or straight-beveled finishing line and the preparation was either completely within enamel or within dentin with a finishing line in enamel. Restorations were adhesively luted to the teeth using composite resin. After storage in water for 1 week specimens were cyclic loaded 600,000 times with a weight of 10kg and additionally, thermocycled 3500 times (5/55 degrees C) in a masticatory simulator. Surviving specimens were loaded until, fracture in a universal testing machine. Statistical analysis was done using three-way ANOVA. RESULTS All specimens survived the masticatory fatigue. Mean fracture resistance ranged from 2895 to 4173N. Influence of ceramic material on fracture resistance was significant (p=0.0001). Lithium disilicate glass-ceramic restorations had higher fracture resistances than leucite reinforced glass-ceramic restorations. Different preparation designs showed no significant influence on fracture resistance (p=0.0969). The design of the finishing line did not influence the fracture resistance (p=0.9461). SIGNIFICANCE The fracture resistance of adhesively luted non-retentive full-coverage molar restorations, made of lithium disilicate or leucite reinforced glass-ceramic is promising and seems to permit clinical application.
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Affiliation(s)
- Jan-Ole Clausen
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Arnold-Heller-Strasse 16, Kiel, Germany
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Long-term survivals of 'direct-wax' cast gold onlays: a retrospective study in a general dental practice. Br Dent J 2009; 207:111-5. [PMID: 19662053 DOI: 10.1038/sj.bdj.2009.668] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2009] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVES Compared to other restoration types, indirect cast posterior restorations of partial coverage exhibit one of the longest survivals. The purpose of the current study was to estimate the success rates of 'direct-wax' cast gold onlays. According to the direct wax technique, the wax pattern is shaped intra-orally followed by direct casting without the need for impressions, resulting in low cost and short processing time. DESIGN AND METHODS A retrospective survival study was undertaken at a mixed National Health Service and private general dental practice based in London. Patients with direct-wax onlays attending over a period of four months for regular check-ups or dental treatment were recruited. Patient discomfort, pain or sensitivity was recorded. Restoration location, extension, marginal fit, and tooth vitality were also recorded. Restoration failure was defined in the event of recurrent caries, pulp infection for vital teeth, increase in the size of periapical radiolucency for non-vital teeth, and restoration decementation. Survival estimates were calculated using the Kaplan-Meier algorithm. RESULT One hundred and ninety-four onlays in 56 patients were examined. Four restorations (2.1%) had failed, mainly due to recurrent caries. The cumulative survival probability was estimated at 415.3 (95% Confidence Interval: 403.0, 427.7) months (34.6, 95% CI: 33.6, 35.6 years), while the 10-year and 20-year survival rates were 97.0% and 94.1% respectively. Vital teeth, compared to non-vital ones, and onlay extension encompassing both the mesial and distal tooth surfaces exhibited significantly (P <0.05) higher success rates. Variations in marginal fit and restoration location did not affect the survival probability. CONCLUSION Direct-wax cast gold restorations of partial coverage were a highly successful treatment option for posterior restorations in a general dental practice environment.
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Stappert CF, Chitmongkolsuk S, Silva NR, Att W, Strub JR. Effect of mouth-motion fatigue and thermal cycling on the marginal accuracy of partial coverage restorations made of various dental materials. Dent Mater 2008; 24:1248-57. [DOI: 10.1016/j.dental.2008.02.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2007] [Revised: 02/05/2008] [Accepted: 02/08/2008] [Indexed: 10/22/2022]
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Zimmer S, Göhlich O, Rüttermann S, Lang H, Raab WHM, Barthel CR. Long-term Survival of Cerec Restorations: A 10-year Study. Oper Dent 2008; 33:484-7. [DOI: 10.2341/07-142] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
Class I and II CAD-CAM ceramic restorations can be considered durable alternatives to direct and laboratory-fabricated restorations.
