Clinical Evaluation of Lithium Disilicate Veneers Manufactured by CAD/CAM Compared with Heat-pressed Methods: Randomized Controlled Clinical Trial

2021 ◽  
Vol 46 (1) ◽  
pp. 4-14
Author(s):  
IBL Soares-Rusu ◽  
CA Villavicencio-Espinoza ◽  
NA de Oliveira ◽  
L Wang ◽  
HM Honório ◽  
...  
Keyword(s):  
Clinical Performance ◽  
Statistical Significance ◽  
United States Public Health ◽  
Lithium Disilicate ◽  
The United States ◽  
Marginal Adaptation ◽  
Fabrication Technique ◽  
Level Of Satisfaction ◽  
Cad Cam

Clinical Relevance Lithium disilicate veneers for esthetic restorations show great accuracy and similarity, regardless of the type of fabrication technique. SUMMARY Objectives: This study aimed to evaluate and compare the clinical performance of two different ceramic veneer methods: CAD/CAM (IPS e.max CAD) and heat-press (IPS e.max Press) at 6 and 12 months of follow-up, and the level of patient satisfaction after treatment. Methods and Materials: Patients were selected according to eligibility criteria, with a minimum of two and a maximum of six veneers per patient, for a total of 178 veneers randomized in two groups. A split-mouth, longitudinal, interventional, double-blind and single-center study was carried out according to the fabrication technique. Scores were attributed to the veneers according to the criteria of the United States Public Health Service (USPHS) regarding marginal adaptation, color change, marginal discoloration, restoration fracture, tooth fracture, restoration wear, antagonist tooth wear, presence of caries, and postoperative sensitivity. All patients answered a satisfaction questionnaire using the Visual Analogue Scale (VAS). Statistical significance was determined using two-way ANOVA and Tukey test, with a significance level of 5%. Results: The marginal adaptation criterion showed statistical difference between periods (p=0.017), regardless of the processing method (baseline means: CAD=1.056, PRESS=1.067, 6- to 12-month follow-up: CAD=1.089, PRESS=1.078). The other evaluated criteria showed no statistical differences between baseline and after 6 to 12 months. The level of satisfaction assessed by the VAS before and after treatment was 7.06 and 9.5, respectively. Conclusions: The two methods presented similar clinical performance after 12 months, and the patient’s level of satisfaction was considered high.

scholarly journals Feldspathic and Lithium Disilicate Onlays with a 2-Year Follow-Up: Split-Mouth Randomized Clinical Trial

2021 ◽  
Vol 32 (2) ◽  
pp. 53-63
Author(s):  
Guilherme de Siqueira Ferreira Anzaloni Saavedra ◽  
João Paulo Mendes Tribst ◽  
Nathália de Carvalho Ramos ◽  
Renata Marques de Melo ◽  
Vinícius Anéas Rodrigues ◽  
...  
Keyword(s):  
Clinical Performance ◽  
Glass Ceramics ◽  
Lithium Disilicate ◽  
Ceramic Materials ◽  
Significant Difference ◽  
Term Trial ◽  
Cad Cam ◽  
Age Range ◽  
Postoperative Sensitivity

Abstract The present study was a prospective, controlled, randomized, clinical short-term trial aiming to evaluate the clinical performance of adhesively luted, lithium disilicate and feldspathic glass-ceramics onlays over a period up to 2 years. A total of 11 patients (7 female, 4 male; age range: 18-60 years, mean age: 39 years) were selected for this study. Each patient received a maximum of two restorations per group in a split-mouth-design. LD: Eleven onlays, performed with lithium disilicate-based ceramic (IPS e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein), and FP: Eleven onlays, performed with feldspathic ceramic (Vita Mark II, Vita Zanhfabrik, Bad Säckingen). Recalls were performed at 2 weeks (baseline = R1), 1 year (R2) and 2 years (R3) after the cementation by three calibrated blinded independent investigators using mirrors, magnifying eyeglasses, probes and bitewing radiographs. The postoperative sensitivity, secondary caries, marginal integrity, marginal discoloration, color match, surface roughness, tooth integrity, and restoration integrity were evaluated. The Friedman test was used to determine if there was a statistically significant difference in time-to-time comparison of the parameters in the ceramics restorations. A total of 95.4% of the restorations were clinically acceptable at the 2-year recall, without a difference for any evaluation parameter for both ceramic materials. Based on the 2-year data, the CAD-CAM onlays manufactured with feldspathic and lithium-disilicate based ceramics showed similar clinical performance.

