This prospective randomized clinical trial evaluated tooth sensitivity and patient satisfaction after the provision of partial ceramic restorations bonded using immediate (IDS) or delayed dentin sealing (DDS) on vital molar teeth through a within-subject comparison study. Between December 2013 and May 2016, a total of 30 patients (13 women, 17 men; mean age, 54 years old) received two lithium disilicate ceramic (IPS-e.max press, Ivoclar Vivadent) partial restorations on vital first or second molar teeth (N=60). The two teeth randomly received either IDS (test group, n=30) or DDS (control group, n=30). Partial preparations were performed on all teeth and directly after tooth preparation. IDS was achieved using self-etch adhesive (Clearfil SE Primer and Adhesive, Kuraray) followed by the application of flowable resin (Clearfil Majesty Flow, Kuraray). Partial ceramic restorations were bonded (Variolink Ultra, Ivoclar Vivadent) two weeks after preparation. The teeth were evaluated preoperatively and at one week, three months, and 12 months postoperatively using a cold test and a questionnaire for perceived tooth sensitivity. Patient satisfaction was evaluated using a visual analog scale (VAS). Data were analyzed using McNemar, chi-squared, and Wilcoxon signed rank tests (α=0.01). There was no significant difference in patient-reported tooth sensitivity between the preoperative phase and all other time points (p>0.01). There was also no significant difference between IDS and DDS (p>0.01) for all items on the questionnaire. VAS scores did not differ significantly between the IDS and DDS groups for all items in the questionnaire at all time points (p>0.01). No tooth sensitivity change was noticed with the application of partial ceramic indirect restorations. This clinical study could not confirm that IDS is more advantageous than DDS in terms of tooth sensitivity and patient satisfaction at 1 year of clinical service of partial ceramic restorations.
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OBJECTIVES: The survival and success rate and the quality of survival of partial ceramic restorations bonded employing Immediate (IDS) or Delayed Dentin Sealing (DDS) in vital molar teeth were evaluated in a randomized clinical trial with within-subject comparison study.MATERIALS AND METHODS: 30 patients received two lithium disilicate ceramic (IPS-e.max press, Ivoclar Vivadent) partial restorations on vital first or second molar teeth (N = 60). The two teeth randomly received either IDS (test group, n = 30) or DDS (control group, n = 30). Partial ceramic restorations were luted (Variolink Ultra, Ivoclar Vivadent) two weeks after preparation. Evaluations were performed at 1 week, 12 months and 36 months post-operatively, using qualitative (FDI) criteria. Representative failures were evaluated microscopically (SEM) and by means of simplified qualitative fractography analysis.RESULTS: One absolute failure occurred in the DDS group due to (secondary) caries. The overall survival rate according to Kaplan-Meier after 3 years was 98.3% (FDI criteria score 1-4, n = 59) and the overall success rate was 85% (FDI criteria score 1-3, n = 51), with no significant difference between restorations in the IDS and DDS group (p = 0.32; Kaplan-Meier, Log Rank (Mantel-Cox), CI = 95%). For the quality of the survival, no statistically significant differences were found between IDS and DDS (p = 0.7; Kaplan-Meier, Log Rank (Mantel-Cox), CI = 95%) restorations on any follow-up timepoints for any of the FDI criteria (Wilcoxon, McNemar, p > 0.05)..CONCLUSION: Adhesively luted partial ceramic restorations in vital molar teeth have a good prognosis, however IDS did not show any differences in success and survival rates after 3 years of function.
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AIM: To compare the shear bond strength (SBS) after aging of two dual-curing composite resin cements to multiphase composite resin (experiment) and glass-ceramics (control).METHODS: Seventy computer-aided design/computer-aided manufacturing (CAD/CAM) blocks were prepared: 24 multiphase composite resin blocks (Lava Ultimate; experiment), and 12 control blocks (groups 5 and 6: 6 IPS e.max CAD, 6 IPS Empress CAD). Surface treatments of the experiment groups were: 1) Al2O3 airborne particle abrasion; 2) bur-roughening; 3) silica-coated aluminum oxide particle abrasion; and 4) hydrofluoric (HF) acid etching. Per study group, Variolink II (a) and RelyX Ultimate (b) were used as cements. Per treatment group, four cement cylinders were adhered to the conditioned blocks (n = 12). After thermocyclic aging (10.000x, 5°C to 55°C), notch-edge shear testing was applied. Modes of failure were examined. A P value of 0.05 was considered significant.RESULTS: Groups 1a (18.68 ± 3.81) and 3a (17.09 ± 3.40) performed equally to 6a (20.61 ± 4.10). Group 5a (14.39 ± 2.80) did not significantly differ from groups 1a, 3a, and 4a (15.21 ± 4.29). Group 2a (11.61 ± 3.39) showed the lowest bond strength. For the RelyX Ultimate specimens, mean bond strengths were: 1b (18.12 ± 2.84) > 4b (15.57 ± 2.31) > 2b (12.34 ± 1.72) = 3b (11.54 ± 2.45) = 6b (12.31 ± 1.87) > 5b (0.78 ± 0.89). Failure mode analysis showed a significant association between bond strength values and modes of failure (chi-square).CONCLUSION: The SBS of the composite cements to the multiphase composite resin that was treated by Al2O3 or silica-coated aluminum oxide particle abrasion is comparable to the bond of the control groups.
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