OBJECTIVES: To evaluate the clinical performance of partial glass-ceramic (IPS e.max Press) posterior restorations.MATERIALS AND METHODS: A total of 765 restorations in 158 patients were placed between 2008 and 2018 and evaluated in a prospective study during regular dental care visits between 2015 and 2018. The restorations were luted with a conventional photo-polymerized resin composite (HFO) in conjunction with an Immediate Dentin Sealing procedure (IDS). Intra-oral photographs and radiographs were made and evaluated using USPHS criteria.RESULTS: The mean observation time was 53.3 months (range 3-113 months). Three absolute failures occurred (tooth fractures, n = 2; apical re-infection, n = 1) all leading to the loss of the restored tooth. Repairable and salvageable failures occurred in 9 teeth (endodontic complications, n = 7; secondary caries, n = 1; debonding, n = 1). The survival and success rates according to Kaplan-Meier after 5 years cumulated to 99.6% and 98.6%, respectively. Location (premolar/molar and mandibula/maxilla), pre-restorative endodontic status (vital/devitalised) and extension of the indirect ceramic restoration (number of sides and cusps involved) did not significantly affect the cumulative success rate (log rank test, p > 0.05). The condition of the vast majority of the restorations remained unaffected for 5 years.CONCLUSIONS: Partial glass-ceramic posterior restorations (pressed lithium disilicate (IPS e.max press, Ivoclar Vivadent) luted by means of a conventional photo-polymerized resin composite in conjunction with the use of an IDS procedure have an excellent medium-term prognosis.CLINICAL RELEVANCE: Partial glass-ceramic posterior restorations can be considered as a highly reliable treatment option. Location and extension of the restoration and pre-restorative endodontic status do not affect success rate.
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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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.