scholarly journals A New Universal Simplified Adhesive: 18-Month Clinical Evaluation

2014 ◽  
Vol 39 (2) ◽  
pp. 113-127 ◽  
Author(s):  
J Perdigão ◽  
C Kose ◽  
AP Mena-Serrano ◽  
EA De Paula ◽  
LY Tay ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Clinical Performance ◽  
Evaluation Criteria ◽  
United States Public Health ◽  
The United States ◽  
Marginal Adaptation ◽  
Cervical Lesions ◽  
Universal Adhesive ◽  
Etch And Rinse ◽  
Usphs Criteria

SUMMARY Purpose To evaluate the 18-month clinical performance of a multimode adhesive (Scotchbond Universal Adhesive, SU, 3M ESPE, St Paul, MN, USA) in noncarious cervical lesions (NCCLs) using two evaluation criteria. Materials and Methods Thirty-nine patients participated in this study. Two-hundred restorations were assigned to four groups: ERm, etch-and-rinse + moist dentin; ERd, etch-and-rinse + dry dentin; Set, selective enamel etching; and SE, self-etch. The composite resin, Filtek Supreme Ultra (3M ESPE), was placed incrementally. The restorations were evaluated at baseline, and at 18 months, using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. Statistical analyses were performed using Friedman repeated-measures analysis of variance by rank and McNemar test for significance in each pair (α=0.05). Results Five restorations (SE: 3; Set: 1; and ERm: 1) were lost after 18 months (p>0.05 for either criteria). Marginal staining occurred in four and 10% of the restorations evaluated (p>0.05), respectively, for USPHS and FDI criteria. Nine restorations were scored as bravo for marginal adaptation using the USPHS criteria and 38%, 40%, 36%, and 44% for groups ERm, ERd, Set, and SE, respectively, when the FDI criteria were applied (p>0.05). However, when semiquantitative scores (or SQUACE) for marginal adaptation were used, SE resulted in a significantly greater number of restorations, with more than 30% of the total length of the interface showing marginal discrepancy (28%) in comparison with the other groups (8%, 6%, and 8%, respectively, for ERm, ERd, and Set). Conclusions The clinical retention of the multimode adhesive at 18 months does not depend on the bonding strategy. The only differences between strategies were found for the parameter marginal adaptation, for which the FDI criteria were more sensitive than the USPHS criteria.

Clinical Evaluation of a Low-shrinkage Composite in Posterior Restorations: One-Year Results

2012 ◽  
Vol 37 (2) ◽  
pp. 117-129 ◽  
Author(s):  
B Baracco ◽  
J Perdigão ◽  
E Cabrera ◽  
I Giráldez ◽  
L Ceballos
Keyword(s):  
Clinical Performance ◽  
Clinical Success ◽  
United States Public Health ◽  
The United States ◽  
Marginal Adaptation ◽  
Etch And Rinse ◽  
One Year ◽  
The One ◽  
Statistical Change ◽  
Self Etch

