RESUMEN
O presente estudo teve como objetivo fazer uma avaliação da taxa de sucesso e sobrevivência de restaurações indiretas, realizadas pelo sistema CEREC AC Bluecam após 5 anos. Trata-se de um estudo piloto, com a inclusão de 102 pacientes e um total de 113 restaurações. As restaurações foram feitas a partir de blocos pré-fabricados de cerâmica feldspática (CEREC Blocs). Os prontuários de todos os pacientes foram avaliados. Um total de 36 restaurações foram avaliadas clinicamente usando-se os critérios USPHS e FDI modificados. Além disso, foi criada uma ficha clínica com um questionário abrangendo uma série de informações clínicas relevantes. A taxa de satisfação do paciente foi avaliada através da escala analógica visual. A taxa de sucesso e sobrevivência para as restaurações avaliadas dentro do critério adotado foi de 80,6% e 0,9% respectivamente. Um total de 19 (18,5%) de falhas foi encontrado. A principal razão das falhas foi a fratura da cerâmica, sendo significativamente maior para dentes não vitais. Restaurações indiretas feitas a partir do sistema CEREC AC tiveram um sucesso clínico considerável com taxa de sucesso de 80,6% após 5 anos. A taxa de satisfação dos pacientes frente a esse tipo de tratamento foi bem alta para todos os parâmetros avaliados, chegando a uma média de 96%(AU)
The present study aimed to evaluate the success and survival rate of indirect restorations performed by the CEREC AC Bluecam system after 5 years. This is a pilot study with the inclusion of 102 patients and a total of 113 restorations. The restorations were made from prefabricated feldspar ceramic blocks (CEREC Blocs). The medical records of all patients were evaluated. A total of 36 restorations were clinically evaluated using the modified USPHS and FDI criteria. In addition, a clinical record was created with a questionnaire covering a range of relevant clinical information. Patients' satisfaction rate was assessed using the visual analogue scale. The success and survival rate for the restorations evaluated according to the adopted criteria was 80.6% and 0.9% respectively. A total of 19 (18.5%) failures were found. The main reason for the failures was ceramic fracture, being significantly higher for non vital teeth. Indirect restorations made from the CEREC AC system have had considerable clinical success with a success rate of 80.6% after 5 years. The patients' satisfaction rate regarding this type of treatment was very high for all parameters evaluated, reaching an average of 96%(AU)
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Cerámica , Diseño Asistido por Computadora , Porcelana Dental , Incrustaciones/normas , Satisfacción del Paciente , Datos PreliminaresRESUMEN
OBJECTIVE: The aim of the present study was to evaluate the clinical performance of indirect resin composite onlays (IRC onlay) compared to stainless steel crowns (SSCs), as an esthetic alternative for rehabilitation of extensively carious primary molars. STUDY DESIGN: Fifty pediatric patients each received either IRC onlay or SSC randomly on extensively carious endodontically treated primary molars. All the restorations were evaluated at baseline and then every 6 months till 36 months using 'modified FDI criteria' for retention, marginal integrity, occlusion, proximal contact, secondary caries and gingival health. The dental chair side treatment time and post-operative acceptability were also evaluated for both the groups. RESULTS: The cumulative survival rate of IRC onlays was 82.9% compared to 90.7% for SSCs over a time period of 36 months. The difference between the two study groups at various time intervals in terms of retention, marginal integrity, secondary caries, proximal contact, occlusion and gingival health was not statistically significant (p>0.05). The IRC onlays required significantly less mean chair side treatment time and were preferred the most by parents and children as per VAS scores compared to SSCs. CONCLUSION: IRC onlays are an acceptable esthetic alternative to SSCs and may be considered for use in aesthetically conscious children/parents as per their preference.
