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Helene Fron Chabouis - One of the best experts on this subject based on the ideXlab platform.
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clinical efficacy of composite versus ceramic Inlays and Onlays a systematic review
Dental Materials, 2013Co-Authors: Helene Fron Chabouis, Violaine Smail Faugeron, Jeanpierre AttalAbstract:Abstract Objectives Large tooth substance losses are frequent in posterior teeth because of primary caries or aging restorations. Inlays and Onlays are often the minimal invasive solution in such cases, but the efficacy of the composite and ceramic materials used is unknown. We performed a systematic review of randomized controlled trials comparing the efficacy of composite and ceramic Inlays or Onlays. Data sources MEDLINE, Embase and the Cochrane Central Register of Controlled Trials were searched without any restriction on date or language, as were references of eligible studies and ClinicalTrials.gov. Study selection Eligible studies were randomized trials comparing the clinical efficacy of composite to ceramic Inlays or Onlays in adults with any clinical outcome for at least 6 months. From 172 records identified, we examined reports of 2 randomized controlled trials involving 138 Inlays (no Onlays evaluated) in 80 patients and exhibiting a high-risk of bias. Outcomes were clinical scores and major failures. The 3-year overall failure risk ratio was 2 [0.38–10.55] in favor of ceramic Inlays although not statistically significant. The reported clinical scores (United States Public Health Services and Californian Dental Association) showed considerable heterogeneity between trials and could not be combined. Conclusions We have very limited evidence that ceramics perform better than composite material for Inlays in the short term. However, this result may not be valid in the long term, and other trials are needed. Trials should follow Federation dentaire internationale recommendations and enhance their methodology. Trials comparing composite and ceramic Onlays are needed.
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efficacy of composite versus ceramic Inlays and Onlays study protocol for the cecoia randomized controlled trial
Trials, 2013Co-Authors: Helene Fron Chabouis, Caroline Prot, Cyrille Fonteneau, Karim Nasr, Olivier Chabreron, Stephane Cazier, Christian Moussally, Alexandre Gaucher, Ines Khabthani Ben JaballahAbstract:Background: Dental caries is a common disease and affects many adults worldwide. Inlay or onlay restoration is widely used to treat the resulting tooth substance loss. Two esthetic materials can be used to manufacture an inlay/onlay restoration of the tooth: ceramic or composite. Here, we present the protocol of a multicenter randomized controlled trial (RCT) comparing the clinical efficacy of both materials for tooth restoration. Other objectives are analysis of overall quality, wear, restoration survival and prognosis. Methods: The CEramic and COmposite Inlays Assessment (CECOIA) trial is an open-label, parallel-group, multicenter RCT involving two hospitals and five private practices. In all, 400 patients will be included. Inclusion criteria are adults who need an inlay/onlay restoration for one tooth (that can be isolated with use of a dental dam and has at least one intact cusp), can tolerate restorative procedures and do not have severe bruxism, periodontal or carious disease or poor oral hygiene. The decayed tissue will be evicted, the cavity will be prepared for receiving an inlay/onlay and the patient will be randomized by use of a centralized web-based interface to receive: 1) a ceramic or 2) composite inlay or onlay. Treatment allocation will be balanced (1:1). The inlay/onlay will be adhesively luted. Follow-up will be for 2 years and may be extended; two independent examiners will perform the evaluations. The primary outcome measure will be the score obtained with use of the consensus instrument of the Federation Dentaire Internationale (FDI) World Dental Federation. Secondary outcomes include this instrument’s items, inlay/onlay wear, overall quality and survival of the inlay/onlay. Data will be analyzed by a statistician blinded to treatments and an adjusted ordinal logistic regression model will be used to compare the efficacy of both materials. Discussion: For clinicians, the CECOIA trial results may help with evidence-based recommendations concerning the choice of materials for inlay/onlay restoration. For patients, the results may lead to improvement in long-term restoration. For researchers, the results may provide ideas for further research concerning inlay/onlay materials and prognosis. This trial is funded by a grant from the French Ministry of Health.
