Clinical evaluation of fractured metal-ceramic fixed dental prostheses repaired with indirect technique.

OBJECTIVES: Metal ceramic restorations continue to be widely used in dental practice, as they combine esthetics with superior mechanical properties. However, ceramic materials have the potential to fracture due to their brittle nature. The purpose of this study was to evaluate the clinical survival of fractured metal-ceramic restorations repaired with an indirect technique which uses a new "overlay" metal-ceramic crown that is luted to the existing restoration. METHOD AND MATERIALS: The study population consisted of 92 patients. Only patients with one or more fractured retainers of multipleunit metal-ceramic fixed partial dentures were involved in this study. In all cases there were a bulk fracture of the overlaying ceramic material and exposure of the underlying metal substructure. The remaining retainers of the fixed partial dentures were intact. The total number of fractured retainers was 106. All clinical procedures of the indirect repairs were carried out by a single investigator, according the previously published technique. The patients were examined clinically at 1, 2, 4, 6, and 8 years after placement of the new restorations. The repaired restorations were examined for debonding, fracture rate, and esthetics. Patient acceptance was also recorded. RESULTS: Of the 92 patients re-examined, all were satisfied with the function and the esthetic appearance of their restorations. None of the repaired restorations fractured after 8 years of service, and there were no gingival margin problems of significance. Four restorations debonded during the evaluation period. The overall survival rate was 96.2% after 8 years. CONCLUSION: Repair methodology and materials employed in this study resulted in satisfactory longevity for metal-ceramic dental prostheses. The success rate was 96.2% after 8 years. The retention rate was very good, patient satisfaction was very encouraging, and maintenance of the esthetics was good.

Clinical evaluation of anterior all-ceramic resin-bonded fixed dental prostheses.

OBJECTIVES: All-ceramic resin-bonded fixed dental prostheses (RBFDPs) were introduced as a conservative treatment many years ago. The purpose of this study was to evaluate for 8 years the clinical survival of RBFDPs made with a conventional two-retainer design. METHOD AND MATERIALS: A total of 54 anterior RBFDPs were made from the glass-infiltrated alumina ceramic In-Ceram. The restorations were placed in 49 patients, aged 18 to 60 years, by a single operator using the same clinical procedure. The restorations were examined for debonding, fracture rate, caries, and patient acceptance. All restorations were examined clinically at 1, 2, 4, 6, and 8 years after placement. RESULTS: At 8 years, the success rate was 85.18%. Patient acceptance was very encouraging and dental caries were not detected with any abutment. Two restorations debonded during the evaluation period and fracture of porcelain occurred in six restorations (two total fractures and four partial fractures). CONCLUSION: All-ceramic RBFDPs made from high-strength oxide ceramics offer an effective conservative treatment for replacing anterior teeth.

Six-year clinical evaluation of ceramic inlays and onlays.

OBJECTIVE: The clinical performance of IPS Empress (Ivoclar Vivadent) inlays and onlays was evaluated at 6 years. METHOD AND MATERIALS: Sixty-four porcelain inlays and onlays were placed in 29 patients, aged 21 to 70 years, by a single operator using the same clinical procedure. The restorations were examined for fracture rate; esthetics; patient acceptance; and marginal integrity, including caries, marginal discoloration, and gingival tolerance. All restorations were evaluated at the time of placement and at 1, 2, 4, and 6 years after placement. RESULTS: At 6 years, 93.7% of the restorations were judged clinically acceptable. The fracture rate was very low (3.1%), patient satisfaction was encouraging, and the maintenance of esthetics was superior. However, marginal discoloration and integrity appeared to deteriorate with time, because of loss of marginal seal and dissolution of the luting agent. CONCLUSION: IPS Empress ceramic inlays and onlays are clinically acceptable. However, a disadvantage is the dissolution of the resin matrix of composite resins in oral fluids.

An indirect repair technique for fractured metal-ceramic restorations: a clinical report.

Metal-ceramic crowns and fixed partial dentures have the potential for fracture of the ceramic veneer. Fractured porcelain poses a serious cosmetic and clinical problem. It may be desirable to repair a broken retainer of a fixed prosthesis rather than to remove the prosthesis and risk the possibility of destroying the entire restoration or damaging the abutment teeth. This article presents an indirect method that may be used to repair metal-ceramic restorations that are otherwise clinically and radiographically acceptable. With this technique, a new metal-ceramic crown is fabricated and is cemented on the prepared fractured retainer of the prosthesis.