Asunto(s)
Resinas Compuestas/química , Coronas , Aleaciones Dentales/química , Caries Dental/terapia , Materiales Dentales/química , Incrustaciones , Diente Molar/patología , Acero Inoxidable/química , Diente Primario/patología , Actitud Frente a la Salud , Niño , Preescolar , Coronas/normas , Caries Dental/etiología , Adaptación Marginal Dental , Oclusión Dental , Retención de Prótesis Dentales , Estética Dental , Estudios de Seguimiento , Humanos , Incrustaciones/normas , Índice Periodontal , Recurrencia , Propiedades de Superficie , Análisis de Supervivencia , Factores de Tiempo , Diente no Vital/terapiaRESUMEN
This systematic review and meta-analysis aimed to evaluate the survival rate of ceramic and resin inlays, onlays, and overlays and to identify the complication types associated with the main clinical outcomes. Two reviewers searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials for articles published between 1983 through April 2015, conforming to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews. Clinical studies meeting the following criteria were included: 1) studies related to resin and ceramic inlays, onlays, and overlays; 2) prospective, retrospective, or randomized controlled trials conducted in humans; 3) studies with a dropout rate of less than 30%; and 4) studies with a follow-up longer than 5 y. Of 1,389 articles, 14 met the inclusion criteria. The meta-regression indicated that the type of ceramic material (feldspathic porcelain vs. glass-ceramic), study design (retrospective vs. prospective), follow-up time (5 vs. 10 y), and study setting (university vs. private clinic) did not affect the survival rate. Estimated survival rates for glass-ceramics and feldspathic porcelain were between 92% and 95% at 5 y (n = 5,811 restorations) and were 91% at 10 y (n = 2,154 restorations). Failures were related to fractures/chipping (4%), followed by endodontic complications (3%), secondary caries (1%), debonding (1%), and severe marginal staining (0%). Odds ratios (95% confidence intervals) were 0.19 (0.04 to 0.96) and 0.54 (0.17 to 1.69) for pulp vitality and type of tooth involved (premolars vs. molars), respectively. Ceramic inlays, onlays, and overlays showed high survival rates at 5 y and 10 y, and fractures were the most frequent cause of failure.
Asunto(s)
Cerámica/uso terapéutico , Resinas Compuestas/uso terapéutico , Materiales Dentales/uso terapéutico , Prótesis de Recubrimiento , Incrustaciones/métodos , Fracaso de la Restauración Dental , Prótesis de Recubrimiento/normas , Humanos , Incrustaciones/normasRESUMEN
STATEMENT OF PROBLEM: Additional polymerization of indirect composite resins enhances their physical properties but lessens the potential for chemical bonding. PURPOSE: The purpose of this in vitro study was to evaluate the influence of different surface treatments and 6-month water storage on the microtensile bond strength (µTBS) of composite resin onlays. MATERIAL AND METHODS: Composite resin onlays (Filtek Z250) randomly received 6 different surface treatments: (1) airborne-particle abrasion with 27-µm alumina particles+Adper Scotchbond 1XT adhesive application, (2) airborne-particle abrasion with alumina particles+silane application (ESPE SIL)+Adper Scotchbond 1XT, (3) airborne-particle abrasion with alumina particles+Scotchbond Universal adhesive, (4) tribochemical silica coating with 30-µm particles (CoJet Sand)+Adper Scotchbond 1XT adhesive, (5) tribochemical silica coating+silane application+Adper Scotchbond 1XT, and (6) tribochemical silica coating+Scotchbond Universal adhesive. Onlays were luted to fresh composite resin specimens with RelyX Ultimate resin cement. Bonded assemblies were stored in water for 24 hours or 6 months at 37°C and subjected to the µTBS test. Additional surface-treated composite resin onlays were analyzed with a contact profilometer to determine average roughness, and micromorphologic changes were analyzed with scanning electron microscopy. RESULTS: Airborne-particle abrasion with alumina followed by Adper Scotchbond 1XT or Scotchbond Universal adhesive application provided the highest bond strength values at 24 hours. Lower values were obtained after tribochemical silica coating. After 6 months of artificial aging, airborne-particle abrasion with alumina or silica-coated alumina particles followed by Scotchbond Universal application yielded the greatest bond strength results. Airborne-particle abrasion with alumina produced the highest roughness values and a more irregular surface. CONCLUSION: Adhesive selection seems to be relevant to the µTBS of luted composite resin onlays after 6 months of water aging, as specimens treated with Scotchbond Universal, after alumina airborne-particle abrasion or tribochemical silica coating, yielded the highest values and better aging stability.