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Efficacy of composite versus ceramic Inlays and Onlays: study protocol for the CECOIA randomized controlled trial
Trials, 2013Co-Authors: Helene Fron Chabouis, Caroline Prot, Cyrille Fonteneau, Karim Nasr, Olivier Chabreron, Stephane Cazier, Christian Moussally, Alexandre Gaucher, Ines Khabthani Ben Jaballah, Renaud BoyerAbstract:Background Dental caries is a common disease and affects many adults worldwide. Inlay or onlay restoration is widely used to treat the resulting tooth substance loss. Two esthetic materials can be used to manufacture an inlay/onlay restoration of the tooth: ceramic or composite. Here, we present the protocol of a multicenter randomized controlled trial (RCT) comparing the clinical efficacy of both materials for tooth restoration. Other objectives are analysis of overall quality, wear, restoration survival and prognosis.
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machinable materials for Inlays and Onlays composite versus ceramics systematic review randomized controlled trial and in vitro evaluation
2013Co-Authors: Helene Fron ChabouisAbstract:Les Inlays-Onlays sont des restaurations qui permettent de restaurer des pertes de substances dentaires moyennes a importantes en preservant les tissus restants ; ils peuvent etre realises esthetiquement en composite ou en ceramique. Les objectifs de ce travail ont ete les suivants : - faire une synthese des materiaux composites et ceramiques qui peuvent etre utilises pour produire des Inlays et Onlays et comprendre les specificites des materiaux usinables, - examiner les donnees et les preuves obtenues a partir des etudes cliniques anterieures comparant Inlays et Onlays en ceramique et en composite, - developper les outils methodologiques necessaires pour les essais cliniques comparant les Inlays-Onlays en composite et en ceramique ; concevoir et mener un tel essai, - comparer les proprietes adhesives des composites et des ceramiques usinables utilises pour produire des Inlays-Onlays. Par consequent, ce travail a compris une revue systematique, un essai clinique et une etude in vitro comparant les composites et les ceramiques utilises pour fabriquer des Inlays-Onlays. Le chapitre 1 definit la Conception et fabrication assistee par ordinateur (CFAO) ainsi que le cahier des charges d’un materiau utilise pour produire des Inlays-Onlays, puis decrit les differents composites et ceramiques accessibles. L’influence du procede de fabrication – traditionnel ou par CFAO – est discutee en termes des proprietes des composites et ceramiques resultants. Enfin nous observons qu’aucun materiau ne permet actuellement de repondre entierement au cahier des charges enonce. Un compromis est donc necessaire. Le deuxieme chapitre decrit une revue systematique des essais cliniques randomises ayant compare le composite et la ceramique pour la realisation d’Inlays-Onlays ; deux essais publies (evaluant 138 Inlays) montrent que les Inlays en ceramique pourraient entrainer moins d’echecs a court terme (rapport de risque d’echec a 3 ans : 2 [0,38-10,55] en faveur de la ceramique) mais ce resultat pourrait ne pas etre valable a long terme ; aucun essai randomise n’a compare des Onlays en composite et en ceramique ou n’a compare ces deux materiaux pour des dents depulpees. Le troisieme chapitre decrit ainsi un essai clinique randomise comparant des Inlays et Onlays en composite ou en ceramique realises par CFAO sur dents pulpees ou depulpees ; la premiere partie decrit les etapes de conception de l’essai et aborde des aspects methodologiques, dont la creation d’un logiciel (Hermes) pour choisir la methode de randomisation la plus adaptee en fonction des caracteristiques de l’essai envisage ; la deuxieme partie decrit les etapes de mise en œuvre et le protocole de l’essai : 400 patients doivent etre inclus dans 7 centres hospitaliers et prives et suivis pendant au moins deux ans, le critere de jugement principal est le score propose par la Federation dentaire internationale. Le quatrieme chapitre compare les proprietes adhesives des materiaux usinables pour Inlays-Onlays in vitro : l’adherence en cisaillement est evaluee sur 900 echantillons apres 24h de stockage dans l’eau en fonction du materiau, du traitement de surface et de la colle ; l’influence du traitement de surface semble preponderante. Les perspectives de recherche comprennent l’etude de l’usinabilite, du vieillissement et de la biocompatibilite des materiaux.
