Complete rehabilitation of compromised full dentitions with adhesively bonded all-ceramic single-tooth restorations: long-term outcome in patients with and without amelogenesis imperfecta
Available online 21 December 2017
Abstract
Objectives
This
clinical follow-up evaluated the long-term outcome of full-mouth
rehabilitations with adhesively bonded all-ceramic restorations in
patients suffering from amelogenesis imperfecta (AI) or affected by
extensive tooth wear including a loss of the vertical dimension of
occlusion.
Materials and methods
Included
for evaluation were all patients treated with adhesively bonded
monolithic single-tooth restorations made of silicate or lithium
disilicate ceramics; allowing a maximum four missing teeth and a facial
feldspathic veneering of LDS anterior crowns. After treatment, patients
have been enrolled in a recall program for dental check-ups including
quality assessment of the restorations. Patients answered the oral
health impact profile (OHIP-14) at their last visit.
Results
Seventeen
patients (mean age = 35 ± 18 years) were observed up to 16.5 years
(mean: 6.2 ± 3.8 years). 12 out of 450 restorations failed due to core
fracture (n = 7), tooth fracture (n = 2), one secondary caries, one
chip-off grade 3, and one fixed dental prosthesis due to discomfort. The
overall mean survival rate of the single-tooth restorations was
estimated 99.4% at 5 and 91.4% at 10 years. The overall mean success
rate was estimated 92.6% at 5 and 81.4% at 10 years, mainly due to
chip-offs and crack formation (27out of 31 relative failures). The mean
annual failure rates (AFR) range between 1.5 and 2% over the years, but
non-AI patients were affected more frequently by early technical
complications in the facial veneering of anteriors, resulting in an AFR
ranging between 5.2 and 4%. Quality assessment revealed stable color,
form and marginal integrity in all patients up to ten years. The
distribution of OHIP values is comparable to the representative sample
of healthy patients.
Conclusion
Adhesively
bonded single-tooth restorations provided a high clinical quality in
the long-run. However, while the survival and success was excellent in
AI patients, restorations in non-AI patients were affected by a higher
complication rate, likely related to a higher risk profile due to a
history of bruxism and tooth wear.
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