[Restoration choices for endodontically treated posterior teeth]. / Restauratieve keuzes voor endodontisch behandelde gebits-elementen in de posterieure zone.

There aren't any generally accepted guidelines for the restoration of an endodontically treated tooth. With a questionnaire among dental general practitioners and endodontists, several restorative treatment options for endodontically treated molars and premolars were identified. The questionnaire inventoried the influence of various parameters on treatment preferences. For each case, additional questions were put about material choice, cuspal coverage and the use of root canal posts. Both groups identified the vertical root fracture as the most common reason for extraction. The dentist general practitioner waited longer than the endodontist to make a permanent restoration in the case of apical periodontitis. Treatment preferences were found to be the same for premolars and molars. In the case of premolars, a root canal post was indicated more often and the location of the wall (bearing/non-bearing) influenced the choice of cuspal coverage. Of the dentist general practitioners and endodontists, 51-53% and 75-94%, respectively, preferred a partial over a full crown preparation in the case of single-walled teeth.

Prospective Randomized Clinical Trial on the Survival of Lithium Disilicate Posterior Partial Crowns Bonded Using Immediate or Delayed Dentin Sealing: Short-term Results on Tooth Sensitivity and Patient Satisfaction.

This prospective randomized clinical trial evaluated tooth sensitivity and patient satisfaction after the provision of partial ceramic restorations bonded using immediate (IDS) or delayed dentin sealing (DDS) on vital molar teeth through a within-subject comparison study. Between December 2013 and May 2016, a total of 30 patients (13 women, 17 men; mean age, 54 years old) received two lithium disilicate ceramic (IPS-e.max press, Ivoclar Vivadent) partial restorations on vital first or second molar teeth (N=60). The two teeth randomly received either IDS (test group, n=30) or DDS (control group, n=30). Partial preparations were performed on all teeth and directly after tooth preparation. IDS was achieved using self-etch adhesive (Clearfil SE Primer and Adhesive, Kuraray) followed by the application of flowable resin (Clearfil Majesty Flow, Kuraray). Partial ceramic restorations were bonded (Variolink Ultra, Ivoclar Vivadent) two weeks after preparation. The teeth were evaluated preoperatively and at one week, three months, and 12 months postoperatively using a cold test and a questionnaire for perceived tooth sensitivity. Patient satisfaction was evaluated using a visual analog scale (VAS). Data were analyzed using McNemar, chi-squared, and Wilcoxon signed rank tests (α=0.01). There was no significant difference in patient-reported tooth sensitivity between the preoperative phase and all other time points (p>0.01). There was also no significant difference between IDS and DDS (p>0.01) for all items on the questionnaire. VAS scores did not differ significantly between the IDS and DDS groups for all items in the questionnaire at all time points (p>0.01). No tooth sensitivity change was noticed with the application of partial ceramic indirect restorations. This clinical study could not confirm that IDS is more advantageous than DDS in terms of tooth sensitivity and patient satisfaction at 1 year of clinical service of partial ceramic restorations.

Randomized clinical trial on the survival of lithium disilicate posterior partial restorations bonded using immediate or delayed dentin sealing after 3 years of function.

OBJECTIVES: The survival and success rate and the quality of survival of partial ceramic restorations bonded employing Immediate (IDS) or Delayed Dentin Sealing (DDS) in vital molar teeth were evaluated in a randomized clinical trial with within-subject comparison study. MATERIALS AND METHODS: 30 patients received two lithium disilicate ceramic (IPS-e.max press, Ivoclar Vivadent) partial restorations on vital first or second molar teeth (N = 60). The two teeth randomly received either IDS (test group, n = 30) or DDS (control group, n = 30). Partial ceramic restorations were luted (Variolink Ultra, Ivoclar Vivadent) two weeks after preparation. Evaluations were performed at 1 week, 12 months and 36 months post-operatively, using qualitative (FDI) criteria. Representative failures were evaluated microscopically (SEM) and by means of simplified qualitative fractography analysis. RESULTS: One absolute failure occurred in the DDS group due to (secondary) caries. The overall survival rate according to Kaplan-Meier after 3 years was 98.3% (FDI criteria score 1-4, n = 59) and the overall success rate was 85% (FDI criteria score 1-3, n = 51), with no significant difference between restorations in the IDS and DDS group (p = 0.32; Kaplan-Meier, Log Rank (Mantel-Cox), CI = 95%). For the quality of the survival, no statistically significant differences were found between IDS and DDS (p = 0.7; Kaplan-Meier, Log Rank (Mantel-Cox), CI = 95%) restorations on any follow-up timepoints for any of the FDI criteria (Wilcoxon, McNemar, p > 0.05). CONCLUSION: Adhesively luted partial ceramic restorations in vital molar teeth have a good prognosis, however IDS did not show any differences in success and survival rates after 3 years of function.