Gordon J Christensen - One of the best experts on this subject based on the ideXlab platform.
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THE STATE OF THE ART IN ESTHETIC RESTORATIVE DENTISTRY
Journal of the American Dental Association, 1997Co-Authors: Gordon J ChristensenAbstract:ABSTRACT Esthetic restorative procedures are routine in most dental practices. The procedures considered to be standard and acceptable by practitioners are bleaching teeth outside the dental office; bonding; intracoronal direct resin restorations; tooth-colored Inlays and Onlays; porcelain veneers; all-ceramic crowns; and PFM crowns. Unfortunately, some third-party payment organizations do not pay adequately for numerous esthetic restorative procedures, and continued education of these groups about the reliability of esthetic restorative procedures is necessary.
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THE COMING DEMISE OF THE CAST GOLD RESTORATION
Journal of the American Dental Association, 1996Co-Authors: Gordon J ChristensenAbstract:: Cast gold restorations have overall characteristics unavailable in any other restorative procedure for Inlays and Onlays, including low restoration wear; low wear of opposing teeth; lack of breakage; burnishability-malleability; and proven long-term service. Bonding cast gold restorations with resin cement improves their characteristics even more. However, they are not tooth-colored, which eliminates them from consideration for many patients. Although tooth-colored Inlays and Onlays, both ceramic and filled polymer, are increasing in use, and their serviceability is acceptable at a moderate level, cast gold restorations remain the standard of care for long-term indirect restorative service.
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Conservative Posterior Tooth Restorations
Journal of Esthetic and Restorative Dentistry, 1993Co-Authors: Gordon J ChristensenAbstract:Conservative restorations for posterior teeth (noncrowns) are in a significant evolution, as tooth-colored restorations are showing strong competition for traditional silver amalgam and gold alloy restorations. Resin restorations (direct and indirect Inlays and Onlays, and directly placed) are major preferences, but porcelain Inlays and Onlays are favored also. Dentists are advised to inform their patients about the availability of the various types of restorations discussed in this paper. This education will stimulate discussion about their choices and will provide optimum patient satisfaction with the result.
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a look at state of the art tooth colored Inlays and Onlays
Journal of the American Dental Association, 1992Co-Authors: Gordon J ChristensenAbstract:Dr. Gordon J. Christensen gives tips on using tooth-colored Inlays and Onlays in “A Look at State-of-the-Art Tooth-Colored Inlays and Onlays.”
Tobias Otto - One of the best experts on this subject based on the ideXlab platform.
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Long-term clinical results of chairside Cerec CAD/CAM Inlays and Onlays: a case series.
International Journal of Prosthodontics, 2020Co-Authors: Tobias Otto, David SchneiderAbstract:PURPOSE: The objective of this follow-up study was to examine the performance of Cerec Inlays and Onlays, all of which were placed by the same clinician, in terms of clinical quality over a functional period of 15 years. MATERIALS and METHODS: Of 200 Cerec Inlays and Onlays placed consecutively in a private practice by one of the authors (TO) between 1989 and early 1991, 187 were closely monitored over a period of 15 years. All ceramic Inlays and Onlays had been placed chairside using the Cerec 1 method and had been luted with a bonding composite. Up to 17 years after their placement, a follow-up assessment was conducted, and the restorations were classified using modified United States Public Health Service criteria. RESULTS: According to Kaplan-Meier analysis, the success rate of Cerec Inlays and Onlays was 88.7% after 17 years. A total of 21 failures (11%) were found in 17 patients. Of these failures, 76% were attributed to ceramic fractures (62%) or tooth fractures (14%). The reasons for the remaining failures were caries (19%) and endodontic problems (5%). Restorations of premolars presented a lower failure risk than those of molars. CONCLUSION: The survival rate probability of 88.7% after up to 17 years of clinical service for Cerec computer-aided design/computer-assisted machining restorations made of Vita Mk I feldspathic ceramic is regarded as a very respectable clinical outcome.
