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First clinical experiences with CAD/CAM-fabricated PMMA-based fixed dental prostheses as long-term temporaries

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Abstract

Objective

The clinical performance of polymethylmethacrylate (PMMA)-based fixed dental prostheses (FDP) was evaluated in the indication of long-term temporaries.

Materials and methods

In the current indication of the applied machinable PMMA-based material (Vita CAD-Temp), i.e. temporary crowns and FDPs, 27 patients with compromised dentitions (uncertain dental prognosis or postponement of a removable treatment option) were recruited and 45 FDPs (3 or 4 units, 37 terminal-retained, 8 cantilevered) were inserted. Frameworks were computer-aided design (CAD)/computer-aided manufacturing (CAM)-manufactured after conventional impression taking and labside scanning of stone master casts. A resin-modified hybrid cement material (RelyX Unicem) was used for luting in a conventional protocol. Clinical follow-up was performed biannually.

Results

Over an observation time from 2 to 26 months (median 13 months), 11 complications were found in 9 out of 45 PMMA restorations: 4 losses of retention, 5 complete fractures; two of these subsequent to a trepanation for endodontic treatment. Thereby, 3 out of 8 cantilevered FDPs had to be removed within 8 months. Thus, the statistical evaluation included FDPs with abutment at end, only. These standard design FDPs (n = 37) showed a 90.4 % survival rate with a complication-free rate of 88.3 % estimated for an observation time of 16 months.

Conclusion

Cantilevered FDPs and reconstructions on abutment teeth with markedly reduced biological prognosis or endodontic intervention yielded a high-failure rate. Terminal-retained FDPs performed clinically well in cases without compromised abutment teeth.

Clinical relevance

PMMA-based material might be used successfully for long-term temporization with 3- to 4-unit FDPs in a standard design over at least one year.

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References

  1. Miyazaki T, Hotta Y (2011) CAD/CAM systems available for the fabrication of crown and bridge restorations. Aust Dent J 56(Suppl 1):97–106. doi:10.1111/j.1834-7819.2010.01300.x

    Article  PubMed  Google Scholar 

  2. Fasbinder DJ (2010) Materials for chairside CAD/CAM restorations. Compend Contin Educ Dent 31:702–4, 706, 708–9

  3. Arnetzl GV, Arnetzl G (2011) Adhesive techniques and machineable high-performance polymer restorations for amelogenesis imperfecta in mixed dentition. Int J Comput Dent 14:129–138

    PubMed  Google Scholar 

  4. Edelhoff D, Beuer F, Schweiger J, Brix O, Stimmelmayr M, Guth JF (2012) CAD/CAM-generated high-density polymer restorations for the pretreatment of complex cases: a case report. Quintessence Int 43:457–467

    PubMed  Google Scholar 

  5. Baltzer A, Kaufmann-Jinoian V (2007) VITA CAD-Temp for inLab and Cerec 3D. Int J Comput Dent 10:99–103

    PubMed  Google Scholar 

  6. Jakob F, Jungbauer G, Schneider J et al (2010) Biocompatibility of new CAD/CAM-machinable materials for provisional long-term restorations. J Dent Res 89:2280 (www.dentalresearch.org)

    Google Scholar 

  7. Stawarczyk B, Ender A, Trottmann A, Ozcan M, Fischer J, Hammerle CH (2012) Load-bearing capacity of CAD/CAM milled polymeric three-unit fixed dental prostheses: effect of aging regimens. Clin Oral Investig. doi:10.1007/s00784-011-0670-4

    Google Scholar 

  8. Alt V, Hannig M, Wostmann B, Balkenhol M (2011) Fracture strength of temporary fixed partial dentures: CAD/CAM versus directly fabricated restorations. Dent Mater 27:339–347. doi:10.1016/j.dental.2010.11.012

    Article  PubMed  Google Scholar 

  9. Rammelsberg P, Spiegl K, Eickemeyer G, Schmitter M (2005) Clinical performance of metal-free polymer crowns after 3 years in service. J Dent 33:517–523. doi:10.1016/j.jdent.2004.11.012

