Objectives. The present prospective, longitudinal study assessed the outcome of posterior extensive restorations and identified risk factors for failure of the restorations.
Materials and methods. ...The sample consisted of 722 amalgam restorations, 115 composite resin restorations and 89 crowns placed in 428 adults by one dentist from 1982 to 1999 in Belgium. Well-defined criteria were used for cavity preparation design, type of retention and selection of restorative material.
Results. At the closure of the study 48% of the restorations were well functioning, 24% were lost to lack of follow-up, and 28% had failed. The most frequent reasons for failure were fracture of restoration (8%), secondary caries (6%) and fracture of cusp (5%). Failures were more often found in premolar teeth (34%) than in molars (27%) (
P=0.05) and occurred in 28% of the amalgam restorations, 30% of the resin restorations and 24% of the crowns (
P=0.55). Molar restorations were more frequently repaired than replaced in contrast to premolar restorations. The highest percentage of extractions was related to complete amalgam restorations in premolars. The Kaplan–Meier median survival times were 12.8 years for amalgam restorations, 7.8 years for resin restorations, and more than 14.6 years for crowns, considering all retreatment as failures (
P=0.002). The survival was influenced by extension of restoration, age of patient, pulpal vitality, 3-year period of treatment, use of base material and dentinal retentive pins.
Conclusion. Within the limits of the study the data support the view that extensive amalgam restorations but not composite resin restorations can be used as an appropriate alternative to crowns, with due consideration to the longevity of the restorations.
Background: Accuracy in fit of cast metal restoration has always remained as one of the primary factors in determining the success of the restoration. A well-fitting restoration needs to be accurate ...both along its margin and with regard to its internal surface. Aim: The aim of the study is to evaluate the marginal fit of metal ceramic crowns obtained by conventional inlay casting wax pattern using conventional impression with the metal ceramic crowns obtained by computer-aided design and computer-aided manufacturing (CAD/CAM) technique using direct and indirect optical scanning. Materials and Methods: This in vitro study on preformed custom-made stainless steel models with former assembly that resembles prepared tooth surfaces of standardized dimensions comprised three groups: the first group included ten samples of metal ceramic crowns fabricated with conventional technique, the second group included CAD/CAM-milled direct metal laser sintering (DMLS) crowns using indirect scanning, and the third group included DMLS crowns fabricated by direct scanning of the stainless steel model. The vertical marginal gap and the internal gap were evaluated with the stereomicroscope (Zoomstar 4); post hoc Turkey's test was used for statistical analysis. One-way analysis of variance method was used to compare the mean values. Results and Conclusion: Metal ceramic crowns obtained from direct optical scanning showed the least marginal and internal gap when compared to the castings obtained from inlay casting wax and indirect optical scanning. Indirect and direct optical scanning had yielded results within clinically acceptable range.
With a wide variety of post systems and materials available for the restoration of lost tooth structure of endodontically treated teeth, the clinical decision of which to use constitutes a challenge ...to dental practitioners. Cast metal post and cores are widely used for restoring endodontically treated teeth with extensive loss of coronal tooth structure and to retain metal-ceramic crowns. When dental aesthetics is of primary concern, the selection of the underlying restorative material becomes an important factor to consider. The fibre-reinforced posts combined with all-ceramic crowns offer a highly aesthetic outcome in anterior region restorations, but longterm evaluation is necessary in order to assess their clinical performance and longevity.
