Fit of monolithic multilayer zirconia fixed partial dentures fabricated by conventional versus digital impression: a clinical and laboratory investigations

Morsy, Noha; El-Kateb, Mohamed; Azer, Amir; Fathalla, Said

doi:10.1007/s00784-021-03845-4

Cited by 9 publications

(20 citation statements)

References 37 publications

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“…However, several factors can affect the accuracy of the prostheses, such as the software version, the experience of both the clinician and the technician, and the adjustment parameters. In the study, a complete digital workflow was performed with patient satisfaction, reduction time, and clinically satisfying outcomes as previously reported [29,31,39,[52][53][54]. However, clinical evidence is scarce and further studies are necessary [31,54].…”

Section: Discussionmentioning

confidence: 93%

“…Digital workflow has shown results comparable to those obtained with conventional techniques. One of the parameters associated with the success of restorations is the marginal fit, along with resistance to fracture, and studies have shown excellent results for restorations made with a digital flow [31,41,52,53]. However, several factors can affect the accuracy of the prostheses, such as the software version, the experience of both the clinician and the technician, and the adjustment parameters.…”

Section: Discussionmentioning

confidence: 99%

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Randomized clinical trial comparing monolithic and veneered zirconia three-unit posterior fixed partial dentures in a complete digital flow: three-year follow-up

et al. 2022

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Objectives To evaluate and to compare the clinical performance and survival rate of posterior monolithic and veneered zirconia fixed partial dentures (FPDs). Material and methods Sixty 3-unit posterior FPDs were included in the study. The patients were randomly distributed into two groups (n = 30 each) to receive either a monolithic (Zenostar T, Wieland Dental) or veneered zirconia (IPS e.max ZirCAD, Ivoclar Vivadent) FPD. Each patient received only 1 FPD. Tooth preparations were scanned (Trios 3, 3Shape), designed (Dental System 2016, 3 Shape), milled (Zenotec CAM 3.2, Wieland Dental), and cemented with a resin cement. Technical and biological outcomes and periodontal parameters were assessed. Data analysis was made using the Friedman and the Wilcoxon signed-rank tests with the Bonferroni correction and the Mann-Whitney U test. ResultsThe survival rate at 3 years was 100% for veneered and 90% for monolithic zirconia restorations. Three monolithic zirconia FPDs were lost because of biologic complications. The main complication in the veneered zirconia FPDs was the fracture of the veneering ceramic in 4 of the veneered zirconia FPDs. No fracture of the frameworks was observed in any of the groups. All restorations were assessed as satisfactory after 3 years. No differences in periodontal parameters were observed between the groups. Conclusions The results of this study suggest that monolithic zirconia and complete digital flow could be a viable alternative to veneered zirconia in the posterior regions. Clinical relevance The monolithic zirconia restorations with a digital workflow can be a viable alternative in posterior fixed partial dentures, with good periodontal outcomes. Clinical trial registration number ClinicalTrials.gov (Identifier NCT 04,879,498).

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Randomized clinical trial comparing monolithic and veneered zirconia three-unit posterior fixed partial dentures in a complete digital flow: three-year follow-up

et al. 2022

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“…[6,12,29,38] In this study, the digital workflow was implemented with good clinical outcomes, consistent with the findings of previous studies that reported results comparable to those obtained using conventional techniques. [30,35,50,51] Although new advances are being introduced every day in this field, clinical evidence remains scarce. [29,35,51] Milled Co-Cr alloy was used with a good performance compared to that of zirconia groups, except for MI, which could be due to the superior fit of zirconia FPDs.…”

Section: Discussionmentioning

confidence: 99%

“…[30,35,50,51] Although new advances are being introduced every day in this field, clinical evidence remains scarce. [29,35,51] Milled Co-Cr alloy was used with a good performance compared to that of zirconia groups, except for MI, which could be due to the superior fit of zirconia FPDs. The authors are unaware of previous studies comparing these MC FPDs with ceramic restorations; therefore, comparisons were not possible.…”

Section: Discussionmentioning

confidence: 99%

Digital workflow for monolithic and veneered zirconia and metal-ceramic posterior fixed partial dentures: A five-year prospective randomized clinical trial

