Abstract
Background
All-ceramic
bilayer systems suffer from technique-sensitivity, resulting in
increased technical complication rates. This might be overcome by
monolithic reconstructions, facilitating digital workflows.
Purpose
To
evaluate the clinical and patient-reported outcome of
CAD/CAM-fabricated implant-supported single crowns (ISCs) made of
lithium disilicate (LS2) cemented on ceramic implants 5 years after implant installation.
Materials and methods
Twenty-four
patients were included in the study. All participants received a
one-piece ceramic implant in anterior (4 incisors) and posterior regions
(10 premolars, 10 molars). LS2 crowns were computer-aided
designed (CAD), manufactured (CAM) and adhesively luted onto the
implants. Follow-ups were performed yearly up to 60 months after implant
installation. The survival/success rates of the restorations were
calculated according to modified US Public Health Service criteria as
follows: Clinically relevant defects that could be repaired intraorally
were accepted for survival, whereas small-area chippings, roughness
(ø < 2 mm), slightly soundable marginal gaps, minimal
undercontours/overcontours, and tolerable color deviations were accepted
for success. Kaplan-Meier plots were used for the success/survival
analyses. Furthermore, patient-reported outcome measures (PROMs) were
assessed by applying visual analog scales (VAS). Linear (PROMs) and
logistic (USPHS criteria) mixed models were fitted to evaluate time
effects on response variables.
Results
Twenty-two
ISCs could be evaluated 55.2 ± 4.2 months after prosthetic delivery.
Two patients were reported as drop-outs (1 died, 1 moved abroad). No
failures were observed, resulting in 100% survival. At two ISCs, a
major-roughness had to be treated. This resulted in a Kaplan-Meier
success estimate of 91.7% (95%CI: 70.6%-97.9%). Compared with
pretreatment, all surveys at prosthetic delivery except for self-esteem (P = .375)
showed significantly improved VAS scores. No decrease in satisfaction
could be observed over time until the end of follow-up (P ≥ .056).
Conclusion
Concerning
survival/success rates and PROMs, the evaluated crown-implant system
showed favorable mid-term results. To date, there are no comparable data
available for implant-supported ISCs made of LS2.
Comments