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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Michaud PL, Dort H. Do onlays and crowns offer similar outcomes to posterior teeth with mesial-occlusal-distal preparations? A systematic review. J ESTHET RESTOR DENT 2024; 36:295-302. [PMID: 37497796 DOI: 10.1111/jerd.13114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/22/2023] [Accepted: 07/14/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Teeth prepared for mesial-occlusal-distal (MOD) restorations have a significant risk of cusp fracture. Crowns and onlays can provide cusp coverage to reinforce posterior teeth at risk. Onlays are often more conservative of tooth structure which may be an advantage for teeth with large MOD preparations. It remains uncertain how onlays and crowns compare for posterior teeth with MOD tooth structure loss. The purpose of this systematic review was to compare the resistance to fracture, success rate, survival rate, and failure rate of teeth with MOD preparations restored with onlays or crowns. MATERIALS AND METHODS An electronic search queried Medline (PubMed), Embase (Ovid), Scopus, the Cochrane Library, and grey literature (OpenGrey) from database inception through April 29, 2023. RESULTS After eliminating duplicates and irrelevant records, 32 manuscripts were assessed. Only three publications met the criteria for inclusion. Most exclusions were due to poor reporting of restorative design and the amount of tooth structure remaining, or due to combining various restorative designs. Due to the limited sample size and high heterogeneity, no meta-analysis was conducted. One study observed a better outcome for onlays and two observed no difference. All three studies reported the mode of failure for crowns as more catastrophic whereas teeth with onlays could be salvaged. CONCLUSIONS Onlays may be an advantageous alternative to crowns for teeth with MOD preparations, but the level of evidence is insufficient to draw meaningful conclusions. CLINICAL SIGNIFICANCE Current evidence is insufficient to determine whether onlays or crowns are providing a different outcome when used to restore posterior teeth with MOD tooth structure loss. However, the fracture of teeth with MOD tooth structure loss restored with onlays appears to be less catastrophic than when restored with crowns.
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Affiliation(s)
- Pierre-Luc Michaud
- Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Hillary Dort
- Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada
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Bresser RA, Hofsteenge JW, Wieringa TH, Braun PG, Cune MS, Özcan M, Gresnigt MMM. Clinical longevity of intracoronal restorations made of gold, lithium disilicate, leucite, and indirect resin composite: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:4877-4896. [PMID: 37597003 PMCID: PMC10492736 DOI: 10.1007/s00784-023-05050-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/28/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis is to assess the comparative clinical success and survival of intracoronal indirect restorations using gold, lithium disilicate, leucite, and indirect composite materials. MATERIAL AND METHODS This systematic review and meta-analysis were conducted following the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. The protocol for this study was registered in PROSPERO (registration number: CRD42021233185). A comprehensive literature search was conducted across various databases and sources, including PubMed/Medline, Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, and gray literature. A total of 7826 articles were screened on title and abstract. Articles were not excluded based on the vitality of teeth, the language of the study, or the observation period. The risk difference was utilized for the analyses, and a random-effects model was applied. All analyses were conducted with a 95% confidence interval (95% CI). The calculated risk differences were derived from the combined data on restoration survival and failures obtained from each individual article. The presence of heterogeneity was assessed using the I2 statistic, and if present, the heterogeneity of the data in the articles was evaluated using the non-parametric chi-squared statistic (p < 0.05). RESULTS A total of 12 eligible studies were selected, which included 946 restorations evaluated over a minimum observation period of 1 year and a maximum observation period of 7 years. Results of the meta-analysis indicated that intracoronal indirect resin composite restorations have an 18% higher rate of failure when compared to intracoronal gold restorations over 5-7 years of clinical service (risk difference = - 0.18 [95% CI: - 0.27, - 0.09]; p = .0002; I2 = 0%). The meta-analysis examining the disparity in survival rates between intracoronal gold and leucite restorations could not be carried out due to methodological differences in the studies. CONCLUSIONS According to the currently available evidence, medium-quality data indicates that lithium disilicate and indirect composite materials demonstrate comparable survival rates in short-term follow-up. Furthermore, intracoronal gold restorations showed significantly higher survival rates, making them a preferred option over intracoronal indirect resin-composite restorations. Besides that, the analysis revealed no statistically significant difference in survival rates between leucite and indirect composite restorations. The short observation period, limited number of eligible articles, and low sample size of the included studies were significant limitations. CLINICAL SIGNIFICANCE Bearing in mind the limitations of the reviewed literature, this systematic review and meta-analysis help clinicians make evidence-based decisions on how to restore biomechanically compromised posterior teeth.