Asunto(s)
Resinas Compuestas/uso terapéutico , Recubrimiento Dental Adhesivo/métodos , Incrustaciones/métodos , Abrasión Dental por Aire/métodos , Abrasión Dental por Aire/normas , Óxido de Aluminio/uso terapéutico , Recubrimiento Dental Adhesivo/normas , Análisis del Estrés Dental , Humanos , Técnicas In Vitro , Incrustaciones/normas , Cementos de Resina/uso terapéutico , Propiedades de Superficie , Factores de TiempoRESUMEN
Objetivos: esta revisão sistemática e metanálise tiveram como objetivo verificar se há diferença na longevidade clínica das restaurações de resinas compostas confeccionadas pelas técnicas direta e indireta em dentes posteriores permanentes. Fontes: foram realizadas busca eletrônica nas bases PubMed, The Cochrane Library, Web of Science, Scopus, LILACS, BBO, ClinicalTrials.gov e SiGLE, seguida de busca manual nas listas de referências dos estudos incluídos, sem restrições de idioma ou ano de publicação. Dados: foram incluídos ensaios clínicos controlados randomizados que compararam o desempenho clínico das resinas compostas confeccionadas pelas técnicas direta e indireta em cavidades de Classe I ou II de dentes permanentes, e tempo de acompanhamento de ao menos 2 anos. A qualificação do risco de viés foi realizada com a ferramenta sugerida pela Colaboração Cochrane. A metanálise foi conduzida utilizando o software Comprehensive Meta-Analysis. A heterogeneidade entre os estudos foi analisada usando o Índice I2 e a Odds ratio foi calculada (p < 0,05). Resultados: após a remoção das duplicatas, 912 estudos foram selecionados para a leitura dos títulos e resumos. Vinte preencheram os critérios de elegibilidade e mais 4 foram adicionados por busca manual. Nove estudos foram incluídos na síntese qualitativa dos quais 6 foram incluídos na metanálise. A metanálise mostrou que não houve distinção na longevidade entre restaurações de resinas compostas diretas e indiretas em dentes posteriores permanentes (p > 0,05) independente da técnica e do tipo de dente restaurado (p>0,05). Conclusão: com base nos achados, as restaurações de resinas compostas diretas e indiretas não apresentaram diferenças na longevidade clínica em 5 anos de acompanhamento, sendo ambas indicadas para restaurações de dentes posteriores. Significância clínica: A odontologia atual baseia-se em procedimentos restauradores minimamente invasivos. A indicação de uma técnica menos conservadora deve ser indiscutivelmente vantajosa. Estudos in vitro e in vivo mostram-se contraditórios quando comparam o desempenho de resinas compostas diretas e indiretas em dentes posteriores; assim esta revisão sistemática e metanálise foram conduzidas para responder essa questão. (AU)
Objectives: this systematic review and meta-analysis aimed to assess the differences in clinical performance using direct and indirect resin composite restorations in permanent posterior teeth. Source: an electronic search was performed in PubMed, The Cochrane Library, Web of Science, Scopus, LILACS, BBO, ClinicalTrials.gov and SiGLE, followed by a manual search of the references list of included studies, without language or time of publication restrictions. Data: randomized clinical trial that compared clinical performance of direct and indirect resin composite restorations in Class I and Class II cavities in permanent teeth was included and, with at least two years of follow-up. The qualification of the risk of bias was through the tool suggested by Cochrane Collaboration. The meta-analysis was conducted using the Comprehensive Meta-Analysis software after the sensitivity analysis. Heterogeneity was assessed using I2 index and the Odds ratio was calculated (p < 0.05). Results: after removing duplicates, 912 studies were selected for reading of the titles and abstract. Twenty fulfilled the inclusion criteria and 4 were added with a supplemental hand search of the references of retrieved articles. Nine studies were included in the qualitative analysis and 6 of which were included in the meta-analysis. The meta-analysis showed that there was no difference in longevity between direct and indirect resin composite restorations in permanent posterior teeth (p > 0.05) regardless of the type of material and the restored tooth. Conclusions: based on the findings, there was no difference in clinical performance between direct and indirect resin composite restorations in 5 years of follow up, so both materials are indicated to posterior dental restoration. Clinical Significance: Contemporary dentistry is based on minimally invasive restorations. Indication of a technique less conservative must have unquestionable advantage. In vitro and in vivo studies show up contradictory when compared the performance of direct and indirect resin composite restorations in posterior teeth, thus, this systematic review and meta-analysis were conducted to answer this question. (AU)
Asunto(s)
Resinas Compuestas/normas , Incrustaciones/normas , Longevidad , Metaanálisis , Restauración Dental Permanente/métodos , RevisiónRESUMEN
SUMMARY This research evaluated the influence of immediate dentin sealing (IDS) techniques on cuspal deflection and fracture resistance of teeth restored with composite resin inlays. Forty-eight maxillary premolars were divided into four groups: G1, sound teeth (control); G2, without IDS; G3, IDS with Clearfil SE Bond (CSE); and G4, IDS with CSE and Protect Liner F. The teeth from groups 2, 3, and 4 received mesio-distal-occlusal preparations. The impressions were made with vinyl polysiloxane, followed by provisional restoration and storage in water for seven days. The impressions were poured using type IV die stone, and inlays with Filtek Z250 composite resin were built over each cast. The inlays were luted with Panavia F. After storage in water for 72 hours, a 200-N load was applied on the occlusal surface using a metal sphere connected to a universal testing machine, and the cuspal deflection was measured with a micrometer. The specimens were then submitted to an axial load until failure. The following mean cuspal deflection (µm) and mean fracture resistance (N) followed by the same lowercase letter represent no statistical difference by analysis of variance and Tukey (p<0.05): cuspal deflection: G1, 3.1 ± 1.5(a); G2, 10.3 ± 4.6(b); G3, 5.5 ± 1.8(ac); and G4, 7.7 ± 5.1(bc); fracture resistance: G1, 1974 ± 708(a); G2, 1162 ± 474(b); G3, 700 ± 280(b); and G4, 810 ± 343(b). IDS with CSE allowed cuspal deflection comparable with that associated with sound teeth. The application of Protect Liner F did not contribute to a decrease in cuspal deflection. The IDS techniques did not influence the fracture resistance of teeth.
