Clinical Outcomes and Predictors of Satisfaction in Patients with Improved Lithium Disilicate All-Ceramic Crowns

Abstract

Objectives: The aim of this study was to determine the clinical outcomes and predictors of satisfaction in patients with lithium disilicate (LD) ceramic crowns. Subjects and Methods: Clinical outcomes were assessed in 47 patients with 88 LD crowns using modified United States Public Health Service (USPHS) evaluation criteria and survival rates. The questionnaire for predictors included 3 aspects: (a) sociodemographic characteristics, (b) oral health habits (tooth brushing frequency, flossing frequency, and dental visits), and (c) satisfaction of the restorations (aesthetics, function, fit, cleansability, and chewing ability of the crowns, and overall satisfaction). Frequency distributions were computed using univariate and multivariate analysis. The Student t test and analysis of variance (ANOVA) were used to compare means across variables. Correlation analysis was done to assess the association between continuous variables. Results: The age of crowns was 34.7 ± 9.7 months. The survival rate was 96.6% at 35.9 ± 9.2 months. There was a significant association between successful crown function and oral hygiene measures: tooth brushing (p˂ 0.001), dental visits (p = 0.006), and flossing (p = 0.009). A strong negative correlation was observed between aesthetic satisfaction (r = -0.717, p˂ 0.001) and chewing ability (r = -0.639, p˂ 0.001) with crown age. The linear regression model was significant for all predictors (p < 0.05) except overall satisfaction (p > 0.05). Conclusion: The LD crowns had long survival rates of 96.6% up to 35.9 ± 9.2 months and provided satisfactory clinical performance (low risk of failure). Oral hygiene habits such as brushing, flossing, and regular dental visits influenced patient satisfaction with LD crowns.

Influence of contemporary CAD-CAM milling systems on the fit and adaptation of partially stabilized Zirconia fixed partial dentures

“…A possible explanation of these findings can be derived from the fact that LAVA Zr milling undergoes post milling sintering for milling (soft machining) efficiency of Zr substructure, resulting in a linear shrinkage of nearly 20%. 22 However there are compensatory mechanisms in the software and scanning process, sintering is a possible cause for increased discrepancies in the marginal fit and internal adaptation of zirconia frameworks, as shown in the present study. A systematic review by Abduo et al, concluded that Zr framework fit discrepancies are related to soft machining, curvatures and long framework spans.…”

Technical Accuracy of Dental Laboratories in the Quality and Shade Matching of Porcelain Fused to Metal Crowns: An In Vitro Study

“…An acceptable and clinically successful restoration must display adequate fit and adaptation, shape and contours, esthetic appearance with shade matching, and suitable hygienic contacts. Poor fit and adaptation lead to micro leakage and secondary caries, however shape and contour errors cause asymmetry and plaque accumulation [ 9 , 10 , 11 ]. Fabrication of acceptable esthetic restoration requires the integration of several critical factors, including an individual’s perception of color and the environment during visual shade selection, knowledge of dental anatomy, compatibility with materials, preparation designs, and accurate impressions [ 12 , 13 ].…”

Clinical Outcomes and Predictors of Satisfaction in Patients with Improved Lithium Disilicate All-Ceramic Crowns

“…Thus, we believe that the results of the study by Samer et al [1] should be interpreted with caution.…”

“…Dear Editor, It is with great interest that we read the article by Samer et al [1] published in Medical Principles and Practice in October 2017. The authors designed and conducted a cross-sectional study to determine the predictors of satisfaction in patients with improved lithium disilicate (LD) all-ceramic crowns among a Malaysian population.…”

“…• Cross-sectional study = Prevalence survey • Case-control study = Retrospective study • Cohort study = Longitudinal study = Prospective study • Prospective cohort study = Concurrent cohort study = Concurrent prospective study • Retrospective cohort study = Historical cohort study = Nonconcurrent prospective study • Randomized trial = Experimental study Secondly, Samer et al [1] in their cross-sectional study concluded that clinical oral hygiene habits were predictors of the clinical survival of LD crowns, and that oral hygiene habits had a significant influence on patient satisfaction with LD crowns. Although cross-sectional studies can be very useful for public health planning [3], they do not show the temporal relationship between the independent and dependent variables because these studies measure the associations between variables at the same time [2].…”