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Affiliation(s)
- R A Bresser
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| | - J W Hofsteenge
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - T H Wieringa
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - P G Braun
- Central Medical Library, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M S Cune
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
- Prosthodontics and Special Dental Care, Department of Oral Maxillofacial Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - M Özcan
- Clinic for Reconstructive Dentistry, Division of Dental Biomaterials, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - M M M Gresnigt
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
- Department of Special Dental Care, Martini Hospital, Groningen, The Netherlands
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Mancuso E, Mazzitelli C, Maravic T, Pitta J, Mengozzi A, Comba A, Baldi A, Scotti N, Mazzoni A, Fehmer V, Sailer I, Breschi L. The influence of finishing lines and margin location on enamel and dentin removal for indirect partial restorations: A micro-CT quantitative evaluation. J Dent 2022; 127:104334. [PMID: 36257512 DOI: 10.1016/j.jdent.2022.104334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES This in vitro research aimed to quantitatively evaluate the enamel and dentin tissue removal and the residual adhesion surface area (RAS) after different margin designs and locations for indirect partial restorations (IPR). METHODS A human molar was scanned using a Micro-CT and the STL file obtained was used to 3D-print 50 resin-tooth replicas. IPR standardized preparations were performed. The specimens were randomly assigned to 5 groups (n = 10), according to preparation and margin location to the dental equator (DE): 1) Rounded shoulder above the DE (SA); 2) Hollow chamfer above the DE (CA); 3) Butt joint above the DE (BJ); 4) Rounded shoulder below the DE (SB); 5) Chamfer below the DE (CB). Then, the tooth replicas were scanned and each STL file was aligned and superimposed to the original STL model file. Data of enamel and dentin volume removal and RAS were assessed and statistically analyzed (one-way ANOVA and Kruskal-Wallis tests for the two dental substrates respectively). Significance was set at p<0.05. RESULTS Differences in dental tissue reductions were related to the margin location. Above the equator, SA, CA, and BJ performed comparably (p>0.05). Below the equator, CB was significantly more conservative in enamel reduction than SB (p<0.05) and showed the highest enamel adhesive surface exposure among the tested preparations (p<0.05). CONCLUSIONS When the preparation margin is placed above DE, BJ determines a greater exposure of dentin, reducing the adhesive surface in enamel. Below DE, SB seems to be more aggressive in terms of tissue removal compared to CB. CLINICAL SIGNIFICANCE The results of this in vitro study suggest that in teeth requiring partial restoration with the margin below the dental equator, a chamfer preparation would be more conservative than a shoulder preparation. When above the equator, preparations with flat designs would expose more dentine providing a worse substrate for adhesion.
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Affiliation(s)
- Edoardo Mancuso
- Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater University of Bologna, via S. Vitale 59, 40125 Bologna, Italy
| | - Claudia Mazzitelli
- Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater University of Bologna, via S. Vitale 59, 40125 Bologna, Italy
| | - Tatjana Maravic
- Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater University of Bologna, via S. Vitale 59, 40125 Bologna, Italy
| | - João Pitta
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Alessandro Mengozzi
- Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater University of Bologna, via S. Vitale 59, 40125 Bologna, Italy
| | - Allegra Comba
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, Via Nizza 230, 10126 Turin, Italy
| | - Andrea Baldi
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, Via Nizza 230, 10126 Turin, Italy
| | - Nicola Scotti
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, Via Nizza 230, 10126 Turin, Italy
| | - Annalisa Mazzoni
- Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater University of Bologna, via S. Vitale 59, 40125 Bologna, Italy
| | - Vincent Fehmer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Lorenzo Breschi
- Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater University of Bologna, via S. Vitale 59, 40125 Bologna, Italy.