et al. 2024

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Ceramic materials have evolved rapidly in recent years owing to a high esthetic demand in dental treatment. However, despite the wide range of available ceramic materials, the most suitable option, there is no clear option for clinicians, especially for posterior restorations, remains unclear. [1] Zirconia has been introduced as an alternative for metal-free restorations and is the strongest material among all ceramics. [2,3] However, owing to its high opacity, the framework must be veneered with feldspathic ceramics. [2,4] The main disadvantage of veneered zirconia (VZ) is porcelain chipping, [5-10] and monolithic zirconia (MZ) has been introduced as an alternative to VZ. [1,11,12] MZ comprises second-generation zirconia with higher translucency than that of conventional zirconia, which is obtained by reducing the concentration of alumina and the porosity and grain size by increasing the sintering temperature. [2,13] Nevertheless, MZ is not without its drawbacks because the hardness and wear of the opposing tooth can be a concern. It has been reported that restoration surface treatment methods play an important role and that polished surfaces are less abrasive and more favorable considering the wear of the opposing tooth. [14-17] The enamel wear due to MZ crowns is greater than that due to natural teeth [1,17,18] but less than that caused by veneer restorations. [16,[18][19][20][21][22][23] Previous studies have also reported that polished zirconia surfaces cause less enamel wear than does glazed zirconia. This may be due to wear and loss of the glazed surface, which leads to increased surface roughness. [16,17,22] Nevertheless, it has been reported that the combination of polishing and glazing reduces wear of the restoration and its antagonist. [15] Metal-ceramic (MC) restorations have been well examined for years, with survival rates of 94.4%-100% at 5 years and 87%-97.08% at 10 years of follow-up for crowns and fixed partial dentures (FPDs). They are considered the gold standard for fixed prostheses. [6,7,9,10,24,25] Therefore, new materials must provide outcomes comparable to those of MC restorations. [6,9,26,27] Clinical trials have suggested that zirconia can replace MC restorations in the near future. [8,9,10,27,28] However, owing to the recent introduction of MZ, limited evidence is available to support its recommendation for routine use. [29]

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“…Four studies analyzed LD-based SFCs, differentiating their laboratory manufacturing processes (CAD/CAM and conventional) [17,[34][35][36]. Only two studies evaluated ZC-based SFCs and FPDs, differentiating their laboratory manufacturing processes (CAD/CAM and conventional) [2,37]. Overall, ZC was used in nine articles, and LD was used in four articles for meta-analysis.…”

Section: Identification Of Studies and Descriptionsmentioning

confidence: 99%

Clinical Outcomes of CAD/CAM (Lithium disilicate and Zirconia) Based and Conventional Full Crowns and Fixed Partial Dentures: A Systematic Review and Meta-Analysis

Aswal¹,

Rawat²,

Dwivedi³

et al. 2023

Cureus

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Although CAD/CAM (computer-aided design/computer-aided manufacturing) restorations act as a favorable alternative to conventional metal-ceramic restorations for fixed dental prostheses, little is known about their intermediate and persistent clinical performance. This systematic review and meta-analysis aimed to assess the clinical performance in terms of biological, technical, and esthetic aspects and the survival and success ratios for single full crowns (SFCs) and fixed partial dentures (FPDs) fabricated by CAD/CAM and conventional techniques and according to the materials used (zirconia {ZC} and lithium disilicate {LD}). The population, intervention, control, outcome, and study design (PICOS) strategy was used to electronically search key terms in the PubMed, Cochrane Library, Embase, and Wiley Online databases for randomized control trials (RCTs) and cohort studies. The bias risks for RCTs and cohort studies were assessed using the Cochrane collaboration tool and the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using Rev5 from Cochrane. A total of 13 studies reporting on 1598 restorations in 1161 patients with a mean observation period of 3.6 years (minimum-maximum: 1-9.3 years) met the inclusion criteria. Meta-analysis of the included studies indicated that CAD/CAM manufacturing resulted in 1.17, 1.14, and 16.88 (95% CI: 0.64-2.17, 0.86-1.52, 7.59-37.56) higher biological, technical, and esthetic complications than conventional manufacturing of restorations. However, the difference was significant for esthetic complications only (p<0.00001). A significant difference was observed for all biological, technical, and aesthetic aspects between SFCs and FPDs (odds ratio {OR} = 2.61 vs. 1.78, 95% CI: 1.92-3.56 vs. 1.33-2.38; p<0.00001). The survival ratio of SFCs was 2.69 (95% CI: 1.98-3.65), significantly higher compared to the 1.76 (95% CI: 1.31-2.36) of FPDs (p<0.00001). The success ratio of FPDs at 1.18 (95% CI: 0.83-1.69) was significantly lower compared to SFCs at 2.36 (95% CI: 1.68-3.33). The clinical performance of LD with 2.42 (CI: 1.16-5.03) was significantly higher compared to ZC with 2.22 (CI: 1.78-2.77) (p<0.00001). The biological, technical, and aesthetic behaviors showed similar clinical outcomes between the CAD/CAM and conventional groups. LD could be a good alternative to zirconia, but its intermediate or persistent clinical performance needs to be evaluated. Overall, zirconia and CAD/CAM techniques must evolve further to outclass the conventional techniques used in the fabrication of SFCs and FPDs.

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Fit of monolithic multilayer zirconia fixed partial dentures fabricated by conventional versus digital impression: a clinical and laboratory investigations

Cited by 9 publications

References 37 publications

Randomized clinical trial comparing monolithic and veneered zirconia three-unit posterior fixed partial dentures in a complete digital flow: three-year follow-up

Randomized clinical trial comparing monolithic and veneered zirconia three-unit posterior fixed partial dentures in a complete digital flow: three-year follow-up

Digital workflow for monolithic and veneered zirconia and metal-ceramic posterior fixed partial dentures: A five-year prospective randomized clinical trial

Clinical Outcomes of CAD/CAM (Lithium disilicate and Zirconia) Based and Conventional Full Crowns and Fixed Partial Dentures: A Systematic Review and Meta-Analysis

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