Asunto(s)
Resinas Compuestas/uso terapéutico , Incrustaciones/métodos , Selladores de Fosas y Fisuras/uso terapéutico , Fracturas de los Dientes/prevención & control , Diente Canino/lesiones , Análisis del Estrés Dental , Dentina/lesiones , Humanos , Incrustaciones/normasRESUMEN
OBJECTIVES: To evaluate marginal quality and resin-resin transition of lab made resin composite inlays in deep proximal cavities with and without 3 mm proximal box elevation (PBE) using resin composites before and after thermo-mechanical loading (TML). METHODS: MOD cavities with one proximal box beneath the cementoenamel junction were prepared in 40 extracted human third molars. Proximal boxes ending in dentine were elevated 3 mm with different resin composites (G-Cem, Maxcem Elite as self-adhesive resin cements and Clearfil Majesty Posterior as restorative resin composite in one or three layers bonded with AdheSE), or left untreated. Clearfil Majesty Posterior inlays were luted with Syntac and Variolink II (n = 8). Marginal quality as well as the PBE-composite inlay interface was analyzed under an SEM using epoxy resin replicas before and after thermomechanical loading (100,000 × 50 N and 2500 thermocylces between +5 °C and +55 °C). RESULTS: Bonding resin composite inlays directly to dentine showed similar amounts of gap-free margins in dentine compared to PBE applied in three consecutive layers (p > 0.05). The groups with self-adhesive resin cements for PBE exhibited significantly more gaps in dentine (p < 0.05). SIGNIFICANCES: With layered resin composite, PBE is effective in indirect resin composite bonding to deep proximal boxes. Self-adhesive resin cements are not suitable for this indication.
Asunto(s)
Resinas Compuestas/química , Preparación de la Cavidad Dental/métodos , Adaptación Marginal Dental , Materiales Dentales/química , Incrustaciones/normas , Resinas Acrílicas/química , Fuerza de la Mordida , Recubrimiento Dental Adhesivo , Análisis del Estrés Dental/instrumentación , Dentina/ultraestructura , Humanos , Ensayo de Materiales , Microscopía Electrónica de Rastreo , Técnicas de Réplica , Cementos de Resina/química , Estrés Mecánico , Propiedades de Superficie , Temperatura , Cuello del Diente/ultraestructuraRESUMEN
PURPOSE: The aim of this clinical retrospective study was to evaluate the clinical quality, estimated survival rate, and failure analysis of different all-ceramic restorations in a long-term analysis of up to 20 years. MATERIALS AND METHODS: Different all-ceramic restorations (crowns [n = 470], veneers [n = 318], onlays [n = 213], and inlays ]n = 334[) were placed in 302 patients (120 men, 182 women) between 1987 and 2009 at Medical University Innsbruck, Innsbruck, Austria. Clinical examination was performed during patients' regularly scheduled maintenance appointments. Esthetic match, porcelain surface, marginal discoloration, and integrity were evaluated following modified California Dental Association/Ryge criteria. Number of restoration failures and reasons for failure were recorded. The study population included 106 (35.1%) individuals diagnosed with bruxism. The success rate was determined using Kaplan-Meier survival analysis. RESULTS: The mean observation time was 102 ± 60 months. Ninety-five failures were recorded. The main reason for failure was fracture of the ceramic (33.68%). The estimated survival rate was 97.3% after 5 years, 93.5% at 10 years, and 78.5% at 20 years. Nonvital teeth showed a significantly higher risk of failure (P < .0001). There was a 2.3-times greater risk of failure associated with existing parafunction (bruxism, P = .0045). Cementation using Variolink showed significantly fewer failures than Optec Cement (P = .0217) and Dual Cement (P = .0099). No significant differences were found for type of restoration and distribution in the mouth. CONCLUSION: All-ceramic restorations offer a predictable and successful restoration with an estimated survival probability of 93.5% over 10 years. Significantly increased failure rates are associated with bruxism, nonvital teeth, and specific cementation agents.