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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] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [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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HAN W, KIM JH, KWON HB, PARK JK, SEO DG. Effect of cyclic thermal stress on the fatigue life of teeth restored with gold inlay. Dent Mater J 2022; 41:567-572. [DOI: 10.4012/dmj.2021-306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Jae-Hoon KIM
- Department of Dental Education, Dental and Life Science Institute, School of Dentistry, Pusan National University, Dental Research Institute
| | - Ho-Beom KWON
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University
| | - Jeong-Kil PARK
- Department of Conservative Dentistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Dental Research Institute
| | - Deog-Gyu SEO
- Department of Conservative Dentistry and Dental Research Institute, School of Dentistry, Seoul National University
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Dioguardi M, Alovisi M, Troiano G, Caponio CVA, Baldi A, Rocca GT, Comba A, Lo Muzio L, Scotti N. Clinical outcome of bonded partial indirect posterior restorations on vital and non-vital teeth: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:6597-6621. [PMID: 34628547 PMCID: PMC8602142 DOI: 10.1007/s00784-021-04187-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/20/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The survival rate of indirect partial adhesive restorations on vital versus endodontically treated teeth is still controversial. The hypothesis is that there may be a difference in the survival rate of partial adhesive restorations performed on non-vital teeth compared to vital teeth. MATERIALS AND METHODS This systematic review was conducted following the PRISMA guidelines. The considered clinical studies investigated the outcomes of adhesive inlays, onlays, and overlays conducted over the past 40 years, focusing on Kaplan-Meier survival curves to calculate the hazard ratio (primary objective) and the survival rate (secondary objective) between vital and non-vital teeth. The risk of bias was assessed using the Newcastle-Ottawa Scale. Studies included in the review were identified through bibliographic research on electronic databases ("PubMed," "Scopus," "Cochrane Central Register of Controlled Trial," and "Embase"). The K agreement between the two screening reviewers was evaluated. RESULTS A total of 55,793 records were identified on PubMed, Scopus, and other bibliographic sources, and after the application of the eligibility and inclusion criteria, eight articles were included for qualitative analysis and six for quantitative analysis. The meta-analysis of the primary and secondary outcomes demonstrated that hazard ratios (HR = 8.41, 95% CI: [4.50, 15.72]) and survival rates (OR = 3.24, 95% CI: [1.76, 5.82]) seemed more favorable for indirect partial adhesive restorations on vital teeth than for those on endodontically treated teeth. CONCLUSIONS Within the limits of this study, these findings suggest that the risk of failure of indirect partial adhesive restorations on endodontically treated teeth is higher than on vital teeth. CLINICAL RELEVANCE The use of partial adhesive restorations on vital and endodontically treated teeth showed different long-term clinical outcomes.
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Affiliation(s)
- Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Mario Alovisi
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10100, Turin, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Carlo Vito Alberto Caponio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Andrea Baldi
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10100, Turin, Italy
| | - Giovanni Tommaso Rocca
- Division of Cariology and Endodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Allegra Comba
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10100, Turin, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Nicola Scotti
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10100, Turin, Italy.
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Mannocci F, Bhuva B, Roig M, Zarow M, Bitter K. European Society of Endodontology position statement: The restoration of root filled teeth. Int Endod J 2021; 54:1974-1981. [PMID: 34378217 DOI: 10.1111/iej.13607] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
This position statement on the restoration of root filled teeth represents the consensus of an expert committee, convened by the European Society of Endodontology (ESE). Current clinical and scientific evidence, as well as the expertise of the committee, have been used to develop this statement. The aim is to provide clinicians with evidence-based principles for decision-making on the choice of restoration following the completion of root canal treatment. By discussing the evidence in relation to key topics regarding post-endodontic restoration, a series of clinical recommendations are made. The scientific basis of the recommendations made in this paper can be found in a recently published review article (Bhuva et al. 2021, International Endodontic Journal, https://doi.org/10.1111/iej.13438). It is the intention of the committee to update this statement as further evidence emerges.