The excessive abrasion of occlusal surfaces in ceramic crowns limits the service life of restorations and their clinical results. However, little is known about the time-dependent wear behavior of ...ceramic restorations during the chewing process. The aim of this in vitro study was to investigate the dynamic evolution of the wear behavior of veneering porcelain in PFM crowns as wear progressed, as tested in a chewing simulator. Twenty anatomical metal-ceramic crowns were prepared using Ceramco III as the veneering porcelain. Stainless steel balls served as antagonists. The specimens were dynamically loaded in a chewing simulator with 350N up to 2.4×10(6) loading cycles, with additional thermal cycling between 5 and 55°C. During the testing, several checkpoints were applied to measure the substance loss of the crowns' occlusal surfaces and to evaluate the microstructure of the worn areas. After 2.4×10(6) cycles, the entire wear process of the veneering porcelain in the PFM crowns revealed three wear stages (running-in, steady and severe wear stages). The occlusal surfaces showed traces of intensive wear on the worn areas during the running-in wear stage, and they exhibited the propagation of cracks in the subsurface during steady wear stage. When the severe wear stage was reached, the cracks penetrated the ceramic layer, causing the separation of porcelain pieces. It also exhibited a good correlation among the microstructure, the wear loss and the wear rate of worn ceramic restorations. The results suggest that under the conditions of simulated masticatory movement, the wear performance of the veneering porcelain in PFM crowns indicates the apparent similarity of the tribological characteristics of the traditional mechanical system. Additionally, the evaluation of the wear behavior of ceramic restorations should be based on these three wear stages.
Purpose: The purpose of this in vitro study was to compare the porcelain fracture resistance between screw‐retained, cement‐retained, and combined screw‐ and cement‐retained metal–ceramic (MC) ...implant‐supported posterior single crowns; and to investigate the effect of offsetting the occlusal screw‐access opening on porcelain fracture resistance of screw‐retained and cement‐retained MC implant‐supported posterior single crowns.
Materials and Methods: Forty standardized MC molar‐shaped restorations were fabricated. The 40 restorations were divided into four groups (SRC, SRO, CRP, and CSC) of 10 specimens each. Group SRC: screw‐retained, screw‐access hole placed in the center of the occlusal surface; Group SRO: screw‐retained, screw access hole placed 1 mm offset from the center of the occlusal surface toward the buccal cusp; Group CRP: cement‐retained, zinc phosphate cement was used; Group CSC: cement‐retained with a screw‐access hole in the center of the occlusal surface. The screw‐retained restorations and abutments were directly attached to 3i implant fixtures embedded in acrylic resin blocks. Subsequently, all test specimens were thermocycled and vertically loaded in a universal testing machine at a crosshead speed of 2 mm/min until fracture. Mean values of load at fracture (in N) were calculated in each group and compared with a one‐way ANOVA and Tukey's Studentized test (α= 0.05).
Results: Mean values of loads required to fracture the restorations were as follows (N): Group SRC: 1721 ± 593; Group SRO: 1885 ± 491; Group CRP: 3707 ± 1086; Group CSC: 1700 ± 526. Groups SRC, SRO, and CSC required a significantly lower force to fracture the porcelain than did the CRP group (p < 0.05).
Conclusion: The cement‐retained restorations showed significantly higher mean fracture loads than the restorations having screw‐access openings in their occlusal surface. The position of the screw‐access hole within the occlusal surface did not significantly affect the porcelain fracture resistance.
The aim of this study was to compare effect of different metal coping designs on fracture resistance of porcelain in metal ceramic restorations.
Fracture resistance of porcelain was assessed in ...porcelain fused to metal crowns with three different coping designs i.e. metal coping extension on labial surface upto gingivoaxial line angle, metal coping extension 1mm short of the gingivoaxial line angle and metal coping with 0.4mm wide labial metal collar. For crowns without labial metal collar margin; shoulder porcelain was used to build the labial cervical margin of the crowns.
RESULTS were assessed with statistical analysis using the student unpaired't' test. Visual examination of the fractured specimens of group A, B and C showed remarkably similar failure modes with nearly all specimens failing through a shear fracture of porcelain from load point to facial margin of the crown.