Asunto(s)
Cerámica/química , Coronas/estadística & datos numéricos , Porcelana Dental/química , Fracaso de la Restauración Dental/estadística & datos numéricos , Coronas con Frente Estético/estadística & datos numéricos , Incrustaciones/estadística & datos numéricos , Bruxismo/complicaciones , Cementación/métodos , Color , Coronas/normas , Cementos Dentales/química , Adaptación Marginal Dental , Coronas con Frente Estético/normas , Estética Dental/estadística & datos numéricos , Femenino , Estudios de Seguimiento , Humanos , Incrustaciones/normas , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Cementos de Resina/química , Análisis de Supervivencia , Diente no Vital/complicacionesRESUMEN
Thermo-mechanical finite element analyses in 3-D models are described for determination of the stress levels due to thermal and mechanical loads in a healthy and restored tooth. Transient thermo-mechanical analysis simulating the ingestion of cold and hot drinks was performed to determine the temperature distribution in the models of the teeth, followed by linear elastic stress analyses. The thermal loads were applied on the occlusal and lingual surfaces. Subsequently, coupled variation of the temperature and mastication loading was considered. The vertical loading was distributed at occlusal points, adding up to 180 N. Maximum stresses were verified in resin restoration under thermal loads. When studying coupled effect of mechanical loading with that arising from thermal effects, higher tensile stress values occurred in porcelain restorations, especially at the restoration-dentin interface. Regions of high tensile stress were detected and their possible clinical significance with respect to restoration damage and microleakage were discussed.
Asunto(s)
Calor , Incrustaciones/normas , Modelos Dentales , Diente Molar/fisiopatología , Estrés Mecánico , Temperatura Corporal/fisiología , Materiales Dentales , Análisis del Estrés Dental/métodos , Estética Dental , Análisis de Elementos Finitos , Humanos , Diente Molar/cirugíaRESUMEN
BACKGROUND AND OBJECTIVES: Compared to other restoration types, indirect cast posterior restorations of partial coverage exhibit one of the longest survivals. The purpose of the current study was to estimate the success rates of 'direct-wax' cast gold onlays. According to the direct wax technique, the wax pattern is shaped intra-orally followed by direct casting without the need for impressions, resulting in low cost and short processing time. DESIGN AND METHODS: A retrospective survival study was undertaken at a mixed National Health Service and private general dental practice based in London. Patients with direct-wax onlays attending over a period of four months for regular check-ups or dental treatment were recruited. Patient discomfort, pain or sensitivity was recorded. Restoration location, extension, marginal fit, and tooth vitality were also recorded. Restoration failure was defined in the event of recurrent caries, pulp infection for vital teeth, increase in the size of periapical radiolucency for non-vital teeth, and restoration decementation. Survival estimates were calculated using the Kaplan-Meier algorithm. RESULT: One hundred and ninety-four onlays in 56 patients were examined. Four restorations (2.1%) had failed, mainly due to recurrent caries. The cumulative survival probability was estimated at 415.3 (95% Confidence Interval: 403.0, 427.7) months (34.6, 95% CI: 33.6, 35.6 years), while the 10-year and 20-year survival rates were 97.0% and 94.1% respectively. Vital teeth, compared to non-vital ones, and onlay extension encompassing both the mesial and distal tooth surfaces exhibited significantly (P <0.05) higher success rates. Variations in marginal fit and restoration location did not affect the survival probability. CONCLUSION: Direct-wax cast gold restorations of partial coverage were a highly successful treatment option for posterior restorations in a general dental practice environment.
