Search

Objectives: The purpose of this randomized clinical study was to evaluate the clinical performance of posterior, metal-free polymer crowns after follow-up for up to six years, and to compare it with the performance of metal-ceramic crowns., Methods: Eighty single crowns, manufactured from a polymer composite resin, were set on posterior teeth. Half of these received a glass-fibre framework (group 1) whereas half were prepared without framework stabilization (group 2). As the control group, 40 conventional metal-ceramic crowns were inserted. Primary endpoints were incidence of complications, investigated on a time-to-event basis, plaque status, and aesthetic performance., Results: Thirty clinically relevant complications occurred after a median time of 2.3 years. Median follow-up time was four years. The most frequent complications were delamination (n=24) and root-canal treatment (n=4) of the crowns; the incidence of complications was not significantly different among crown materials (p=0.60). Twenty crowns had to be replaced (six polymer crowns in group 1, nine polymer crowns in group 2, four crowns in the control group, and one tooth (in group 1) had to be extracted). Mean plaque and gingival indexes for the test groups did not differ from those for the control group., Conclusions: Within a median follow-up period of four years, the clinical performance of posterior polymer crowns with and without a glass-fibre framework was not significantly different from that of metal-ceramic crowns, although the number of catastrophic failures of composite crowns was higher than that of the metal-ceramic crowns., Clinical Significance: On the basis of the study results, posterior polymer crowns may be an alternative to metal-ceramic crowns, although additional research is needed before they can be recommended, without reservation, as permanent restorations., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objective: (1) To quantify wear of two different denture tooth materials in vivo with two study designs, (2) to relate tooth variables to vertical loss., Methods: Two different denture tooth materials had been used (experimental material=test; DCL=control). In study 1 (split-mouth, 6 test centers) 60 subjects received complete dentures, in study 2 (two-arm, 1 test center) 29 subjects. In study 1 the mandibular dentures were supported by implants in 33% of the subjects, in study 2 only in 3% of the subjects. Impressions of the dentures were taken and poured with improved stone at baseline and after 6, 12, 18 and 24 months. Each operator evaluated the wear subjectively. Wear analysis was carried out with a laser scanning device. Maximal vertical loss of the attrition zones was calculated for each tooth cusp and tooth. A mixed linear model was used to statistically analyse the logarithmically transformed wear data., Results: Due to drop-outs and unmatchable casts, only 47 subjects of study 1 and 14 of study 2 completed the 2-year recall. Overall, 75% of all teeth present could be analysed. There was no statistically difference in the overall wear between the test and control material for either study 1 or study 2. The relative increase in wear over time was similar in both study designs. However, a strong subject effect and center effect were observed. The fixed factors included in the model (time, tooth, center, etc.) accounted for 43% of the variability, whereas the random subject effect accounted for another 30% of the variability, leaving about 28% of unexplained variability. More wear was consistently recorded in the maxillary teeth compared to the mandibular teeth and in the first molar teeth compared to the premolar teeth and the second molars. Likewise, the supporting cusps showed more wear than the non-supporting cusps. The amount of wear did not depend on whether or not the lower dentures were supported by implants. The subjective wear was correct in about 67% of the cases if it is postulated that a wear difference of 100μm should be subjectively detectable., Significance: The clinical wear of denture teeth is highly variable with a strong patient effect. More wear can be expected in maxillary denture teeth compared to mandibular teeth, first molars compared to premolars and supported cusps compared to non-supported cusps. Laboratory data on the wear of denture tooth materials may not be confirmed in well-structured clinical trials probably due to the large inter-individual variability., (Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

The objectives of this study were to measure the occlusal wear of composite resin denture teeth in patients wearing a complete denture and to evaluate factors affecting wear. Fifty participants provided with complete dentures in at least one jaw were included. Gypsum casts were made from preliminary vinyl polysiloxane impressions 4 weeks after insertion, then after 6 (t(1)), 12 (t(2)), and 24 months (t(3)). Three-hundred and three posterior denture teeth were evaluated after 24 months. Wear was measured indirectly, from the casts, by means of a three-dimensional laser scanner device. Sequential images of the occlusal surfaces were digitized and superimposed (occlusal matching). Statistical analysis was performed by the use of mixed regression models, with the patient being a random effect. Mean wear (median, interquartile range; micrometer) of the entire occlusal surface was 8 (19) at t(1), 18 (34) at t(2), and 40 (61) at t(3). Maximum vertical loss (median, interquartile range; micrometer) was 92 (112) at t(1), 146 (148) at t(2), and 226 (184) at t(3). The dental status of the opposing jaw and the nature of the opposing material significantly affected the wear of denture teeth at t (3). Gender, daily wearing time, jaw, and type of tooth had no significant effects on the extent of wear. Clinically relevant vertical loss of composite resin denture teeth occurs after 24 months. Considering the limitations of this study, wear of denture teeth was affected by dental status and opposing material. The results suggest that wear of composite resin denture teeth exceeds that of enamel.