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17
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Federlin M, Wagner J, Männer T, Hiller KA, Schmalz G. Three-year clinical performance of cast gold vs ceramic partial crowns. Clin Oral Investig 2007; 11:345-52. [PMID: 17973129 DOI: 10.1007/s00784-007-0158-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2007] [Accepted: 10/10/2007] [Indexed: 11/29/2022]
Abstract
Cast gold partial crowns (CGPC) and partial ceramic crowns (PCC) are both accepted for restoring posterior teeth with extended lesions today. However, as esthetics in dentistry becomes increasingly important, CGPC are being progressively replaced by PCC. The aim of the present prospective split-mouth study was the comparison of the clinical performance of PCC and CGPC after 3 years of clinical service. Twenty-eight patients (11 men and 17 women) participated in the 3-year recall with a total of 56 restorations. In each patient, one CGPC (Degulor C) and one PCC (Vita Mark II ceramic/Cerec III) had been inserted at baseline. CGPC were placed using a zinc phosphate cement (Harvard); PCC were adhesively luted (Variolink II/Excite). All restorations were clinically assessed using modified US Public Health Service (USPHS) criteria at baseline, 1 year, 2 years, and 3 years after insertion. Twenty-eight CGPC and 14 PCC were placed in molars, and 14 PCC were placed in premolars. Early data were reported previously under the same study design. After 3 years, the evaluation according to USPHS criteria revealed no statistically significant differences between both types of restorations with the exception of marginal adaptation and marginal discoloration: A statistically significant difference within the PCC group (baseline/3 years) was determined for the criterion marginal adaptation. For the 3-year recall period, overall failure was 0% for CGPC and 6.9% for PCC. At 3 years, PCC meet American Dental Association Acceptance Guidelines criteria for tooth-colored restorative materials for posterior teeth.
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Affiliation(s)
- M Federlin
- Department of Operative Dentistry and Periodontology, Dental School, University of Regensburg, Franz Josef Strauss Allee 11, 93042 Regensburg, Germany.
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Stoll R, Cappel I, Jablonski-Momeni A, Pieper K, Stachniss V. Survival of Inlays and Partial Crowns Made of IPS Empress After a 10-year Observation Period and in Relation to Various Treatment Parameters. Oper Dent 2007; 32:556-63. [DOI: 10.2341/07-13] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
Ceramic inlays as aesthetic restorations in the posterior region can be used successfully in routine clinical therapy. Cement viscosity, the operator (experienced dentist vs dental student) and the number of surfaces have no influence on longevity.
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Jamous I, Sidhu S, Walls A. An evaluation of the performance of cast gold bonded restorations in clinical practice, a retrospective study. J Dent 2007; 35:130-6. [PMID: 16919861 DOI: 10.1016/j.jdent.2006.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2006] [Revised: 06/07/2006] [Accepted: 06/10/2006] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To evaluate the performance of cast gold bonded restorations in clinical practice. MATERIALS AND METHODS The records of all patients treated with cast gold bonded restorations between 1997 and 2004 of The Dental Hospital of Newcastle upon Tyne were reviewed. The following data were recorded: sex of patient, location of teeth (anterior or posterior), position of teeth (upper or lower) and type of cement (glass ionomer, zinc phosphate or resin cement). The survival time was calculated for each restoration; and the reason for failure (either debond or change of treatment plan) identified for each case. The restorations were stratified according to the age of the patient into 10-year age bands and survival analysis was used to identify variables associated with increased risk of failure. RESULTS Restorations luted with resin cement showed the highest rate of survival after 7 years of follow-up. The alternative lutes had significantly worse survival (p<0.05). Restorations on anterior teeth had poorer survival than on posterior teeth but there were no differences between those placed in the mandible and the maxilla. CONCLUSIONS Within the limitations of this study resin cements are most appropriate for this type of restoration with 80% survival at 7 years. Restorations placed on posterior teeth survived better.