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Affiliation(s)
| | - Francesco Mannocci
- Faculty of Dentistry, Oral & Craniofacial Sciences, Department of Endodontics, King's College London, Guy's Hospital, London, UK
| | - Bhavin Bhuva
- Faculty of Dentistry, Oral & Craniofacial Sciences, Department of Endodontics, King's College London, Guy's Hospital, London, UK
| | - Miguel Roig
- Section for Endodontology, Department of Restorative Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Kerstin Bitter
- Department of Operative and Preventive Dentistry, Charité - University Medicine, Berlin, Germany
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Gomes de Carvalho AB, de Andrade GS, Mendes Tribst JP, Grassi EDA, Ausiello P, Saavedra GDSFA, Bressane A, Marques de Melo R, Borges ALS. Mechanical Behavior of Different Restorative Materials and Onlay Preparation Designs in Endodontically Treated Molars. Materials (Basel) 2021; 14:ma14081923. [PMID: 33921347 PMCID: PMC8070423 DOI: 10.3390/ma14081923] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 11/24/2022]
Abstract
This study evaluated the effect of the combination of three different onlay preparation designs and two restorative materials on the stress distribution, using 3D-finite element analysis. Six models of first lower molars were created according to three preparation designs: non-retentive (nRET), traditional with occlusal isthmus reduction (IST), and traditional without occlusal isthmus reduction (wIST); and according to two restorative materials: lithium-disilicate (LD) and nanoceramic resin (NR). A 600 N axial load was applied at the central fossa. All solids were considered isotropic, homogeneous, and linearly elastic. A static linear analysis was performed, and the Maximum Principal Stress (MPS) criteria were used to evaluate the results and compare the stress in MPa on the restoration, cement layer, and tooth structure (enamel and dentin). A novel statistical approach was used for quantitative analysis of the finite element analysis results. On restoration and cement layer, nRET showed a more homogeneous stress distribution, while the highest stress peaks were calculated for LD onlays (restoration: 69–110; cement layer: 10.2–13.3). On the tooth structure, the material had more influence, with better results for LD (27–38). It can be concluded that nRET design showed the best mechanical behavior compared to IST and wIST, with LD being more advantageous for tooth structure and NR for the restoration and cement layer.
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Affiliation(s)
- Ana Beatriz Gomes de Carvalho
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (A.B.G.d.C.); (G.S.d.A.); (E.D.A.G.); (G.d.S.F.A.S.); (R.M.d.M.); (A.L.S.B.)
| | - Guilherme Schmitt de Andrade
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (A.B.G.d.C.); (G.S.d.A.); (E.D.A.G.); (G.d.S.F.A.S.); (R.M.d.M.); (A.L.S.B.)
| | - João Paulo Mendes Tribst
- Graduate Program in Dentistry, Department Dentistry, University of Taubate (UNITAU), Taubate 12020-270, Brazil;
| | - Elisa Donária Aboucauch Grassi
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (A.B.G.d.C.); (G.S.d.A.); (E.D.A.G.); (G.d.S.F.A.S.); (R.M.d.M.); (A.L.S.B.)
| | - Pietro Ausiello
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Dentistry, University of Naples Federico II, 80138 Naples, Italy
- Correspondence:
| | - Guilherme de Siqueira Ferreira Anzaloni Saavedra
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (A.B.G.d.C.); (G.S.d.A.); (E.D.A.G.); (G.d.S.F.A.S.); (R.M.d.M.); (A.L.S.B.)
| | - Adriano Bressane
- Graduate Oral Health Applied Science, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil;
| | - Renata Marques de Melo
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (A.B.G.d.C.); (G.S.d.A.); (E.D.A.G.); (G.d.S.F.A.S.); (R.M.d.M.); (A.L.S.B.)
| | - Alexandre Luiz Souto Borges
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (A.B.G.d.C.); (G.S.d.A.); (E.D.A.G.); (G.d.S.F.A.S.); (R.M.d.M.); (A.L.S.B.)
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Bhuva B, Giovarruscio M, Rahim N, Bitter K, Mannocci F. The restoration of root filled teeth: a review of the clinical literature. Int Endod J 2021; 54:509-535. [PMID: 33128279 DOI: 10.1111/iej.13438] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023]
Abstract
Clinicians often face dilemmas regarding the most appropriate way to restore a tooth following root canal treatment. Whilst there is established consensus on the importance of the ferrule effect on the predictable restoration of root filled teeth, other factors, such as residual tooth volume, tooth location, number of proximal contacts, timing of the definitive restoration and the presence of cracks, have been reported to influence restoration and tooth survival. The continued evolution of dental materials and techniques, combined with a trend towards more conservative endodontic-restorative procedures, prompts re-evaluation of the scientific literature. The aim of this literature review was to provide an updated overview of the existing clinical literature relating to the restoration of root filled teeth. An electronic literature search of the PubMed, Ovid (via EMBASE) and MEDLINE (via EMBASE) databases up to July 2020 was performed to identify articles that related the survival of root filled teeth and/or restoration type. The following and other terms were searched: restoration, crown, onlay, root canal, root filled, post, clinical, survival, success. Wherever possible, only clinical studies were selected for the literature review. Full texts of the identified articles were independently screened by two reviewers according to pre-defined criteria. This review identifies the main clinical factors influencing the survival of teeth and restorations following root canal treatment in vivo and discusses the data related to specific restoration type on clinical survival.