Within the scope of this study, it was observed that the mean facture strength of the samples with shoulder porcelain labial margins having metal coping design extending upto gingivoaxial line angle of the finish line was highest as compared to samples with shoulder porcelain labial margins having metal coping design 1mm short of gingivoaxial line angle & samples having porcelain fused to metal coping design with 0.4mm wide metal collar.
Purpose: The purpose of this in vitro study was to determine if packable resin composite with/without flowable resin composite has the ability to prevent coronal leakage in restored endodontic access ...openings following aging.
Materials and Methods: Eighty simulated standardized access cavities of metal‐ceramic crowns were fabricated and fixed on Vitrebond cavities filled with an epoxy resin. The specimens were randomly divided into two main groups: (1) Group A—Access cavities filled with only packable composite (Filtek P60); (2) Group B—Access cavities filled with Filtek P60 and a flowable composite (Filtek Z350) as liner. Each main group was further subdivided randomly into four subgroups according to water storage and thermocycling periods. All specimens were immersed in blue ink solution for 24 hours and then sectioned into quadrants. The extension of blue ink along the metal‐ceramic crown/composite resin interface was measured linearly using image analyzer and then analyzed by three‐way ANOVA and independent t‐test with a Mann‐Whitney test. The level of significance was set at p < 0.05.
Results: All tested subgroups demonstrated different levels of microleakage. There was no significant difference related to restorative technique; however, there was a significant difference related to water storage and thermocycling.
Conclusions: All tested techniques and materials in this study showed microleakage. Packable composite while a flowable liner showed a marginally better result than packable composite alone. Excessive thermocycling resulted in significant differences among the test groups.
The paper aims on microfabrication and corrosion processes evaluation of three different metal-ceramic crowns with CoCrMo substructures. The samples have different exposed metal surface and the ...electrochemical investigations are Tafel analysis and Electrochemical Impedance Spectroscopy (EIS).
Ensuring the integrity of the oral tissue complex depends primarily on the regenerative capacity of the patient's body but also on the materials and methods used within the regenerative therapy. ...Authors have proposed to summarize the regenerative treatment methods available to update the clinician the methods and recent developments in the research. Personal experience is presented for guided regeneration of oral tissues insisting on patient management where such treatment is recommended.
To investigate the effect of abutment finish line curvature on the fit of all-ceramic CAD/CAM crowns and metal-ceramic crowns.
Three types of finish line curvature abutments (1-, 3-, and 5-mm ...curvature) were prepared on typodont maxillary central incisors. For each type of abutment, 5 all-ceramic crowns (Cercon system, DeguDent) and 5 metal-ceramic crowns were fabricated. The marginal gaps of copings and veneered crowns were measured on a profile projector. The data were calculated and analyzed with 2-way ANOVA and Tukey HSD test (alpha = .05).
The mean labial, lingual, mesial, and distal marginal gaps (SD) of all-ceramic crowns were similar: respectively, 54 (10), 51 (11), 47 (13), and 49 (9) microm for 1-mm curvature; 49 (12), 53 (11), 54 (10), and 55 (12) microm for 3-mm curvature; and 57 (12), 54 (11), 53 (10), and 52 (9) microm for 5-mm curvature. The mean labial, lingual, mesial, and distal marginal gaps (SD) of metal-ceramic crowns were 36 (7), 41 (9), 26 (8), and 28 (10) microm, respectively, for 1-mm curvature. The mean labial and lingual marginal gaps (SD) of metal-ceramic crowns for 3-mm curvature were 45 (8) and 48 (9) microm, respectively-significantly larger than mesial (P = .01 and .007) and distal (P = .03 and .02) gaps. The mean labial and lingual marginal gaps (SD) of metal-ceramic crowns for 5-mm curvature were 76 (10) and 74 (15) microm, respectively-significantly larger than mesial (P = .001 and .001) and distal (P = .001 and .001) gaps.
The abutment finish line curvature had no significant effect on the marginal fit of all-ceramic crowns, but had a significant effect on the marginal fit of metal-ceramic crowns.
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