Asunto(s)
Técnica de Colado Dental , Diseño de Prótesis Dental , Aleaciones de Oro , Incrustaciones , Diente Premolar/patología , Caries Dental/etiología , Revestimiento para Colado Dental/química , Preparación de la Cavidad Dental/métodos , Técnica de Impresión Dental , Adaptación Marginal Dental , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Odontología General , Aleaciones de Oro/química , Humanos , Colado de Cera para Incrustaciones , Incrustaciones/normas , Londres , Estudios Longitudinales , Masculino , Bandas de Matriz , Persona de Mediana Edad , Diente Molar/patología , Recurrencia , Estudios Retrospectivos , Propiedades de Superficie , Análisis de Supervivencia , Diente no Vital/terapia , Resultado del TratamientoRESUMEN
AIM: This paper describes the database used to assess the survival of indirect restorations and presents general data on survival of these restorations. METHODS: Data, based on the complete attendance and treatment history, over the 11 years from 1991 to 2001, of a statistically representative sample of 23,165 General Dental Services' (GDS) patients in England and Wales, all of whom received at least one indirect restoration during the observation period, have been analysed. The patients on the database received a total of 36,397 courses of treatment, and there were 52,481 indirect restorations placed. The method of analysis involved the estimation of the probability that the patient will eventually return, given an interval without attending, by analysing the observed patterns of re-attendance. This estimated probability of re-attendance was then used to modify the standard Kaplan-Meier procedure to produce realistic estimates of the hazard of re-intervention. RESULTS: Overall, 75% of indirect restorations remained without re-intervention after 5 years, and 61% after 10. Crowns outperformed other types of indirect restoration. Multi-surface metal inlays, by contrast, had a median interval to re-intervention of less than 8 years. CONCLUSIONS: The times to re-intervention for different types of indirect restoration have been successfully estimated and crowns shown to outperform veneers and inlays.
Asunto(s)
Bases de Datos como Asunto , Restauración Dental Permanente/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Coronas/normas , Coronas/estadística & datos numéricos , Aleaciones Dentales/normas , Atención Odontológica/estadística & datos numéricos , Porcelana Dental/normas , Restauración Dental Permanente/normas , Coronas con Frente Estético/normas , Coronas con Frente Estético/estadística & datos numéricos , Inglaterra , Femenino , Humanos , Incrustaciones/normas , Incrustaciones/estadística & datos numéricos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Probabilidad , Modelos de Riesgos Proporcionales , Resinas Sintéticas/normas , Retratamiento/estadística & datos numéricos , Odontología Estatal , Análisis de Supervivencia , Gales , Adulto JovenRESUMEN
PURPOSE: The objective of this follow-up study was to examine the performance of Cerec inlays and onlays, all of which were placed by the same clinician, in terms of clinical quality over a functional period of 15 years. MATERIALS AND METHODS: Of 200 Cerec inlays and onlays placed consecutively in a private practice by one of the authors (TO) between 1989 and early 1991, 187 were closely monitored over a period of 15 years. All ceramic inlays and onlays had been placed chairside using the Cerec 1 method and had been luted with a bonding composite. Up to 17 years after their placement, a follow-up assessment was conducted, and the restorations were classified using modified United States Public Health Service criteria. RESULTS: According to Kaplan-Meier analysis, the success rate of Cerec inlays and onlays was 88.7% after 17 years. A total of 21 failures (11%) were found in 17 patients. Of these failures, 76% were attributed to ceramic fractures (62%) or tooth fractures (14%). The reasons for the remaining failures were caries (19%) and endodontic problems (5%). Restorations of premolars presented a lower failure risk than those of molars. CONCLUSION: The survival rate probability of 88.7% after up to 17 years of clinical service for Cerec computer-aided design/computer-assisted machining restorations made of Vita Mk I feldspathic ceramic is regarded as a very respectable clinical outcome.
Asunto(s)
Cerámica/química , Diseño Asistido por Computadora , Porcelana Dental/química , Diseño de Prótesis Dental , Incrustaciones , Adolescente , Adulto , Anciano , Silicatos de Aluminio/química , Color , Resinas Compuestas/química , Recubrimiento Dental Adhesivo , Adaptación Marginal Dental , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Humanos , Incrustaciones/normas , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Compuestos de Potasio/química , Cementos de Resina/química , Propiedades de Superficie , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
Las restauraciones rígidas pueden fijarse a través de procedimientos convencionales no adhesivos, semiadhesivos o adhesivos de acuerdo al tipo de restauración, así como a otras variables. Las fijaciones adhesivas exigen el empleo de medios cementantes resinosos y preparaciones superficiales específicas de las superficies a unir. Otorgan algunas ventajas pero convierten el proceso en más complejo, extenso y costoso. Las fijaciones semiadhesivas son alternativas válidas en muchos casos, simplificando el proceso. Es fundamental reconocer las características y necesidades de cada situación clínica para indicar una u otra técnica de fijación.