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Up to 27-years clinical long-term results of chairside Cerec 1 CAD/CAM Inlays and Onlays.
International journal of computerized dentistry, 2020Co-Authors: Tobias OttoAbstract:: The objective of this follow-up study was to examine the performance of Cerec 1 Inlays and Onlays in terms of clinical quality over a mean functional period of 25 years. Out of 200 Cerec 1 Inlays and Onlays placed consecutively in 108 patients in a private practice between 1989 and early 1991, 141 restorations could be reevaluated in 65 patients after up to 26 years and 10 months. All ceramic Inlays and Onlays had been generated chairside using the Cerec 1 method, and had been seated adhesively using bonding composite. At follow-up examinations, the restorations were classified based on modified United States Public Health Service (USPHS) criteria. According to the Kaplan-Meier analysis, the success rate of Cerec 1 Inlays and Onlays dropped to 87.5% after up to 27 years. In 19 patients, a total of 23 failures were found. Of these failures, 78% were caused by either ceramic fractures (65%) or tooth fractures (13%). The reasons for the remaining failures were caries (18%), and endodontic problems (4%). Three-surface restorations had a significantly higher failure risk (P < 0.05) than one-, two-, and four-surface restorations, and restorations in premolars presented a lower failure risk than those in molars. The survival probability of 87.5% after up to 27 years of clinical service of Cerec 1 computer-assisted design/computer-assisted manufacturing (CAD/CAM) restorations made of Vita Mark I feldspathic ceramic proved to be highly acceptable in private practice.
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up to 27 years clinical long term results of chairside cerec 1 cad cam Inlays and Onlays
International journal of computerized dentistry, 2017Co-Authors: Tobias OttoAbstract:: The objective of this follow-up study was to examine the performance of Cerec 1 Inlays and Onlays in terms of clinical quality over a mean functional period of 25 years. Out of 200 Cerec 1 Inlays and Onlays placed consecutively in 108 patients in a private practice between 1989 and early 1991, 141 restorations could be reevaluated in 65 patients after up to 26 years and 10 months. All ceramic Inlays and Onlays had been generated chairside using the Cerec 1 method, and had been seated adhesively using bonding composite. At follow-up examinations, the restorations were classified based on modified United States Public Health Service (USPHS) criteria. According to the Kaplan-Meier analysis, the success rate of Cerec 1 Inlays and Onlays dropped to 87.5% after up to 27 years. In 19 patients, a total of 23 failures were found. Of these failures, 78% were caused by either ceramic fractures (65%) or tooth fractures (13%). The reasons for the remaining failures were caries (18%), and endodontic problems (4%). Three-surface restorations had a significantly higher failure risk (P < 0.05) than one-, two-, and four-surface restorations, and restorations in premolars presented a lower failure risk than those in molars. The survival probability of 87.5% after up to 27 years of clinical service of Cerec 1 computer-assisted design/computer-assisted manufacturing (CAD/CAM) restorations made of Vita Mark I feldspathic ceramic proved to be highly acceptable in private practice.
