Fixed Dental Prostheses and Single-Tooth Crowns Based on Ceria-Stabilized Tetragonal Zirconia/Alumina Nanocomposite Frameworks: Outcome After 2 Years in a Clinical Trial.

PURPOSE: This clinical trial tested bilayered restorations based on ceria-stabilized tetragonal zirconia/alumina frameworks veneered with feldspathic ceramic. MATERIALS AND METHODS: A total of 67 crowns and 40 fixed dental prostheses (FDPs) were luted in 57 patients with self-etching/self-adhesive composite resin cement. Dental status and integrity of restorations were evaluated at 2 weeks, 6 months, and then annually. RESULTS: A total of 66 crowns and 36 FDPs (88% posterior) survived for success rates of 93.4% for crowns and 89% for FDPs at 2 years. In particular, 11 cohesive ceramic chippings were observed in 5 crowns and 6 FDPs. CONCLUSION: The material allows excellent marginal adaptation. Susceptibility to veneering failures might be due to framework design and the necessities of esthetics.

First clinical experiences with CAD/CAM-fabricated PMMA-based fixed dental prostheses as long-term temporaries.

OBJECTIVE: The clinical performance of polymethylmethacrylate (PMMA)-based fixed dental prostheses (FDP) was evaluated in the indication of long-term temporaries. MATERIALS AND METHODS: In the current indication of the applied machinable PMMA-based material (Vita CAD-Temp), i.e. temporary crowns and FDPs, 27 patients with compromised dentitions (uncertain dental prognosis or postponement of a removable treatment option) were recruited and 45 FDPs (3 or 4 units, 37 terminal-retained, 8 cantilevered) were inserted. Frameworks were computer-aided design (CAD)/computer-aided manufacturing (CAM)-manufactured after conventional impression taking and labside scanning of stone master casts. A resin-modified hybrid cement material (RelyX Unicem) was used for luting in a conventional protocol. Clinical follow-up was performed biannually. RESULTS: Over an observation time from 2 to 26 months (median 13 months), 11 complications were found in 9 out of 45 PMMA restorations: 4 losses of retention, 5 complete fractures; two of these subsequent to a trepanation for endodontic treatment. Thereby, 3 out of 8 cantilevered FDPs had to be removed within 8 months. Thus, the statistical evaluation included FDPs with abutment at end, only. These standard design FDPs (n = 37) showed a 90.4 % survival rate with a complication-free rate of 88.3 % estimated for an observation time of 16 months. CONCLUSION: Cantilevered FDPs and reconstructions on abutment teeth with markedly reduced biological prognosis or endodontic intervention yielded a high-failure rate. Terminal-retained FDPs performed clinically well in cases without compromised abutment teeth. CLINICAL RELEVANCE: PMMA-based material might be used successfully for long-term temporization with 3- to 4-unit FDPs in a standard design over at least one year.