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Polymer-infiltrated ceramic CAD/CAM inlays and partial coverage restorations: 3-year results of a prospective clinical study over 5 years

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Abstract

Objective

The aim of this prospective clinical 5-year study was to evaluate the long-term behavior of monolithic computer-aided design and computer-aided manufacturing (CAD/CAM)-fabricated minimally invasive polymer-infiltrated ceramic network (PICN) inlays and partial coverage restorations (PCR).

Material and methods

Posterior teeth of 47 patients were restored with 103 restorations (45 inlays, 58 PCRs). After defect-oriented preparations, monolithic PICN restorations of VITA Enamic were fabricated with a CAD/CAM system (inEoS blue/CEREC inLab MCXL) and adhesively bonded (Variolink II). Clinical reevaluations were so far performed at baseline and 6, 12, 24, and 36 months after insertion according to modified United States Public Health Service (USPHS) criteria. Absolute failures were demonstrated by Kaplan-Meier survival rate and relative failures by Kaplan-Meier success rate. A logistic regression model was adjusted for modified USPHS criteria to investigate time and restoration effects (p < 0.05).

Results

After an observation time of 3 years, survival rates were 97.4% for inlays and 95.6% for PCRs. Three restorations had to be replaced due to clinically unacceptable fractures. Secondary caries and debonding were not observed. The 3-year Kaplan-Meier success rate was 84.8% for inlays and 82.4% for PCRs. The decrease in marginal adaption (p = 0.0005), increase in marginal discoloration (p < 0.0001), and surface roughness (p = 0.0005) over time were significant. Color match and anatomic form were excellent. No significant differences were found between both types of restorations for survival (p = 0.716) and success rate (p = 0.431).

Conclusions

Minimally invasive PICN restorations showed a favorable clinical performance over an observation period of 36 months. However, clinical long-term data have to be awaited.

Clinical relevance

PICN restorations are a suitable treatment option for posterior inlays and PCRs.

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Funding

This study was supported by VITA Zahnfabrik.

Author information

Authors and Affiliations

  1. Department of Prosthodontics, School of Dentistry, Heinrich-Heine-University, Moorenstraße 5, 40225, Düsseldorf, Germany

    F. A. Spitznagel & P. C. Gierthmuehlen

  2. Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany

    K. J. Scholz

  3. Department of Prosthodontics, School of Dentistry, Albert-Ludwigs-University Freiburg, Freiburg im Breisgau, Germany

    J. R. Strub

  4. Center for Medical Biometry and Medical Informatics, Albert-Ludwigs-University Freiburg, Freiburg im Breisgau, Germany

    K. Vach

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  1. F. A. Spitznagel
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  2. K. J. Scholz
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Corresponding author

Correspondence to F. A. Spitznagel.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the ethics committee of the Alberts-Ludwigs-University Freiburg (Registration Number 241/101 10628) and with the 1964 Helsinki Declaration and its later amendments.

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Informed consent was obtained from all of the participants included in the study.

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Spitznagel, F.A., Scholz, K.J., Strub, J.R. et al. Polymer-infiltrated ceramic CAD/CAM inlays and partial coverage restorations: 3-year results of a prospective clinical study over 5 years. Clin Oral Invest 22, 1973–1983 (2018). https://doi.org/10.1007/s00784-017-2293-x

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  • DOI: https://doi.org/10.1007/s00784-017-2293-x

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