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Affiliation(s)
- Issam Jamous
- Department of Restorative Dentistry, School of Dental Sciences, University of Newcastle upon Tyne, Framlington Place, Newcastle upon Tyne NE2 4BW, United Kingdom.
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Janus CE, Unger JW, Best AM. Survival Analysis of Complete Veneer Crowns vs. Multisurface Restorations: A Dental School Patient Population. J Dent Educ 2006. [DOI: 10.1002/j.0022-0337.2006.70.10.tb04183.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Charles E. Janus
- Department of Prosthodontics; Virginia Commonwealth University, School of Dentistry
| | - John W. Unger
- Department of Prosthodontics; Virginia Commonwealth University, School of Dentistry
| | - Al M. Best
- Department of Biostatistics; Virginia Commonwealth University, School of Dentistry
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Stappert CFJ, Guess PC, Chitmongkolsuk S, Gerds T, Strub JR. Partial coverage restoration systems on molars – comparison of failure load after exposure to a mastication simulator. J Oral Rehabil 2006; 33:698-705. [PMID: 16922744 DOI: 10.1111/j.1365-2842.2006.01529.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This in vitro study evaluated the failure load of partial coverage restorations (PCR) made of various materials cemented on natural molars after exposure to the mastication simulator. Sixty-four maxillary molars were divided into four groups of 16 test specimens each. The specimens in one group remained unprepared (group NP); the teeth in the other groups were prepared equally according to standardized guidelines and restored with the following PCR: Group GO (Gold-Pontor-MPF; Metaux Precieux SA, Metalor, Neuchatel, Switzerland), group TA (Targis; Ivoclar Vivadent AG, Schaan, Liechtenstein) and group EM (IPS-Empress; Ivoclar Vivadent AG). The restorations in group GO were cemented conventionally, while those in groups TA and EM were luted adhesively. Groups NP and GO served as control groups. All test specimens were subjected to 1.2 million cycles (F = 49 N) in a mastication simulator. Subsequently, all test specimens were loaded occlusally until fracture occurred using an universal testing machine. All specimens withstood the masticating simulation. The median (IQR = x(0.25)-x(0.75)) failure loads were as follows: group NP: 1960.3(1480.5-2227.5) N, group TA: 1478.6(1293.4-1856.7) N and group EM: 1400.1(1043.1-1721.6) N. All test specimens of group GO achieved fracture strength values which exceeded a fracture load of 5500 N. The values of group GO were statistically significantly higher than those of groups NP, TA and EM (P < 0.00001). Furthermore, the results of group NP were significantly higher (P = 0.0226) than those of group EM. The results of groups NP and TA (P = 0.2022) as well as of groups TA and EM (P = 0.5340) did not differ significantly. The median values of all PCR systems obtained were within the limits of clinical acceptance. Long-term clinical investigations which take additional parameters into consideration are required before the composite-based Targis(R) (Ivoclar Vivadent AG) material can be recommended for indirect PCR.
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Affiliation(s)
- C F J Stappert
- Department of Prosthodontics, Faculty of Dentistry, Albert-Ludwigs-University, Freiburg, Germany.
