Abstract
To evaluate the clinical outcomes of resin composite CAD/CAM restorations in a prospective cohort study, and to assess patient and operator satisfaction after restoration placement, 59 indirect resin composite were placed by supervised undergraduate students, of which 43 restorations were followed over a mean period of 28 months (14–44 months) and evaluated using USPHS criteria. Patient and operator satisfaction levels were assessed using a visual analogue scale (VAS) after restoration placement. A total of 37 patients and 47 restorations were included for further study. Four teeth were extracted—three due to extensive drug-induced secondary caries in the same patient, and one tooth due to large periapical periodontitis after 44 months of service. The overall survival rate was 91.4%, and success rate was 87.2%. Differences between baseline and endpoint scores were significant for marginal discoloration (p < 0.05) and adaptation (p < 0.001). Color match (p < 0.05) and surface texture (p < 0.001) differed significantly, affecting all restoration types. VAS scores for patient and operator satisfaction showed a significant rank correlation (p < 0.01), and pairwise comparison showed significant differences for mean overall patient and operator VAS scores (p < 0.001). Lava Ultimate CAD/CAM may be considered a suitable material for overlays and endocrown restorations when combined with IDS, air abrasion, and MDP-containing adhesive systems. Marginal disintegration may present in inlays and onlays over time.
Highlights
For many clinicians, direct composite resin restorations are the first choice when treating decayed teeth
Lava Ultimate computer assisted design–computer assisted machining (CAD/CAM) may be considered a suitable material for overlays and endocrown restorations when combined with Immediate dentin sealing (IDS), air abrasion, and MDP-containing adhesive systems
A total of 45 patients were enrolled in the study: 17 males and 28 females with a mean age of 48 ± 13 years; 59 restorations were initially placed in molars and 16 premolars, including 27 overlays, 16 endocrowns, 12 onlays, and 4 inlays
Summary
Direct composite resin restorations are the first choice when treating decayed teeth. A number of technical limitations, such as anatomical challenges in teeth with major substrate loss and marginal leakage associated with deep proximal boxes, as well as the often disappointing lifespan of composites, have legitimized the indirect restorative approach combining extra-oral fabrication and the use of materials with superior mechanical properties. Monolithic computer assisted design–computer assisted machining (CAD/CAM) restorations have gained popularity and have started to replace large direct composite buildups. The digitalization, and the introduction of chairside CAD/CAM fabrication units, has made the workflow for the manufacturing of indirect restorations easier, faster, and more accurate compared to the conventional workflow using impressions and cast models [1]. According to Nedelcu et al [5], digital data capturing can reliably replace conventional impression-taking when restoring up to ten units
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