    Article  PubMed  Google Scholar 

  10. Fokkinga WA, Kreulen CM, Bronkhorst EM, Creugers NH (2008) Composite resin core-crown reconstructions: an up to 17-year follow-up of a controlled clinical trial. Int J Prosthodont 21:109–115

    PubMed  Google Scholar 

  11. Vanoorbeek S, Vandamme K, Lijnen I, Naert I (2010) Computer-aided designed/computer-assisted manufactured composite resin versus ceramic single-tooth restorations: a 3-year clinical study. Int J Prosthodont 23:223–230

    PubMed  Google Scholar 

  12. Creutzfeldt H (2007) A composite material for CAD/CAM-fabricated, metal free long term temporaries. Quintessenz Zahntech 33:348–352

    Google Scholar 

  13. Handel G (2002) Wissenschaftliche Stellungnahme der DGZMK: Langzeitprovisorien. Dtsch Zahnärztl Z 57:450

    Google Scholar 

  14. Ryge G (1980) Clinical criteria. Int Dent J 30:347–358

    PubMed  Google Scholar 

  15. Groten M, Axmann D (2004) Time needed for data collection in clinical studies on fixed prosthodontics. Int J Prosthodont 17:651–656

    PubMed  Google Scholar 

  16. Hickel R, Roulet JF, Bayne S, Heintze SD, Mjor IA, Peters M, Rousson V, Randall R, Schmalz G, Tyas M, Vanherle G (2007) Recommendations for conducting controlled clinical studies of dental restorative materials. Clin Oral Investig 11:5–33. doi:10.1007/s00784-006-0095-7

    Article  PubMed  Google Scholar 

  17. van Noort R (2012) The future of dental devices is digital. Dent Mater 28:3–12. doi:10.1016/j.dental.2011.10.014

    Article  PubMed  Google Scholar 

  18. Tan K, Pjetursson BE, Lang NP, Chan ES (2004) A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res 15:654–666. doi:10.1111/j.1600-0501.2004.01119.x

    Article  PubMed  Google Scholar 

  19. Walls AW (2010) Cantilever FPDs have lower success rates than end abutted FPDs after 10-years of follow-up. J Evid Based Dent Pract 10:41–43. doi:10.1016/j.jebdp.2009.11.020

    Article  PubMed  Google Scholar 

  20. v. Mohrenschildt S (2009) Untersuchung zur Bruchfestigkeit von CAD/CAM-gefertigten Seitenzahnbrücken aus Hochleistungspolymer-Kunststoffen: Eine In-vitro-Untersuchung. In: Faculty of Medicine, Dissertation, Ludwig-Maximilians-Universität, Munich

  21. Hamakubo T, Sawase T, Yoshida K, Kamada K, Taira Y, Atsuta M (2004) Thephysical properties of a machinable resin composite for esthetic restorations. Dent Mater J 24:24–29

    Article  Google Scholar 

  22. Edelhoff D, Ozcan M (2007) To what extent does the longevity of fixed dental prostheses depend on the function of the cement? Working group 4 materials: cementation. Clin Oral Implants Res 18(Suppl 3):193–204. doi:10.1111/j.1600-0501.2007.01442.x

    Article  PubMed  Google Scholar 

  23. Hill EE, Lott J (2011) A clinically focused discussion of luting materials. Aust Dent J 56(Suppl 1):67–76. doi:10.1111/j.1834-7819.2010.01297.x

    Article  PubMed  Google Scholar 

  24. Breschi L, Mazzoni A, Ruggeri A, Cadenaro M, Di Lenarda R, De Stefano DE (2008) Dental adhesion review: aging and stability of the bonded interface. Dent Mater 24:90–101. doi:10.1016/j.dental.2007.02.009

    Article  PubMed  Google Scholar 

  25. Frankenberger R, Kramer N, Appelt A, Lohbauer U, Naumann M, Roggendorf MJ (2011) Chairside vs. labside ceramic inlays: effect of temporary restoration and adhesive luting on enamel cracks and marginal integrity. Dent Mater 27:892–898. doi:10.1016/j.dental.2011.05.007