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long term clinical results of chairside cerec cad cam Inlays and Onlays a case series
International Journal of Prosthodontics, 2008Co-Authors: Tobias Otto, David SchneiderAbstract:PURPOSE: The objective of this follow-up study was to examine the performance of Cerec Inlays and Onlays, all of which were placed by the same clinician, in terms of clinical quality over a functional period of 15 years. MATERIALS and METHODS: Of 200 Cerec Inlays and Onlays placed consecutively in a private practice by one of the authors (TO) between 1989 and early 1991, 187 were closely monitored over a period of 15 years. All ceramic Inlays and Onlays had been placed chairside using the Cerec 1 method and had been luted with a bonding composite. Up to 17 years after their placement, a follow-up assessment was conducted, and the restorations were classified using modified United States Public Health Service criteria. RESULTS: According to Kaplan-Meier analysis, the success rate of Cerec Inlays and Onlays was 88.7% after 17 years. A total of 21 failures (11%) were found in 17 patients. Of these failures, 76% were attributed to ceramic fractures (62%) or tooth fractures (14%). The reasons for the remaining failures were caries (19%) and endodontic problems (5%). Restorations of premolars presented a lower failure risk than those of molars. CONCLUSION: The survival rate probability of 88.7% after up to 17 years of clinical service for Cerec computer-aided design/computer-assisted machining restorations made of Vita Mk I feldspathic ceramic is regarded as a very respectable clinical outcome.
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computer aided direct ceramic restorations a 10 year prospective clinical study of cerec cad cam Inlays and Onlays
International Journal of Prosthodontics, 2002Co-Authors: Tobias Otto, De Nisco SAbstract:Purpose The objective of this follow-up study was to examine the performance of Cerec Inlays and Onlays in terms of clinical quality over a functional period of 10 years. Materials and methods Of 200 Cerec Inlays and Onlays placed in a private practice between 1989 and early 1991, 187 restorations were observed over a period of 10 years. The restorations were fabricated chairside using the Cerec-1 computer-aided design/manufacturing (CAD/CAM) method and Vita MK I feldspathic ceramic. An adhesive technique and luting composite resin were used for seating the restorations. After 10 years, the clinical performance of the restorations was evaluated using modified USPHS criteria. The results were used to classify success and failure. Results According to Kaplan-Meier analysis, the success rate of Cerec Inlays and Onlays dropped to 90.4% after 10 years. A total of 15 (8%) failures were found in 11 patients. Of these failures, 73% were caused by either ceramic fractures (53%) or tooth fractures (20%). The reasons for the remaining failures were caries (20%) and endodontic problems (7%). The three-surface Cerec reconstructions were found to have the most failures. Conclusion The failure rate of 8% and the drop of the survival probability rate to 90.4% after 10 years of clinical service of Cerec-1 CAD/CAM restorations made of Vita MK I feldspathic ceramic appear to be acceptable in private practice. This is particularly true in light of the very high patient satisfaction.
Jeanpierre Attal - One of the best experts on this subject based on the ideXlab platform.
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clinical efficacy of composite versus ceramic Inlays and Onlays a systematic review
Dental Materials, 2013Co-Authors: Helene Fron Chabouis, Violaine Smail Faugeron, Jeanpierre AttalAbstract:Abstract Objectives Large tooth substance losses are frequent in posterior teeth because of primary caries or aging restorations. Inlays and Onlays are often the minimal invasive solution in such cases, but the efficacy of the composite and ceramic materials used is unknown. We performed a systematic review of randomized controlled trials comparing the efficacy of composite and ceramic Inlays or Onlays. Data sources MEDLINE, Embase and the Cochrane Central Register of Controlled Trials were searched without any restriction on date or language, as were references of eligible studies and ClinicalTrials.gov. Study selection Eligible studies were randomized trials comparing the clinical efficacy of composite to ceramic Inlays or Onlays in adults with any clinical outcome for at least 6 months. From 172 records identified, we examined reports of 2 randomized controlled trials involving 138 Inlays (no Onlays evaluated) in 80 patients and exhibiting a high-risk of bias. Outcomes were clinical scores and major failures. The 3-year overall failure risk ratio was 2 [0.38–10.55] in favor of ceramic Inlays although not statistically significant. The reported clinical scores (United States Public Health Services and Californian Dental Association) showed considerable heterogeneity between trials and could not be combined. Conclusions We have very limited evidence that ceramics perform better than composite material for Inlays in the short term. However, this result may not be valid in the long term, and other trials are needed. Trials should follow Federation dentaire internationale recommendations and enhance their methodology. Trials comparing composite and ceramic Onlays are needed.