SUMMARY Objectives The aim of this study was to compare the one-year clinical performance of three restorative systems, which included a novel low-shrinkage composite and two bonding strategies. Materials and Methods Twenty-five patients received three Class I (occlusal) or Class II restorations performed with one of three restorative systems: Filtek Silorane Restorative System (FS); Adper Scotchbond 1 XT, a two-step etch-and-rinse adhesive, with Filtek Z250 (XT); and Adper Scotchbond SE, a two-step self-etch adhesive, with Filtek Z250 (SE). All materials were applied following the manufacturer's instructions. Two independent observers evaluated the restorations at baseline, after six months, and after one year, according to the United States Public Health System modified criteria. The Kruskal-Wallis test and the Mann-Whitney U-test were computed to compare the behavior of the restorative systems; Friedman and Wilcoxon tests were used to analyze the intrasystem data (α=0.05). Results All restorations were evaluated at one year. FS and XT performed statistically similarly at one year, but marginal staining for SE was statistically worse. Intrasystem comparisons between baseline and one year also showed deterioration of marginal staining for SE, while a deterioration of the marginal adaptation was recorded for both SE and FS. XT was the only system for which there was no statistical change of the parameters measured in this study. Conclusions Both restorative systems using self-etch adhesives showed a tendency to degradation of marginal adaptation after one year of clinical use, compared to baseline values. Although the clinical performance of FS was deemed acceptable after one year, this study did not find any advantage of the silorane-based composite over the methacrylate-based composite. The low-shrinkage associated with FS may not be a determinant factor for clinical success.

scholarly journals Clinical Performance of Bulk-Fill Resin Composite Restorations Using the United States Public Health Service and Federation Dentaire Internationale Criteria: A 12-Month Randomized Clinical Trial

2020 ◽  
Author(s):  
Márcia de Almeida Durão ◽  
Ana Karina Maciel de Andrade ◽  
Maria do Carmo Moreira da Silva Santos ◽  
Marcos Antônio Japiassú Resende Montes ◽  
Gabriela Queiroz de Melo Monteiro
Keyword(s):  
Public Health ◽  
United States ◽  
Health Service ◽  
Public Health Service ◽  
Clinical Performance ◽  
Resin Composite ◽  
United States Public Health ◽  
The United States ◽  
Resin Composites

Abstract Objective This study was aimed to compare the 12-month clinical performance of two full-body bulk-fill resin composites Filtek bulk fill/3M ESPE (FBF) and Tetric EvoCeram bulk fill/Ivoclar Vivadent (TBF) and a conventional microhybrid resin composite Filtek Z250/3M ESPE (Z250) using the modified the United States Public Health Service (USPHS) and Federation Dentaire Internationale (FDI) criteria. Also, the agreement between the two evaluation criteria was evaluated at baseline and after 12 months of follow-up. Materials and Methods A total of 138 class I and II restorations were placed in posterior teeth (split-mouth design) of 46 volunteers following manufacturer’s instructions and bonded with a self-etching bonding agent (Clear fill SE Bond/Kuraray). The restorations were evaluated at baseline and after 12 months of follow-up by three previously calibrated dentists (Cohen’s K = 0.84). Statistical Analysis Fisher’s exact test and Pearson’s Chi-squared test were used to evaluating the homogeneity of distribution of the clinical characteristics. Friedman’s test was applied to evaluate differences among the resin composites. The results obtained for the USPHS and FDI criteria at the different observation times were compared using the Wilcoxon test. A level of significance of 0.05 was adopted for all tests. Results After 12 months (recall rate, 78.3%, n = 36 patients), the overall success rate was 99.07% for both criteria. Only one failed restoration (0.93%) was detected for each system during follow-up in the TBF group. Conclusion The bulk-fill resin composites showed satisfactory clinical performance compared with conventional resin composite after 12 months. The percentage of the acceptable scores was significantly higher for the USPHS criteria, due to discrepancies in the score description for each criterion.