    Article  PubMed  Google Scholar 

  26. Freitas AC Jr, Rocha EP, dos Santos PH, de Almeida EO, Anchieta RB (2010) All-ceramic crowns over single implant zircon abutment. Influence of young’s modulus on mechanics. Implant Dent 19:539–548. doi:10.1097/ID.0b013e31820030ca

    Article  PubMed  Google Scholar 

  27. Keul C, Muller-Hahl M, Eichberger M, Liebermann A, Roos M, Edelhoff D, Stawarczyk B (2014) Impact of different adhesives on work of adhesion between CAD/CAM polymers and resin composite cements. J Dent 42:1105–1114. doi:10.1016/j.jdent.2014.02.020

    Article  PubMed  Google Scholar 

  28. Hikita K, Van Meerbeek B, De Munck J, Ikeda T, Van Landuyt K, Maida T, Lambrechts P, Peumans M (2007) Bonding effectiveness of adhesive luting agents to enamel and dentin. Dent Mater 23:71–80. doi:10.1016/j.dental.2005.12.002

    Article  PubMed  Google Scholar 

  29. Keul C, Kohen D, Eichberger M, Roos M, Gernet W, Stawarczyk B (2015) The effect of different pretreatment methods of PMMA-based crowns on the long-term tensile bond strength to dentin abutments. Clin Oral Investig 19:35–43. doi:10.1007/s00784-014-1215-4

    Article  PubMed  Google Scholar 

  30. Edelhoff D, Schweiger J, Brix O et al (2011) Initial treatment of complex cases with CAD/CAM-generated restorations made from high-performance resins. Quintessenz 62:625–635

    Google Scholar 

  31. Wiegand A, Stucki L, Hoffmann R, Attin T, Stawarczyk B (2015) Repairability of CAD/CAM high-density PMMA- and composite-based polymers. Clin Oral Investig. doi:10.1007/s00784-015-1411-x

    Google Scholar 

  32. Magne P, So WS, Cascione D (2007) Immediate dentin sealing supports delayed restoration placement. J Prosthet Dent 98:166–174. doi:10.1016/S0022-3913(07)60052-3

    Article  PubMed  Google Scholar 

  33. Ohlmann B, Gruber R, Eickemeyer G, Rammelsberg P (2008) Optimizing preparation design for metal-free composite resin crowns. J Prosthet Dent 100:211–219. doi:10.1016/S0022-3913(08)60180-8

    Article  PubMed  Google Scholar 

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Acknowledgments

This clinical trial was approved by the Ethics Committee of Tuebingen University (30/2009MPG2) and is listed at the German Clinical Trials Register (DRKS00000644). The authors thank the following dental technicians of Tuebingen University Hospital’s Dental Lab: MDT Ekkehard Kroewerath, DT Volker Scheer and DT Karina Wuensch. The study was partially financed by Vita Zahnfabrik (Bad Säckingen, Germany) and by the Medical Faculty of Eberhard Karls University of Tuebingen.

Conflict of interest

The authors declare no personal conflict of interest, besides being involved in this clinical trial.

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Authors and Affiliations

  1. Department of Prosthodontics with Section “Medical Materials and Technology” at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tübingen, Germany

    Fabian Huettig, Andreas Prutscher, Christoph Goldammer, Curt A. Kreutzer & Heiner Weber

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  1. Fabian Huettig
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  2. Andreas Prutscher
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  4. Curt A. Kreutzer
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Correspondence to Fabian Huettig.

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Huettig, F., Prutscher, A., Goldammer, C. et al. First clinical experiences with CAD/CAM-fabricated PMMA-based fixed dental prostheses as long-term temporaries. Clin Oral Invest 20, 161–168 (2016). https://doi.org/10.1007/s00784-015-1475-7

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  • DOI: https://doi.org/10.1007/s00784-015-1475-7

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