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Affiliation(s)
- B Bhuva
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - M Giovarruscio
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.,Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - N Rahim
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - K Bitter
- Department of Operative and Preventive Dentistry, Charité - University Medicine, Berlin, Germany
| | - F Mannocci
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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11
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Irusa K, Al-Rawi B, Donovan T, Alraheam IA. Survival of Cast Gold and Ceramic Onlays Placed in a School of Dentistry: A Retrospective Study. J Prosthodont 2020; 29:693-698. [PMID: 32767417 DOI: 10.1111/jopr.13233] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE This study was done to compare the survival rates of cast gold and ceramic onlays placed in a dental school setting. MATERIAL AND METHODS An electronic search was conducted in the patient records at Adams School of Dentistry, University of North Carolina at Chapel Hill for onlay codes that were in the database (From 1998 until 2018). Progress notes and radiographs were scrutinized to establish the survival time of the restorations. Any complications that occurred during the life time of the restorations were noted. The survival was summarized by categorization based on ranges of survival time in years; group 1: 1 to 5 years, group 2: 6 to 22 years. The mean survival time and standard deviation were calculated. One-way ANOVA was used to determine whether there was a statistically significant difference in the survival times between gold and ceramic onlays. RESULTS The mean survival rate of cast gold onlays (86.6%) was comparable to that of ceramic onlays (81.1%). The gold onlays in Group 1 had a higher mean survival time (2.43 years) than the ceramic onlays (2.03 years). This difference was statistically significant (p = 0.002). The ceramic onlays in Group 2 had a mean survival time of 19.75 years while gold onlays had a mean survival time of 17.63 years. This difference was not statistically significant (p = 0.91). CONCLUSION It was concluded that while the survival rate of ceramic onlays (81.1%) was inferior to that of cast gold onlays (86.6%), it was comparable.
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Affiliation(s)
- Karina Irusa
- Advanced Education in Operative Dentistry and Biomaterials, University of North Carolina at Chapel Hill, 385 S Columbia St, Brauer Hall, Room 429, Chapel Hill, NC
| | - Bassam Al-Rawi
- Advanced Education in Operative Dentistry and Biomaterials, University of North Carolina at Chapel Hill, 385 S Columbia St, Brauer Hall, Room 429, Chapel Hill, NC
| | - Terrence Donovan
- Division of Comprehensive Oral Health, University of North Carolina at Chapel Hill
| | - Islam Abd Alraheam
- Department of Conservative Dentistry, University of Jordan, Amman, Jordan
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12
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Vagropoulou GI, Klifopoulou GL, Vlahou SG, Hirayama H, Michalakis K. Complications and survival rates of inlays and onlays vs complete coverage restorations: A systematic review and analysis of studies. J Oral Rehabil 2018; 45:903-920. [PMID: 30019391 DOI: 10.1111/joor.12695] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 07/07/2018] [Accepted: 07/16/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of this study was to identify if different types of indirect restorations used for single teeth had different biological and technical complications, as well as survival rates. METHOD An electronic search was performed in various electronic databases to identify articles, published between 1980 and 2017. The search terms were categorised into 4 groups: inlay, onlay, inlay/onlay and crown. Manual searches of published full-text articles and related reviews were also performed. RESULTS A total number of 2849 papers were retrieved initially. After a detailed assessment for eligibility, 9 studies were selected for inclusion. The heterogeneity of the studies did allow neither a meta-analysis nor any meaningful comparison between types of restorations or materials. Only some pooling was performed for representative reasons. The mean survival rate of inlays was 90.89%, while for onlays and crowns it was 93.50% and 95.38%, respectively. For the fourth study group, consisting of both inlays and onlays, the survival rate was found to be 99.43%. Statistical analysis demonstrated caries to be the main biological complication for all types of restorations, followed by a root and/or tooth fracture incidence (11.34%) and endodontic incidence. Ceramic fractures represented the most common technical complication, followed by loss of retention and porcelain chipping. CONCLUSION The 5-year survival rate for crowns and inlays/onlays is very high, exceeding 90%. An association between the kind of complications and different types of restorations could not be established. Nevertheless, a relatively high failure rate due to caries and ceramic fractures was noted.