Resin Composite Class I Restorations: A 54-month Randomized Clinical Trial

2014 ◽  
Vol 39 (6) ◽  
pp. 588-594 ◽  
Author(s):  
AKM de Andrade ◽  
RM Duarte ◽  
FDSC Medeiros e Silva ◽  
AUD Batista ◽  
KC Lima ◽  
...  
Keyword(s):  
Clinical Performance ◽  
Resin Composite ◽  
United States Public Health ◽  
Class I ◽  
Marginal Adaptation ◽  
Posterior Teeth ◽  
Level Of Significance ◽  
Postoperative Sensitivity

SUMMARY The objective of this longitudinal clinical randomized trial was to evaluate the clinical performance of a nanofilled and a nanohybrid resin composite in Class I occlusal restorations of posterior teeth over the course of 54 months. Forty-one adolescents participated in the study. The teeth were restored with Adper Single Bond 2 (3M ESPE) and nanofilled (Filtek Z350, 3M ESPE), nanohybrid (Esthet-X, Dentsply) and microhybrid Filtek Z250 (3M ESPE) used as a control. After 54 months, the restorations were evaluated in accordance with the modified United States Public Health Service criteria. The McNemar and Friedman tests were used for statistical analysis, at a level of significance of 5%. Five failed restorations were observed during the follow-up. A change to unacceptable restoration occurred for one Esthet-X, two Filtek Z350, and two Filtek Z250 restorations, which received the clinically unacceptable score, Charlie, for both anatomic form and marginal adaptation. Secondary caries and postoperative sensitivity occurred in one Filtek Z250 and one Filtek Z350 restoration. When the five evaluation periods (baseline and six, 12, 30, and 54 months) were compared, significant differences were found in the marginal adaptation of Filtek Z250 and Filtek Z350. Significant differences in the roughness criteria (p=0.005) were also observed when the three composites were compared after 54 months (Filtek Z350 > Filtek Z250 > Esthet-X), always within clinically acceptable limits. The materials investigated showed acceptable clinical performance for Class I restoration after 54 months. Long-term reevaluations are necessary for a more detailed analysis of these composites.

scholarly journals Clinical Evaluation of Flowable Composite Materials in Permanent Molars Small Class I Restorations: 3-Year Double Blind Clinical Study

Materials ◽  
2021 ◽  
Vol 14 (15) ◽  
pp. 4283
Author(s):  
Walter Dukić ◽  
Mia Majić ◽  
Natalija Prica ◽  
Ivan Oreški
Keyword(s):  
Clinical Study ◽  
Composite Materials ◽  
Retention Rate ◽  
Statistical Significance ◽  
United States Public Health ◽  
Class I ◽  
Marginal Adaptation ◽  
Small Class ◽  
Flowable Composite ◽  
Permanent Molars

This study evaluated the 3-year clinical performance of four different flowable composite materials used in Small Class I restorations in permanent molars. This double-blinded, clinical study analyzed 229 Small Class I restorations/103 children at baseline, 12, 24, and 36 months with modified United States Public Health Services (USPHS) criteria. The tested flowable materials were Voco Grandio Flow + Voco Solobond M, Vivadent Tetric EvoFlow + Vivadent Excite, Dentsply X-Flow + Dentsply Prime&Bond NT, and 3M ESPE Filtek Supreme XT Flow + 3M ESPE Scotchbond Universal. The retention and marginal adaptation rates were highest for Grandio Flow and X Flow materials after 36 months, resulting in the highest score of clinical acceptability at 95.3% and 97.6%, respectively. The Tetric EvoFlow and Filtek Supreme XT Flow had the same retention rate after 36 months at 88.1%. Statistical significance was found in Grandio flow material in postoperative sensitivity criteria (p = 0.021). Tetric EvoFlow showed statistical differences in retention (p = 0.01), color match (p = 0.004), and marginal adaptation (p = 0.042). Filtek Supreme showed statistical differences in retention (p = 0.01) and marginal adaptation (p < 0.001). The flowable composite materials showed excellent clinical efficacy after 36 months of their clinical usage. There was no difference among the tested flowable composite materials quality in Small Class I restorations over time.