Asunto(s)
Cementación/instrumentación , Cementos de Resina/química , Restauración Dental Permanente , Recubrimiento Dental Adhesivo/métodos , Cerámica , Cementos Dentales/clasificación , Cementos Dentales/química , Coronas/normas , Adaptación Marginal Dental , Porcelana Dental , Filtración Dental/prevención & control , Grabado Ácido Dental/métodos , Incrustaciones/normas , Técnica de Perno Muñón , Resinas Compuestas/química , Propiedades de SuperficieRESUMEN
Las restauraciones rígidas pueden fijarse a través de procedimientos convencionales no adhesivos, semiadhesivos o adhesivos de acuerdo al tipo de restauración, así como a otras variables. Las fijaciones adhesivas exigen el empleo de medios cementantes resinosos y preparaciones superficiales específicas de las superficies a unir. Otorgan algunas ventajas pero convierten el proceso en más complejo, extenso y costoso. Las fijaciones semiadhesivas son alternativas válidas en muchos casos, simplificando el proceso. Es fundamental reconocer las características y necesidades de cada situación clínica para indicar una u otra técnica de fijación.(AU)
Asunto(s)
Cementación/instrumentación , Recubrimiento Dental Adhesivo/métodos , Restauración Dental Permanente , Cementos de Resina/química , Cementos Dentales/clasificación , Cementos Dentales/química , Coronas/normas , Cerámica , Porcelana Dental , Propiedades de Superficie , Filtración Dental/prevención & control , Adaptación Marginal Dental , Resinas Compuestas/química , Incrustaciones/normas , Técnica de Perno Muñón , Grabado Ácido Dental/métodosRESUMEN
The aim of this study was to test the utilization of a generally accepted quality criteria system (United States Public Health Services Modified Quality Criteria) in the authors' practice, in the cases of all ceramic inlays and onlays. 41 ceramic inlays/onlays--29 pressed and 12 laminated--were made for 28 patients. Restorations were controlled after 2 years of cementation. According to the USPHS criteria system the following characteristics were controlled: anatomic contour, marginal integrity, marginal discoloration, color match, secondary caries, and surface roughness. In addition, postoperative sensitivity, patient's satisfaction and tooth vitality were examined as well. The USPHS quality criteria system together with the complementary data proved to be an objective examination method that was easily applicable to our clinical practice. On the basis of these studies the utilization of this system together with patient's satisfaction, tooth vitality and sensitivity records appeared a good basis for a regular quality control system of ceramic inlays and onlays.
Asunto(s)
Cerámica , Incrustaciones/normas , Control de Calidad , Cerámica/normas , Humanos , Estudios Retrospectivos , Tecnología Odontológica/normasRESUMEN
OBJECTIVES: The purpose of this clinical investigation was to compare a chair-side adhesive all-ceramic system to a laboratory processed adhesive all-ceramic system with respect to quality and time expenditure for the dentist. METHODS: The same dentist treated 10 patients, who were each to receive two large posterior single tooth restorations of similar location and extent. One restoration was made in the laboratory by using the IPS Empress system [LAB], the other one was done chair-side by utilizing the Cerec system [CHAIR]. The time expenditure was measured for [LAB] and [CHAIR] and compared by the Wilcoxon signed rank test. The restorations were also evaluated according to the USPHS criteria. RESULTS: The mean time expenditure for the dentist with low-level assistance was 111:03 min [S.D.+/-24:09 min] for [LAB] and 115:31 min [S.D.+/-15:54 min] for [CHAIR]. Time expenditure with medium level assistance for the operator was 100:53 min [S.D.+/-23:59] for [LAB] and 105:50 [S.D.+/-15:28] for [CHAIR]. Assuming a high level of assistance, the mean time values were 53:11 min [S.D.+/-14:29] for [LAB] and 54:29 min [S.D.+/-09:21] for [CHAIR]. The baseline investigation according to the modified USPHS criteria did not reveal any differences between [CHAIR] and [LAB]. CONCLUSION: There were no statistical significant differences with respect to time expenditure or quality between [LAB] and [CHAIR] in this study.