Roland Frankenberger - One of the best experts on this subject based on the ideXlab platform.
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leucite reinforced glass ceramic Inlays and Onlays after 12 years
Journal of Adhesive Dentistry, 2008Co-Authors: Roland Frankenberger, Michael Taschner, Franklin Garciagodoy, Anselm Petschelt, Norbert KramerAbstract:PURPOSE: This controlled clinical trial aimed to evaluate IPS Empress Inlays and Onlays over 12 years. The null hypothesis was that different luting resins would have no influence on clinical outcome. MATERIALS and METHODS: In the course of a prospective clinical long-term trial, 96 ceramic Inlays and Onlays were placed in 34 patients using one adhesive (Syntac) and four different luting composites (Tetric, Variolink Low, Variolink Ultra, Dual Cement). Recalls were carried out by two calibrated investigators using modified USPHS codes and criteria at baseline, 1, 2, 4, 6, 8, and 12 years. RESULTS: Fifteen of the 96 restorations had to be replaced (failure rate 16%; Kaplan-Meier); 12 of them suffered bulk fractures. After twelve years of clinical service, significantly more bulk fractures were found when light-curing composite was used for luting (p < 0.05). Fractures were noticed between 3 and 4 years of clinical service and later after 11 to 12 years; aside from those times, no single fracture occurred. Secondary caries was not observed. CONCLUSION: IPS Empress Inlays and Onlays exhibited satisfactory clinical outcomes over a 12-year clinical period. Restorations luted with dual-cured resin composites revealed significantly fewer bulk fractures.
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totally bonded ceramic Inlays and Onlays after eight years
Journal of Adhesive Dentistry, 2008Co-Authors: Norbert Kramer, Anselm Petschelt, Michael Taschner, Ulrich Lohbauer, Roland FrankenbergerAbstract:PURPOSE: The aim of the present study was to clinically evaluate the effect of two different adhesive/resin composite combinations for luting IPS Empress Inlays with a special focus on luting gap wear and marginal adaptation. MATERIALS and METHODS: In the course of a controlled prospective clinical split-mouth study, 94 IPS Empress restorations were placed in 31 patients. The Inlays were luted with EBS Multi + Compolute (EC; 3M ESPE) or with Syntac + Variolink II low (SV; Ivoclar Vivadent). At baseline and after 0.5, 1, 2, 4, and 8 years, the ceramic restorations were examined according to modified USPHS codes and criteria. Thirty-five selected samples were investigated under an SEM regarding morphological changes; marginal quality analysis was carried out using a stereo light microscope, and luting composite wear was scanned with a profilometer. RESULTS: Eight patients (including 25 restorations) missed the recalls; the recall rate at the last investigation was 72%. After 96 months of clinical service, seven restorations in five patients (six EC, one SV) had to be replaced due to hypersensitivities (n = 5) or inlay fractures (n = 2) resulting in a survival rate of 90%. Over the 8-year period, the restorations revealed no statistically significant differences in terms of surface roughness, color matching, proximal contact, sensitivity, or complaints (p > 0.05, Friedman test). Significant deteriorations were found for marginal integrity (p 0.05; Mann-Whitney U-test), however, the scans of the luting gap showed that Compolute was more prone to wear (p < 0.05). CONCLUSION: For luting of ceramic Inlays, no difference between the two luting systems was detectable. The overall failure rate after 8 years was 10%.