scholarly journals Marginal Integrity of CAD/CAM Ceramic Crowns Using Two Different Finish Line Designs

2021 ◽  
Author(s):  
Jaber Hussain Akbar ◽  
Ridwaan Omar ◽  
Yacoub Al Tarakmah
Keyword(s):  
Dental Treatment ◽  
Statistical Significance ◽  
United States Public Health ◽  
Finish Line ◽  
Marginal Integrity ◽  
Computer Aided ◽  
Cad Cam ◽  
Group A ◽  
Group B ◽  
Line Design

Statement of problem- Research on evaluation of crowns made by the latest CAD/CAM systems for their marginal adaptation is scarce. Purpose- The purpose of this in vitro study was to evaluate the marginal integrity of crowns fabricated by the latest Chairside Economical Restorations of Esthetic Ceramic (CEREC) system using two different finish line preparation designs: Chamfer and Shoulder. Material and methods- Typhodont teeth were equally divided into two groups, group A and B. The teeth were prepared for full coverage crowns with a shoulder (group A) and chamfer finish line design (group B). An experienced prosthodontist prepared all crown preparations. Evaluation of six sites per sample was completed by two calibrated, experienced prosthodontists using the modified United States Public Health Services (USPHS) criteria. The descriptive statistics and Z-test were used to evaluate the results. Results- A total of 180 teeth were included in the study (90 teeth in each group). Only two crowns in group A and one crown in group B were clinically unacceptable. There was no statistical significance (p=0.282) between the two groups regarding finish-line design. Conclusions- CEREC system provides clinically acceptable crowns and can safely be utilized in dental treatment. Therefore, Contemporary Dental Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) restorations should be considered as a safe treatment modality by dental professionals.

Clinical Significance of Indeterminate Lupus Anticoagulant (LAC) Results.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3988-3988
Author(s):  
Khaldoun J. Alkayed ◽  
Kandice Kottke-Marchant
Keyword(s):  
Autoimmune Disease ◽  
Clinical Significance ◽  
Lupus Anticoagulant ◽  
Statistical Significance ◽  
The United States ◽  
Test Results ◽  
Clinical Variables ◽  
Significant Difference ◽  
Initial Cohort