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Federlin M, Männer T, Hiller KA, Schmidt S, Schmalz G. Two-year clinical performance of cast gold vs ceramic partial crowns. Clin Oral Investig 2006; 10:126-33. [PMID: 16614863 DOI: 10.1007/s00784-006-0042-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2005] [Accepted: 02/24/2006] [Indexed: 11/26/2022]
Abstract
Cast gold partial crowns (CGPC) are an accepted means of restoring posterior teeth with extended lesions. However, for esthetic reasons, CGPC are being increasingly substituted with partial ceramic crowns (PCC). The aim of the present prospective split-mouth study was to compare the clinical performance of PCC and CGPC. There were 29 patients (male 12, female 17) who participated in the investigation for a total of 58 restorations. In each patient, one CGPC (Degulor C) and one PCC (Vita MarkII/Cerec III) were placed. CGPC were inserted using conventional zinc-phosphate cement (Harvard); PCC were adhesively luted to the cavities (Variolink II/Excite). The restorations were clinically rated using modified United States Public Health Service (USPHS) criteria at baseline and 1 and 2 years after placement. The median patient age was 38 years (range 25-54). There were 29 of the CGPC and 14 PCC placed in molars, while 15 PCC were placed in premolars. All patients were available for the 1- and the 2-year recall. One PCC (1.7%) failed and had to be replaced after 2 years in situ. The rest of the restorations were functional without need of replacement. The evaluation using USPHS criteria revealed no statistically significant differences between CGPC and PCC with the exception of anatomic form: PCC showed occlusal chipping in two cases without need of replacement. From these data, it can be concluded that PCC may provide an esthetic and tissue-conservative alternative to CGPC. However, long-term studies comparing the clinical performance and longevity of cast gold and ceramic partial crowns for posterior teeth are desirable.
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Affiliation(s)
- Marianne Federlin
- Department of Operative Dentistry and Periodontology Dental School, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany.
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Stoll R, Betke K, Stachniss V. The influence of different factors on the survival of root canal fillings: a 10-year retrospective study. J Endod 2006; 31:783-90. [PMID: 16249719 DOI: 10.1097/01.don.0000158229.43298.a9] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of the present study was to determine the survival time of root canal fillings performed in 1990 and 1991 at the Dental School, Philipps University of Marburg, Germany. Data were collected retrospectively from the dental records and control radiographs were evaluated. The survival probability was determined by Kaplan-Meier analysis. Intergroup differences were verified with the log-rank test. The 914 evaluated root canal fillings yielded an overall 10-yr cumulative survival probability of 0.74. The factors baseline periapical condition (p < 0.001), length (p < 0.001), condensation (p < 0.001), vitality (p < 0.001), and pain symptoms (p = 0.005) were found to have a significant influence on the long-term success of root canal fillings. Higher survival rates were recorded for teeth with healthy periapical conditions, root canal fillings of the correct length, homogeneously condensed root canal fillings, root canal fillings in previously vital teeth, and teeth that had been asymptomatic during treatment. A nonsignificant influence was recorded for the parameters operator (p = 0.606) and retreatment (p = 0.196).
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Affiliation(s)
- Richard Stoll
- Department of Operative Dentistry and Endodontics, Dental School, Philipps-University of Marburg, Marburg, Germany.
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Schulte AG, Vöckler A, Reinhardt R. Longevity of ceramic inlays and onlays luted with a solely light-curing composite resin. J Dent 2005; 33:433-42. [PMID: 15833400 DOI: 10.1016/j.jdent.2004.10.026] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2004] [Revised: 10/23/2004] [Accepted: 10/29/2004] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES To determine the longevity of heat-pressed glass ceramic inlays and onlays luted with solely light-curing composite resin. METHODS The records of patients who had received a ceramic inlay or onlay at the Heidelberg University Department of Conservative Dentistry from 1993 to 2002 were evaluated. The mean observation time and the survival probability of the ceramic inlays and onlays was calculated with the aid of the Kaplan-Meier algorithm. This was done for the total number of all restorations as well as for various subgroups (number of surfaces, tooth type, endodontic condition at the time that the ceramic restoration was incorporated, experience of operator). The log-rank test was used to compare groups and look for significant differences, and p<0.05 was set to be statistically significant. In addition, 95% confidence intervals of the survival probability values were computed. RESULTS At the time of the last observation, 783 (96.7%) of these restorations were still in place. The mean observation period for all ceramic restorations was 17.3 months (SD 20.2), with an observation interval of between 0 and 116 months. The last loss of a ceramic restoration was observed 45 months after it had been placed, so that the survival probability of all ceramic restorations amounted to p=0.90 (95% confidence interval 0.86-0.94) from this time onward. Factors such as endodontic condition of tooth, type of tooth, position of tooth, extent of restoration, experience of operator or gender of patient had no significant influence on the survival probability of the ceramic restorations. CONCLUSIONS Heat-pressed glass ceramic inlays and onlays can be used successfully in routine clinical therapy. In addition, this type of inlays and onlays can be placed successfully with solely light-curing composite resin.
