Seven-year clinical performance of CEREC-2 all-ceramic CAD/CAM restorations placed within deeply destroyed teeth

Abstract

Adhesively luted all-ceramic restorations represent a promising way to preserve and stabilize weakened tooth substance, but little information is published about the clinical performance of extensive all-ceramic restorations. A total of 78 large CEREC 2™ single-tooth all-ceramic restorations had been placed in 35 patients. After 7years, 59 teeth in 25 patients were reevaluated according to USPHS or modified USPHS criteria regarding aesthetic properties, e.g., "anatomic form," "color match," and "marginal discoloration"; functional properties, e.g., "marginal integrity," wear expressed by the criteria "proximal contact" and "static/dynamic occlusal relationship"; and biological properties, e.g., "tooth vitality" and "secondary caries". Additionally, the "proportion of margin below/above cemento-enamel junction" was included. Two restorations had failed prior to the 7-year recall, one due to a bulk fracture of the restoration and one due to poor marginal integrity (rated "Charlie") after 4years. Other six restorations were rated as failure at the 7-year evaluation (three restorations revealed secondary caries, one was bulk fracture of the Cerec 2 restoration, and two failures were related to endodontic problems resulting in extraction or amputation of one root, respectively), resulting in a failure rate of 13.1% after 7years. A total of 96.4% of the restorations revealed sufficient ratings for esthetic properties "anatomic form," "color match," "marginal discoloration," and "marginal integrity". The survival rate of 86.9% at the 7-year recall demonstrates that adhesively luted all-ceramic CAD/CAM-generated restorations are suitable for restoration of extended coronal defects. CAD/CAM-generated all-ceramic restorations facilitate the reconstruction of deeply destroyed teeth irrespectively of the location of the cavity margins.