Comparison of Short-Term Restorative Effects and Periodontal Health Status of Restorations Made of Different Materials in Full-Crown Restoration of Mandibular Premolar Tooth Defects

Abstract

Purpose. To compare the short-term restorative effect and periodontal health status of restorations with different materials in full-crown restoration of mandibular premolar tooth defects. Methods. A total of 105 cases (123 affected teeth) of mandibular premolar tooth defects who visited the Department of Stomatology between January 2019 and January 2020 were selected, of which 58 cases (68 affected teeth) restored with cobalt-chromium alloy porcelain crowns were included in the metal-ceramic crown (MCC) group and 47 cases (55 affected teeth) repaired by zirconium dioxide all-ceramic crowns were assigned to the zirconia crown (ZC) group. The restorative effect, inflammatory factors (high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α)) and periodontal health indicators (human cartilage glycoprotein-39 (YKL-40), resistin, aspartate aminotransferase (AST), and alkaline phosphatase (ALP)) after treatment, and the occurrence of adverse reactions were compared between the two groups. Results. The ZC group outperformed the MCC group in terms of margin fitness, restoration fracture, gingival condition, and color matching. After restoration, hs-CRP and TNF-α were statistically decreased in both groups, while YKL-40, resistin, AST, and ALP were significantly increased; and compared with the MCC group, hs-CRP, TNF-α, YKL-40, resistin, AST, and ALP were lower in the ZC group. The ZC group also scored statistically higher in retention effect, aesthetic effect, masticatory function, voice function, and comfort. Moreover, the ZC group had a higher total effective rate and a lower incidence of adverse reactions than the MCC group, with statistical significance. Conclusions. Zirconia dioxide all-ceramic crowns contribute to a better short-term restorative effect in the full-crown restoration of mandibular premolar tooth defects, with little impact on periodontal health and high patient satisfaction, which deserves popularization and application.

Potential Impact of Prosthetic Biomaterials on the Periodontium: A Comprehensive Review

“…This type of restoration is very durable, require a minimally invasive preparation, which allows a greater preservation of the dental tissue, a high resistance to bending and fracture, as well as their translucency property to be retained; however, they are more expensive than metal-ceramic prostheses [47]. As a consequence of the use of this type of biomaterials, less biofilm formation has been found and therefore a more accentuated decrease in the levels of proinflammatory cytokines [26,28,29,31,48]. Of these prosthetic biomaterials, researchers have most frequently analyzed the use of metal-ceramic prostheses followed by zirconium prostheses with the main purpose of knowing their effects on the composition of the subgingival microbiota, the levels of various inflammatory mediators and the periodontal condition to determine which type of prosthetic biomaterial induces a lower inflammatory response and thus to have a therapeutic alternative that maintains the patient's periodontal health [4,6].…”

“…A variety of inflammatory mediators such as IL-1α, TNF-α, IL-1β, IL-6, MIP-1, IL-8, IL-1ra, CRP, PGE2 and IgG have been used to gain insight into the inflammatory response as a consequence of the use of different prosthetic restorative materials [27][28][29][30][31][32][33][34][36][37][38][39][40][41] and even some enzymes such as resistin, aspartate aminotransferase, alkaline phosphatase and matrix metalloproteases (MMPs), mainly MMP-2, MMP-8, aMMP-8 and MMP-9, which have been implicated in the destruction of periodontal tissues [26,35] (Table 1). [41] GCF: gingival crevicular fluid; Ni-Cr: nickel-chromium; Cr-Co: chromium-cobalt; Au-Pt: gold-platinum; Cr-Ni-M: chromium-nickel-molybdenum; TNF-α: tumor necrosis factor alpha; CRP: C-reactive protein; YKL-40: chitinase 3like protein 1; AST: aspartate aminotransferase; ALP: alkaline phosphatase; IL-6: interleukin 6; IL-8: interleukin 8; IL-1 α: interleukin 1 alpha; IL-1β: interleukin 1 beta; IL-1ra: interleukin 1 receptor antagonist; MIP-1α: macrophage inflammatory protein 1 alpha; MIP-1β: macrophage inflammatory protein 1 beta; PGE2: prostaglandin E2; MMP-2: matrix metalloprotease 2; MMP-8: matrix metalloprotease 8; aMMP-8: matrix metalloprotease 8 in its active form; MMP-9: matrix metalloprotease 9; TIMP-1: tissue inhibitor of metalloproteases 1; TIMP-2: tissue inhibitor of metalloproteases 2; IgG: immunoglobulin G.…”

“…Several prosthetic materials are used for the fabrication of fixed dental prostheses (as shown in Figure 1 ), including metal-ceramic and metal-free ceramics such as zirconium oxide and lithium disilicate [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], as well as polymeric materials such as polymethylmethacrylate (PMMA), with the latter mainly used for provisional purposes [ 28 , 42 ].…”

“…They are characterized because they are ideal where there is little tooth structure and are more economical compared to metal-free ceramics [ 43 ]. In relation to the use of this type of prosthesis, twenty-one different inflammatory mediators have been analyzed [ 26 , 29 , 30 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], and currently, it is very well documented that metal ceramic prostheses increase bacterial levels; therefore, there is a greater production of proinflammatory cytokines which leads to the destruction of the supporting tissues of the teeth [ 20 , 26 ]. This is partly due to the fact that the bacteria in the biofilm lower the pH by producing acidic substances that dissolve the surface oxides of the dental alloys, reducing the resistance to corrosion and, therefore, generating rough and irregular surfaces that favor a greater accumulation and retention of bacteria in the area [ 44 ].…”

“…This type of restoration is very durable, require a minimally invasive preparation, which allows a greater preservation of the dental tissue, a high resistance to bending and fracture, as well as their translucency property to be retained; however, they are more expensive than metal-ceramic prostheses [ 46 ]. As a consequence of the use of this type of biomaterials, less biofilm formation has been found and therefore a more accentuated decrease in the levels of proinflammatory cytokines [ 26 , 28 , 29 , 31 , 47 ].…”