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Affiliation(s)
- Andreas G Schulte
- Department of Conservative Dentistry, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
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Donovan T, Simonsen RJ, Guertin G, Tucker RV. RETROSPECTIVE CLINICAL EVALUATION OF 1,314 CAST GOLD RESTORATIONS IN SERVICE FROM 1 TO 52 YEARS. J ESTHET RESTOR DENT 2004; 16:194-204. [PMID: 15597641 DOI: 10.1111/j.1708-8240.2004.tb00034.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A retrospective clinical evaluation of 1,314 cast gold restorations in 114 patients placed by one practitioner was conducted. A very high percentage of patients contacted (114/116 [98.3%]) participated in the evaluation. Almost 90% of the restorations had been in service for over 9 years, 72% for over 20 years, and 45% from 25 to 52 years. All restorations had been cemented using zinc phosphate cement. The restorations were evaluated by independent evaluators in terms of marginal integrity, anatomic form, and surface texture, and 96% of the evaluations were excellent (Figures 1-5). Sixty restorations required removal and replacement, yielding an overall failure rate of 4.6% or a survival rate of 95.4%. The survival rates at various time periods were 97% at 9 years, 90.3% at 20 years, 94.9% at 25 years, 98% at 29 years, 96.9% at 39 years, and 94.1% for restorations in place > 40 years. It appears that properly fabricated cast gold inlays, onlays, partial veneer crowns, and full veneer crowns can provide extremely predictable, long-term restorative service. It is suggested that the use of such restorations should not be automatically precluded simply because they are gold colored. These restorations should be considered in patients who are more concerned with longevity than esthetics, and in those patients in whom placement of a conservative cast gold restoration would not result in an unesthetic display of metal.
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Affiliation(s)
- Terry Donovan
- Advanced Education in Prosthodontics, University of Southern California, Los Angeles, CA 90089-0641, USA.
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Van Nieuwenhuysen JP, D'Hoore W, Carvalho J, Qvist V. Long-term evaluation of extensive restorations in permanent teeth. J Dent 2003; 31:395-405. [PMID: 12878022 DOI: 10.1016/s0300-5712(03)00084-8] [Citation(s) in RCA: 197] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES The present prospective, longitudinal study assessed the outcome of posterior extensive restorations and identified risk factors for failure of the restorations. MATERIALS AND METHODS The sample consisted of 722 amalgam restorations, 115 composite resin restorations and 89 crowns placed in 428 adults by one dentist from 1982 to 1999 in Belgium. Well-defined criteria were used for cavity preparation design, type of retention and selection of restorative material. RESULTS At the closure of the study 48% of the restorations were well functioning, 24% were lost to lack of follow-up, and 28% had failed. The most frequent reasons for failure were fracture of restoration (8%), secondary caries (6%) and fracture of cusp (5%). Failures were more often found in premolar teeth (34%) than in molars (27%) (P=0.05) and occurred in 28% of the amalgam restorations, 30% of the resin restorations and 24% of the crowns (P=0.55). Molar restorations were more frequently repaired than replaced in contrast to premolar restorations. The highest percentage of extractions was related to complete amalgam restorations in premolars. The Kaplan-Meier median survival times were 12.8 years for amalgam restorations, 7.8 years for resin restorations, and more than 14.6 years for crowns, considering all retreatment as failures (P=0.002). The survival was influenced by extension of restoration, age of patient, pulpal vitality, 3-year period of treatment, use of base material and dentinal retentive pins. CONCLUSION Within the limits of the study the data support the view that extensive amalgam restorations but not composite resin restorations can be used as an appropriate alternative to crowns, with due consideration to the longevity of the restorations.
