Seven-year clinical performance of CEREC-2 all-ceramic CAD/CAM restorations placed within deeply destroyed teeth

Abstract

Objectives: Adhesively luted all-ceramic restorations represent a promising way to preserve and stabilize weakened tooth substance, but little information is published about the clinical performance of extensive all-ceramic restorations.

Materials and methods: A total of 78 large CEREC 2™ single-tooth all-ceramic restorations had been placed in 35 patients. After 7 years, 59 teeth in 25 patients were reevaluated according to USPHS or modified USPHS criteria regarding aesthetic properties, e.g., "anatomic form," "color match," and "marginal discoloration"; functional properties, e.g., "marginal integrity," wear expressed by the criteria "proximal contact" and "static/dynamic occlusal relationship"; and biological properties, e.g., "tooth vitality" and "secondary caries". Additionally, the "proportion of margin below/above cemento-enamel junction" was included.

Results: Two restorations had failed prior to the 7-year recall, one due to a bulk fracture of the restoration and one due to poor marginal integrity (rated "Charlie") after 4 years. Other six restorations were rated as failure at the 7-year evaluation (three restorations revealed secondary caries, one was bulk fracture of the Cerec 2 restoration, and two failures were related to endodontic problems resulting in extraction or amputation of one root, respectively), resulting in a failure rate of 13.1% after 7 years. A total of 96.4% of the restorations revealed sufficient ratings for esthetic properties "anatomic form," "color match," "marginal discoloration," and "marginal integrity".

Conclusions: The survival rate of 86.9% at the 7-year recall demonstrates that adhesively luted all-ceramic CAD/CAM-generated restorations are suitable for restoration of extended coronal defects.

Clinical relevance: CAD/CAM-generated all-ceramic restorations facilitate the reconstruction of deeply destroyed teeth irrespectively of the location of the cavity margins.