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clinical performance of bonded leucite reinforced glass ceramic Inlays and Onlays after eight years
Dental Materials, 2005Co-Authors: Norbert Kramer, Roland FrankenbergerAbstract:Summary Objective: Ceramic Inlays and Onlays are a tooth colored alternative to metallic restorations. Clinical long-term data are scarce though, especially about Inlays and Onlays having proximal margins in dentin. The present prospective controlled clinical study evaluated the clinical performance of IPS Empress Inlays and Onlays with cuspal replacements and proximal margins below the cementoenamel junction over eight years. Methods: Ninety six ceramic restorations were placed in 34 patients by six dentists. The restorations were bonded with an enamel/dentin bonding system (Syntac Classic) and four different resin composite systems. The restorations were assessed after placement by two calibrated investigators using modified USPHS codes and criteria at the following time periods: baseline, 1,2,4,6 and 8 years. Results: Eight of the 96 restorations investigated had to be replaced (failure rate 8%; Kaplan‐Meier): Six Inlays suffered cohesive bulk fractures, two teeth required endodontic treatment. After eight years of clinical service, significant deterioration (Friedman 2-way ANOVA; P , 0:05) was found for marginal adaptation of the remaining restorations. 98% of the surviving restorations exhibited marginal deficiencies, independent of the luting composite. Conclusions: IPS Empress Inlays and Onlays demonstrated to be successful even in large defects. Neither the absence of enamel margins, nor cuspal replacement significantly affected the quality of the restorations.
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leucite reinforced glass ceramic Inlays and Onlays after six years clinical behavior
Operative Dentistry, 2000Co-Authors: Roland Frankenberger, Anselm Petschelt, Norbert KramerAbstract:: Ceramic Inlays are an esthetic substitute for large amalgam and other metallic restorations. This controlled clinical study evaluated the performance of IPS Empress Inlays and Onlays with cuspal replacements and proximal margins below the cementoenamel junction over six years of clinical service. Six dentists placed 96 ceramic restorations in 34 patients. Luting was accomplished using the enamel-etch-technique, a dentin bonding system (Syntac Classic) and four different composite systems. The restorations were assessed by two calibrated investigators using modified USPHS criteria at baseline (96 restorations), one (96), two (95), four (89) and six years (67). Seven of the 96 restorations investigated had to be replaced (failure rate 7%; Kaplan-Meier): Five Inlays suffered cohesive bulk fractures and two teeth required endodontic treatment. After six years of clinical service, significant deterioration (Friedman 2-way ANOVA; p < 0.05) was found for marginal adaptation of the remaining restorations. Ninety-four percent of the surviving restorations exhibited marginal deficiencies, independent of the luting composite. Neither the absence of enamel margins, nor cuspal replacement significantly affected the quality of the restorations.
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ips empress Inlays and Onlays after four years a clinical study
Journal of Dentistry, 1999Co-Authors: Norbert Kramer, Roland Frankenberger, Matthias Pelka, Anselm PetscheltAbstract:Objective: Ceramic Inlays are used as esthetic alternatives to amalgam and other metallic materials for the restoration of badly damaged teeth. However, only limited clinical data are available regarding adhesive Inlays and Onlays with proximal margins located in dentine. In a prospective, controlled clinical study, the performance of IPS Empress Inlays and Onlays with cuspal replacements and margins below the amelocemental junction was examined. Materials and methods: Ninety-six IPS Empress fillings were placed in 34 patients by six clinicians. The restorations were luted with four different composite systems. The dentin bonding system Syntac Classic was used in addition to the acid-etch-technique. At baseline and after 6 months, one, two and four years after placement the restorations were assessed by two calibrated investigators using modified USPHS codes and criteria. A representative sample of the restorations was investigated by scanning electron microscopy to evaluate wear. Results: Seven of the 96 restorations investigated had to be replaced (failure rate 7%; Kaplan-Meier). Four Inlays had suffered cohesive bulk fractures and three teeth required endodontic treatment. After four years in clinical service, significant deterioration (Friedman 2-way Anova; p<0.05) was found to have occurred in the marginal adaptation of the remaining restorations. Seventy-nine percent of the surviving restorations exhibited marginal deficiencies, independent of the luting composite. Neither the absence of enamel margins, nor cuspal replacement significantly affected the adhesion or marginal quality of the restorations. Conclusion: After four years, extensive IPS Empress Inlays and Onlays bonded with the dentin bonding system Syntac Classic were found to have a 7% failure rate with 79% of the remaining restorations having marginal deficiencies.