Abstract

ObjectivesTo evaluate the clinical performance of partial glass-ceramic (IPS e.max Press) posterior restorations.Materials and methodsA 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.ResultsThe 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.ConclusionsPartial 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 relevancePartial 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.

Highlights

  • Partial indirect restorations can be indicated when it is difficult to restore form and function using direct composite restorations

  • The aim of this study is to evaluate the clinical survival and success rate of partial glass-ceramic posterior restorations luted with conventional photo-polymerized resin composite in conjunction with the use of immediate dentin sealing concept (IDS)

  • The extension of the indirect ceramic restoration could not be determined from the photograph made at baseline, nor from the patients’ record

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Summary

Introduction

Partial indirect restorations can be indicated when it is difficult to restore form and function using direct composite restorations. Clin Oral Invest (2021) 25:1463–1473 toughness from the crystallites as these induce the fracture to bow, deflect and branch [2] Besides their strength, adhesive luting is possible and this increases strength and regain aesthetics at a minimum biological price, removing defect structures only [3,4,5]. Comparing acid-etched e.max lithium disilicate monolithic and bilayered complete coverage restorations resulted in an estimated cumulative survival rate of 96.5% after 10.4 years for monolithic and 100% after 7.9 years for bilayered restorations. This difference was statistically significant [10]. Long-term data with a high number of these partial all-ceramic restorations is limited, which precludes firm statements regarding their effectiveness [11]

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