Abstract

Background: Despite the fact that preliminary clinical results of conservative partial coverage restorations (PCRs) are promising, the clinical behavior of different PCR ceramic materials is rarely investigated in clinical trials. This study aimed to evaluate the clinical outcomes of partial coverage restorations (PCR) fabricated with zirconia-reinforced lithium silicate ceramic system compared to partial coverage restorations fabricated with lithium disilicate ceramic system. Methods: 46 vital premolars and molars of 14 patients were restored with PCRs (23 Vita Suprinity and 23 IPS e.max CAD). PCRs were CAD/CAM fabricated in the lab and adhesively luted with dual-polymerizing resin cement (Duolink. BISCO, USA). Clinical evaluation of PCRs was performed according to the Modified United States Public Health Service (USPHS) at baseline, 6 and 12 months post-insertion. Absolute failure was demonstrated by Kaplan-Meier survival rate analysis. Results: After 12 months observation, all PCRs of both ceramic groups demonstrated 100% survival rate. Non-significant decrease in Alpha ratings for marginal adaptation (p = 0.1560) and marginal discoloration (p = 0.6078) in e-max group. While in the Suprinity group, PCRs demonstrated 100% Alpha ratings for marginal adaptation and only one Bravo rating (p= 0.3625) for marginal discoloration after 12 month observation. Conclusions: Both Vita-Suprinity and e.max CAD partial coverage restorations are considered reliable treatment options for restoring larger defects in posterior dentition. Trial registration: ClinicalTrials.gov NCT02861729 04/08/2016

Highlights

  • High survival rates, fracture resistance and proper marginal integrity of CAD/CAM partial coverage restorations (PCRs) were reported in studies simulating 5-year clinical service1–4.clinical behavior of PCRs utilizing morphology driven preparation design was never assessed in randomized clinical trials5–11.long-term clinical studies have shown that bulk fracture and marginal deterioration of PCRs has a direct correlation to the use of brittle ceramic materials, such as feldspathic and leucite-based ceramics12–15, which encouraged researchers to use higher strength lithium disilicate glass ceramic in such restorations16–21

  • Some clinical studies tested the performance of lithium disilicate PCRs, no randomized clinical trial tried to compare between lithium disilicate ceramic material and the newly introduced zirconia-reinforced lithium silicate ceramic material in posterior partial coverage22–24

  • The aim of this randomized controlled split-mouth clinical study was to evaluate the clinical outcomes of zirconia-reinforced lithium silicate (Vita Suprinity) and lithium disilicate (IPS e.max CAD) partial coverage restorations

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Summary

Introduction

Fracture resistance and proper marginal integrity of CAD/CAM partial coverage restorations (PCRs) were reported in studies simulating 5-year clinical service1–4.clinical behavior of PCRs utilizing morphology driven preparation design was never assessed in randomized clinical trials5–11.long-term clinical studies have shown that bulk fracture and marginal deterioration of PCRs has a direct correlation to the use of brittle ceramic materials, such as feldspathic and leucite-based ceramics, which encouraged researchers to use higher strength lithium disilicate glass ceramic in such restorations. Fracture resistance and proper marginal integrity of CAD/CAM partial coverage restorations (PCRs) were reported in studies simulating 5-year clinical service. Some clinical studies tested the performance of lithium disilicate PCRs, no randomized clinical trial tried to compare between lithium disilicate ceramic material and the newly introduced zirconia-reinforced lithium silicate ceramic material in posterior partial coverage. Some clinical studies tested the performance of lithium disilicate PCRs, no randomized clinical trial tried to compare between lithium disilicate ceramic material and the newly introduced zirconia-reinforced lithium silicate ceramic material in posterior partial coverage22–24 The aim of this randomized controlled split-mouth clinical study was to evaluate the clinical outcomes of zirconia-reinforced lithium silicate (Vita Suprinity) and lithium disilicate (IPS e.max CAD) partial coverage restorations.

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