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Affiliation(s)
- Georgia I Vagropoulou
- Department of Prosthodontics, Division of Graduate Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Stefania G Vlahou
- School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Hiroshi Hirayama
- Department of Restorative Sciences and Biomaterials, Division of Graduate Prosthodontics, Henry M Goldman School of Dental Medicine, Boston University, Boston, Massachusetts
| | - Konstantinos Michalakis
- Department of Prosthodontics, Division of Graduate Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Department of Prosthodontics, Division of Graduate and Postgraduate Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts
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Abstract
OBJECTIVE This systematic review aimed to evaluate the longevity of ceramic onlays and identify the factors that influence their survival. MATERIALS AND METHODS An electronic search was conducted through PubMed (MEDLINE), Google Scholar and Cochrane Library, up to August 2017. The literature search aimed to retrieve all the clinical studies on the longevity of ceramic onlays. Ceramic onlay was defined as any partial ceramic restoration that covers at least one cusp. RESULTS A total of 21 studies met the selection criteria and were deemed suitable for this review. The medium-term studies (2-5 years) indicated a survival rate of 91-100%, and the long term studies (more than 5 years) showed a survival rate of 71-98.5%. The most common reason of failure was fracture, followed by debonding and caries. The most common patterns of deterioration were loss of margin integrity and discoloration. Onlay longevity can be enhanced if the preparation allows for at least 2 mm occlusal ceramic thickness and incorporates additional retentive features. Restoring teeth that are nonvital, teeth in a more posterior region, or teeth for patients with parafunctional habits appears to be associated with greater ceramic failure. Fabrication materials and methods, and adhesive bonding system did not seem to influence onlay longevity. CONCLUSIONS The clinical performance of the ceramic onlay appears acceptable regardless of the follow-up duration. Fracture of the ceramic onlay is the predominant cause of failure, and the most observed form of deterioration was associated with the restoration margin. CLINICAL SIGNIFICANCE Ceramic onlay appears to be a reliable option to restore posterior teeth. The most common pattern of failure is fracture of the ceramic material. The risk of ceramic onlay failure seems to increase if the restored tooth is nonvital and the patient demonstrates parafunctional habits.
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Affiliation(s)
- Jaafar Abduo
- Restorative Section, Melbourne Dental School, Melbourne University, 720 Swanston Street, Melbourne, Victoria, 3010, Australia
| | - Raelene Jo Sambrook
- Department of Prosthodontics, Royal Dental Hospital of Melbourne, Melbourne, Victoria 3010, Australia
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14
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Wu W, Lin T, Liu P, Ramp LC, Pan Y. In vitro compressive fracture resistance of human maxillary first premolar with different mesial occlusal distal cavity. J Dent Sci 2014; 9:221-8. [DOI: 10.1016/j.jds.2014.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] 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: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Guess PC, Vagkopoulou T, Zhang Y, Wolkewitz M, Strub JR. Marginal and internal fit of heat pressed versus CAD/CAM fabricated all-ceramic onlays after exposure to thermo-mechanical fatigue. J Dent 2014; 42:199-209. [PMID: 24161516 DOI: 10.1016/j.jdent.2013.10.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [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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Hamouda IM, Shehata SH. Fracture resistance of posterior teeth restored with modern restorative materials. J Biomed Res 2011; 25:418-24. [PMID: 23554719 PMCID: PMC3596721 DOI: 10.1016/s1674-8301(11)60055-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 08/31/2011] [Accepted: 09/20/2011] [Indexed: 11/29/2022] Open
Abstract
We studied the fracture resistance of maxillary premolars restored with recent restorative materials. Fifty maxillary premolars were divided into five groups: Group 1 were unprepared teeth; Group 2 were teeth prepared without restoration; Group 3 were teeth restored with tetric ceram HB; Group 4 were teeth restored with InTen S; and Group 5 were teeth restored with Admira. The samples were tested using a universal testing machine. Peak loads at fracture were recorded. The teeth restored with Admira had the highest fracture resistance followed by those restored with InTen-S and tetric ceram HB. Prepared, unrestored teeth were the weakest group. There was a significant difference between the fracture resistance of intact teeth and the prepared, unrestored teeth. There was also a significant difference among the tested restorative materials. Teeth restored with Admira showed no significant difference when compared with the unprepared teeth. It was concluded that the teeth restored with Admira exhibited the highest fracture resistance.