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Affiliation(s)
- J-P Van Nieuwenhuysen
- School of Dentistry, Catholic University of Louvain, 15 Hippocrate Avenue, B-1200, Brussels, Belgium.
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Wagner J, Hiller KA, Schmalz G. Long-term clinical performance and longevity of gold alloy vs ceramic partial crowns. Clin Oral Investig 2003; 7:80-5. [PMID: 12743836 DOI: 10.1007/s00784-003-0205-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2002] [Accepted: 03/05/2003] [Indexed: 11/30/2022]
Abstract
Cast gold partial crowns (CGPC) are an accepted means of restoring posterior teeth. For aesthetic reasons, gold alloys are being increasingly substituted with ceramics. The aim of the present study was to investigate retrospectively the long-term clinical performance and survival of CGPC and compare the results to the ones already reported for ceramic partial crowns (CPC). The CGPC group consisted of 42 patients (24 male, 18 female) randomly sampled from a total of 106 patients with CGPC, with one restoration per patient. The CPC group consisted of 22 patients with a total of 42 restorations. Both types of restoration were done by one experienced dentist. Another two experienced dentists who were not involved in performing the restorations rated both kinds of partial crowns using the modified United State Public Health Service (USPHS) criteria [14]. The Median age of the CGPC was 57 months (range 3-157) and of the CPC and 63 months (range 24-72). Forty-one (98%) of the CGPC and 27 (64%) of the CPC were placed in molars, the rest in premolars. In each group, 40 (95%) restorations were still functioning without any necessity of replacement. Two teeth with CGPC, in situ for 4.5 and 11 years, respectively, had been extracted for periodontal reasons. Two CPC fractured and had to be replaced after 2 and 6.5 years in situ. The USPHS criteria results were similarly good for the gold and ceramic groups. Kaplan-Meier analysis revealed survival probabilities of 72+/-21% and 96+/-4% after 13 and 7 years, respectively, for the CGPC. Survival of the CPC was 81+/-15% after 7 years. No statistically significant difference among survival functions of CGPC and CPC was found. From this data, it can be concluded that the longevity of CPC is not inferior to that of gold alloys. However, more long-term studies comparing the clinical performance and longevity of these two types of indirect restoration in the posterior region with larger numbers of restorations are desirable.
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Affiliation(s)
- J Wagner
- Dental School, University of Regensburg, Regensburg, Germany
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Abstract
UNLABELLED The application of multisurfaced tooth-colored restorations in the posterior dentition is an exercise in risk tolerance when dentin occupies the bulk of the tooth substrate. Not only is interfacial integrity capricious, but also a recent in vivo study has confirmed that dentin bond strengths deteriorate with time. Although the literature is replete with esthetic guidelines for posterior restitution, most practicing clinicians appreciate the prime tenet that clinical success involves more than esthetic realism in the posterior dentition. Success with indirect ceramic restorations is dependent on interfacial integrity, which, although multitudinous, is contingently related to operative competence. Innovative clinical techniques are described in this two-part article, along with a discussion of the probationary status of current adhesive options and the need for excellence in all phases of this demanding restorative sequence. CLINICAL SIGNIFICANCE Restorative success in the posterior dentition is profoundly influenced by the variability of operative competence and diligence. This article discusses the precincts of posterior indirect ceramic restorations and submits a number of innovative solutions to the clinical challenge.
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Jokstad A, Bayne S, Blunck U, Tyas M, Wilson N. Quality of dental restorations. FDI Commission Project 2-95. Int Dent J 2001; 51:117-58. [PMID: 11563679 DOI: 10.1002/j.1875-595x.2001.tb00832.x] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- A Jokstad
- Institute of Clinical Dentistry, Dental Faculty, University of Oslo, Blindern, Norway.
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