Purpose: Improvements in the physical properties of modern composites have led to continuous expansion of their field of application to include extensive, occlusion-bearing posterior restorations and even metal-free polymer crowns. The objective of this clinical study was to investigate the influence of gender, arch, and crown location on the occlusal wear of metal-free ceramic-filled polymer crowns and to compare their wear with the mean annual occlusal wear of enamel (15 to 38 microm)., Materials and Methods: One hundred fourteen ceramic-filled polymer crowns made of Artglass (Heraeus Kulzer) were placed in 74 patients. After 1 year, 93 crowns were available for wear measurement. After 2 years, 76 crowns were available. Wear was determined by use of replicas. A 3-dimensional optical profilometer (Laserscan 3D, Willytec) was used to digitize and superimpose the occlusal surfaces of the baseline and recall replicas (occlusal matching)., Results: After 1 year, median wear of the entire occlusal surface was 19 microm for anterior and canine teeth, 19 microm for premolars, and 21 microm for molars. After 2 years, median wear was 36 pm for anterior and canine teeth, 44 microm for premolars, and 84 microm for molars. The wear of the occlusal contact areas was significantly higher. Significant effects of crown location (premolar or molar) on the extent of wear of the occlusal contact areas were found., Conclusions: Ceramic-filled polymer crowns are subject to measurable occlusal wear that exceeds that of natural enamel.

Objectives: The purpose of this study was to evaluate the clinical performance of two adhesively retained composite core materials and compare them with a metal-added glass ionomer. The main objective evaluated was total or partial loss of build-ups during the treatment prior to crown cementation., Methods: In 187 patients, 315 vital and non-vital teeth were built up after randomisation with either Rebilda D (RD), Rebilda SC (RSC) or Ketac Silver Aplicap (KSA). The composites were applied in the total-etch-technique with the corresponding dentin bonding agent. The metal-added glass ionomer was used with a conditioner. One group of patients was treated by experienced dentists, the other by dental students, in order to evaluate the effects of different levels of experience. Data were analysed using Mann-Whitney-U-Test and binomial logistic regression., Results: The early failure rate (partial or total loss) of core build-ups before crown cementation was significantly higher for KSA (28.8%), as compared to RSC (15.3%, p=0.037) and RD (15%, p=0.025). Most failures were observed during the removal of the temporary crowns. The rate of replacements was between 3.0 (RD/dentists) and 20.4% (KSA/students). Furthermore, we found that build-ups made by students had a significantly higher risk of loss than those made by dentists (p=0.028)., Conclusions: Adhesively retained self-curing composites show a better clinical short-term performance and can be recommended as core build-up materials.

Objectives: The aim of the investigation was to examine the color stability of seven resin-based facing composites with a high content of inorganic filling material (Colombus, Artglass, Sinfony, Targis, Zeta LC, Zeta HC, BelleGlass HP/dentine, BelleGlass HP/enamel)., Methods: Changes in color of test samples were determined after UV irradiation in a fast-action UV instrument, Sunset CPS+, and after storage in a mouthrinse, tea, coffee, red wine and a 0.1% turmeric (curcuma) solution. Color differences were measured by using a Castor colorimeter and the total amount of color difference represented as DeltaE., Results: Red wine and the turmeric solution caused the most severe cases of discoloration (DeltaE>10). Tea, coffee, the mouthrinse and UV irradiation caused invisible (DeltaE<1) or visible (DeltaE>1), and to some extent clinically unacceptable (DeltaE>3.3), discoloration., Significance: It is apparent from the results that it remains essential to improve the color stability of the composite resin materials used for facings.