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Affiliation(s)
| | - Salah H. Shehata
- Department of Conservative Dentistry, Mansoura University, Al-Gomhoria St, Mansoura 35516, Egypt.
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18
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Bandlish LK, Mariatos G. 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] [What about the content of this article? (0)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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20
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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: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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21
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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: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Gandjour A, Kerschbaum T, Reis A, Lauterbach KW. Technology assessment in dentistry: A comparison of the longevity and cost-effectiveness of inlays. Int J Technol Assess Health Care 2005; 21:319-25. [PMID: 16110711 DOI: 10.1017/s0266462305050427] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objectives: An example of technology assessment in dental care by evaluating the (cost-)effectiveness of types of three-surface inlays (gold, laboratory-fabricated ceramic, and chairside CAD/CAM ceramic) is provided.Methods: MEDLINE, EMBASE, and the Cochrane Library were searched for studies published between 1966 and June 2003 that reported annual survival probabilities and annual observations. The longevity of different types of inlays was measured by the number of failure-free years. Annual survival rates from different studies were pooled by weighing the rates of each study by the inverse of the variance of the effect estimate. A cost-effectiveness analysis from the perspective of German private health insurers was performed using billing charges.Results: Three, five, and two case series on laboratory-fabricated ceramic, chairside CAD/CAM ceramic, and gold inlays, respectively, were included. Over a 9-year observation period, the number of undiscounted failure-free years was 8.62 (95 percent confidence interval, 8.40–8.85), 8.65 (8.58–8.73), and 8.76 (8.72–8.80) for laboratory-fabricated ceramic, chairside CAD/CAM ceramic, and gold inlays, respectively. Laboratory-fabricated ceramic inlays were the most expensive.Conclusions: While laboratory-fabricated ceramic, chairside CAD/CAM ceramic, and gold inlays had a strikingly similar failure-free survival rate, laboratory-fabricated ceramic inlays had the highest costs and, thus, were less cost-effective than chairside CAD/CAM ceramic and gold inlays.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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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Abstract
Metal-free tooth-colored restorative systems for fabricating indirect intracoronal and extracoronal restorations have been developed because of patients' demand for superior esthetics. During the past decade, long-term clinical studies have demonstrated the success of many of these types of restorations in terms of function and esthetics. Ceramic veneers, all-ceramic crowns, ceramic onlays, and composite-resin inlays are becoming an integral part of contemporary clinical practice. The constant evolution in bonding techniques, adhesive systems, and cements plays a major role in the success of these metal-free restorations. In addition, home-bleaching procedures have become an integral part of the esthetically oriented dental practice. This article discusses the rationale, scientific basis, and implementation of a new undergraduate preclinical esthetics course for second-year dental students at the Louisiana State University Health Sciences Center School of Dentistry.
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Affiliation(s)
- Ariel J Raigrodski
- Department of Prosthodontics, Louisiana State University School of Dentistry, New Orleans, LA 70119, USA.
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Abstract
STATEMENT OF PROBLEM intact, prepared, and restored human maxillary premolars. MATERIAL AND METHODS Fifty intact, noncarious human maxillary premolars were divided into 5 groups of 10 and were mounted with their roots imbedded in autopolymerized acrylic. In the first group, the teeth were intact with no preparation. In the other 4 groups, Class II MOD preparations were made with a water-cooled high-speed hand piece. In 1 group, the cavity preparations were restored with bonded CAD/CAM ceramic inlays. In 2 groups, the preparations were restored with bonded CAD/CAM composite inlays (acid etched or air particle abraded). In the final group, the teeth were prepared but unrestored. Specimens were tested individually in a universal testing machine, in which a 4.82-mm-diameter steel sphere plunger was mounted in the crosshead moving at 0.5 mm/min. The plunger contacted the facial and lingual triangular ridges beyond the margins of the restorations. Peak load to fracture (N) was measured for each specimen. Means were calculated and analyzed with analysis of variance (P</=.05). RESULTS MOD preparations weakened the teeth by approximately 59%. Restoring the teeth with ceramic or composite inlays did not significantly strengthen the teeth under this testing system. Of the restored teeth, those restored with indirect composite inlays cemented following manufacturer's recommendations had the highest fracture resistance. CONCLUSION Within the limitations of this study, under static compression load testing, bonded inlay restorations did not strengthen maxillary premolars with large MOD preparations.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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