Abstract 3988 Poster Board III-924 Abstract: Introduction The International Society of Thrombosis and Hemostasis (ISTH) criteria for the diagnosis of the lupus anticoagulant (LAC) include: Screening test that demonstrates the prolongation of a phospholipid-dependent (PL-D) clotting time; mixing test that confirms the presence of an inhibitor; the confirmation that the inhibitor is PL-D and exclusion of other coagulopathies. Test results that do not fulfill all the criteria are considered indeterminate. These indeterminate results are common (Kottke-Marchant et al. J Thromb Haemost. 2007; 5 Supplement 2: P-M-455), still there is no published data regarding clinical significance. Patients/methods This study investigated the prevalence of thrombotic events in an initial cohort of unselected patients (n=256) from one tertiary hospital in the United States, who were tested for LAC and other antiphospholipid (aPL) antibodies from a 2 month period in 2006. The laboratory results (PT/INR, aPTT, dilute Russell's viper venom time (DRVVT), STACLOT and platelet neutralization (PNP)) were evaluated. The profile included 3 separate PL -D assays (DRVVT confirm, STACLOT, PNP). Samples containing heparin (>0.1U/ml) were pre-treated with Hepadsorb. The LAC profile was considered indeterminate if PL test results were positive, but without a positive aPTT or DRVVT mixing study. The initial cohort included 83 patients with indeterminate results. From this group, 18 patients were excluded: Four due to incomplete data, 2 due to high heparin level (anti Xa>1.0 U/ml), 5 due to other prothrombotic etiologies and 7 with other positive aPL antibodies. For an assessment of thrombotic history, we performed retrospective chart reviews and tabulated all Sapporo clinical features, malignancy and auto-immune disorders within 5 years before and 2 years after the index laboratory testing. Events that did not fulfill diagnostic criteria for thrombosis, ischemic events or obstetrical complications were excluded. The final analysis sample included 65 patients with indeterminate LAC, 106 with negative and 27 with positive LAC. Results The final indeterminate LAC cohort included 65 patients, with mean follow-up of 18 months. Malignancy was present in 29% and autoimmune disease in 25% of patients. The most common thrombotic events were deep vein thrombosis (DVT) (28%), cerebral ischemic stroke (14%) and pulmonary embolism (14%). When compared to those with negative tests, indeterminate group patients were more likely males, relatively older, and more likely to have DVT, superficial thrombosis (ST) or myocardial infarction (MI) (P= 0.049, 0.021, 0.044, 0.005 and 0.045 respectively). Concurrent coumadin (warfarin) therapy was more prevalent in the indeterminate group, but it did not reach statistical significance (p=0.15). There was no statistical significant difference in the prevalence of cancer or autoimmune disease (P=0.19 and 0.48 respectively). In the multivariate analysis model none of the previous variables reached any statistical significance between the two groups. When compared the above clinical variables between indeterminate results and positive LAC results groups from the same cohort, we failed to show any major statistically significant differences. We noticed very poor retesting rate in the indeterminate group during the follow up period of 2 years (15% only). Conclusions Indeterminate results are common among patients referred for LAC testing. When compared to those with negative results, patients with indeterminate results are more likely to have a history of DVT, superficial thrombosis or MI, but none of the clinical variables reached statistical significance in a multivariate model. On the other hand, patients in the indeterminate group shared demographic and clinical profiles with those in the positive results group. This further highlights the need to study the clinical significance of indeterminate LAC results in a prospective study. Disclosures: No relevant conflicts of interest to declare.

A Five-Year Clinical Evaluation of Direct Nanofilled and Indirect Composite Resin Restorations in Posterior Teeth

2013 ◽  
Vol 38 (2) ◽  
pp. E31-E41 ◽  
Author(s):  
AR Cetin ◽  
N Unlu ◽  
N Cobanoglu
Keyword(s):  
Composite Resin ◽  
Clinical Performance ◽  
United States Public Health ◽  
The United States ◽  
Composite Resins ◽  
Posterior Teeth ◽  
Indirect Composite ◽  
Composite Resin Restorations ◽  
Clinical Conditions ◽  
Resin Restorations

SUMMARY Aim: To assess the clinical efficacy of posterior composite resin restorations placed directly and indirectly in posterior teeth after five years. Materials and Methods: A total of 108 cavities in 54 patients were restored with three direct composite resins (Filtek SupremeXT [FSXT], Tetric Evo Ceram [TEC], AELITE Aesthetic [AA]) and two indirect composite resins (Estenia [E] and Tescera ATL [TATL]). All restorations were evaluated by two examiners using the United States Public Health Service criteria at baseline and five years after placement. Statistical analysis was completed with Fisher exact and McNemar χ2 tests. Results: At baseline, 4% (five) of the restored teeth presented postoperative sensitivity; however, only one of them (a member of the E group) required canal treatment and replacement after two years. At the five-year evaluation, all restorations were retained, with Alpha ratings at 100%. Only one tooth (in the TEC group) required replacement after three years due to secondary caries. Color match, surface texture, and marginal integrity were predominantly scored as Alpha after five years for all groups. After that time, marginal discoloration was scored as Alpha in 64% of AE restorations, 70% of TATL restorations, 73% of E restorations, and 87% of FSXT restorations. There were no Charlie scores recorded for any of the restorative systems. Conclusions: Under controlled clinical conditions, indirect composite resin inlays and direct composite resin restorations exhibited an annual failure rate of 2.5% and 1.6%, respectively, after five years. Therefore, the investigated materials showed acceptable clinical performance, and no significant differences were found among them.

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