The aim of this clinical study was to compare the internal gaps between abutment teeth and posterior fixed partial dentures (FPDs) fabricated utilizing milled zirconia and cast gold-alloy frameworks. As part of an ongoing randomized controlled clinical trial, 32 three-unit FPDs (16 zirconia and 16 metal-ceramic) in 25 patients were randomly selected for adaptation measurements. During the bisque-stage ceramic try-in, an A-silicone impression material was placed between the abutment teeth and the framework. The internal gap, corresponding to the thickness of the replica, was measured under magnification at the following locations: cervical, axial, and occlusal (cusp-tips and central). The internal gaps of FPDs with zirconia frameworks were significantly larger in cervical, axial, and centro-occlusal regions (cervical: 189.6 +/- 71.8 mum vs. 118.6 +/- 31.5 mum; axial: 140.5 +/- 38.3 mum vs. 95.7 +/- 18.1 mum; and centro-occlusal: 192.0 +/- 66.5 mum vs. 153.1 +/- 69.8 mum). The cervical gaps next to the pontics were significantly larger compared with those of the outer walls in both types of FPDs (zirconia: mean difference 67.7 +/- 114.7 mum; metal-ceramic: mean difference 30.0 +/- 71.2 mum). Posterior three-unit FPDs incorporating milled zirconia frameworks exhibited larger internal gaps than those constructed using conventional metal-ceramic techniques.
The aim of the present study was to assess the clinical behaviour of cast gold restorations with respect to define a gold control against current and future ceramic and composite restorations. The study sample included 50 patients with 303 cast gold restorations. All restorations were cemented with a non-adhesive technique. A total of 303 restorations were evaluated clinically and radiographically using modified United States Public Health Service criteria. Restorations recorded as having an A- or a B-rating were defined as successful. Of the 303 restorations, 42 were judged as failures, which resulted in a failure rate of 13.8% for a mean observation time (+/- s.d.) of 18.7 ( +/- 9.5) years. The estimated Kaplan-Meier survival rates (s.e.) were 96.1% (+/- 1.1%) at 10 years, 87.0% (+/- 2.2%) at 20 years and 73.5% (+/- 5.4%) at 30 years. In total, biological reasons were counted 25 times in comparison to 17 technical reasons for those 42 failed cast gold restorations, with 17 secondary caries (40%) as the most common biological reason and with 13 retention losses (31%) as the most common technical reason. The endodontically treated tooth was exclusively identified as a risk factor. The restoration type (inlay versus onlay) did not influence the survival rate.
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