Asunto(s)
Diseño Asistido por Computadora , Recubrimiento Dental Adhesivo/métodos , Porcelana Dental , Incrustaciones/métodos , Silicatos de Aluminio/química , Cementación , Cerámica/química , Color , Preparación de la Cavidad Dental/métodos , Técnica de Impresión Dental , Adaptación Marginal Dental , Porcelana Dental/química , Femenino , Humanos , Incrustaciones/normas , Laboratorios Odontológicos , Masculino , Propiedades de Superficie , Factores de TiempoRESUMEN
O objetivo deste estudo foi avaliar a microinfiltração em restaurações diretas e indiretas em resina composta por meio de estereomicroscopia e microscopia eletrônica de varredura (MEV). Trinta incisivos bovinos foram lixados de forma a produzir uma plataforma incisal, simulando a face oclusal de um molar humano. Cada dente recebeu dois preparos proximais com 8º e término cervical em esmalte ou dentina. Uma cavidade foi restaurada pela técnica direta com Filtek Z250/Single Bond, e a outra pela técnica indireta com Solidex/RelyX ARC/Single Bond. As amostras foram armazenadas em água a 37°C por 24 horas e então imersas em solução de 50% de nitrato de prata por 6 horas em recipiente escuro. As amostras foram lavadas em água corrente, imersas em solução reveladora e expostas à luz fluorescente por 12 horas. Os dentes foram seccionados para avaliação da penetração do marcador em lupa estereoscópica e MEV. Não houve diferença entre as técnicas direta e indireta para o término em esmalte, porém, para o término em dentina, a técnica indireta resultou em menor infiltração. MEV mostrou infiltração similar à da lupa estereoscópica. A análise por meio de lupa estereoscópica e MEV melhora a avaliação da microinfiltração.
Asunto(s)
Animales , Bovinos , Resinas Compuestas/normas , Preparación de la Cavidad Dental/normas , Filtración Dental/diagnóstico , Recubrimientos Dentinarios/química , Dentina/ultraestructura , Incrustaciones/métodos , Análisis de Varianza , Resinas Compuestas/química , Filtración Dental/prevención & control , Recubrimientos Dentinarios/normas , Dentina/química , Incisivo/química , Incisivo/ultraestructura , Incrustaciones/normas , Luz , Microscopía Electrónica de Rastreo , Microscopía/métodos , Estadísticas no Paramétricas , AguaRESUMEN
Las restauraciones directas adhesivas con resinas compuestas pueden ofrecer ventajas en la reconstrucción de la porción coronaria de los dientes posteriores endodónticamente tratados con poca o moderada destrucción, pero las mismas quedan supeditadas al logro de adhesión/integración del material al diente para mejorar las propiedades mecánicas del diente restaurado. Muchos factores afectan ese objetivo y llevan a un pobre funcionamiento mecánico del diente, filtración marginal, caries secundaria y/o complicaciones periapicales. Asimismo, las tensiones de contracción de polimerización de los composites pueden generar deformaciones de las paredes del remanente que muchas veces terminan en fracturas. Existen diferentes alternativas que el odontólogo restaurador puede poner en práctica para obtener mejores resultados. Dichos procedimientos y actitudes clínicas son discutidos en este artículo (AU)
Asunto(s)
Diente Molar , Recubrimiento Dental Adhesivo/métodos , Preparación de la Cavidad Dental/métodos , Grabado Ácido Dental/métodos , Incrustaciones/normasRESUMEN
The aim of this study was to evaluate the microleakage of direct and indirect composite inlays by stereomicroscopy and scanning electron microscopy (SEM). Thirty bovine incisors were ground to obtain an incisal platform, simulating the occlusal surface of a human molar. Each tooth received two 8 degrees proximal cavities with cervical finishing line prepared in dentine or enamel. One of the cavities was filled with Filtek Z250/Single Bond, using the direct technique, and the other was filled with with Solidex/Rely X ARC/Single Bond, using the indirect technique. The samples were stored in water at 37 degrees C for 24 hours and placed in a 50% silver nitrate solution for 6 hours in a dark container. Next, the samples were washed under running water, immersed in a developing solution and exposed to fluorescent light for 12 hours. The teeth were then severed and evaluated for dye penetration by stereomicroscopy and SEM. There were no significant differences between the direct and indirect techniques for the cervical finishing line in enamel, but for the finishing line in dentin, the indirect technique allowed less microleakage than the direct technique. SEM analysis showed leakage similar to that observed by stereomicroscopic analysis. The use of stereomicroscopic and SEM evaluations improves microleakage analysis.