Clinical long-term evaluation and failure characteristics of 1,335 all-ceramic restorations.

PURPOSE The aim of this clinical retrospective study was to evaluate the clinical quality, estimated survival rate, and failure analysis of different all-ceramic restorations in a long-term analysis of up to 20 years. MATERIALS AND METHODS Different all-ceramic restorations (crowns [n = 470], veneers [n = 318], onlays [n = 213], and inlays ]n = 334[) were placed in 302 patients (120 men, 182 women) between 1987 and 2009 at Medical University Innsbruck, Innsbruck, Austria. Clinical examination was performed during patients' regularly scheduled maintenance appointments. Esthetic match, porcelain surface, marginal discoloration, and integrity were evaluated following modified California Dental Association/Ryge criteria. Number of restoration failures and reasons for failure were recorded. The study population included 106 (35.1%) individuals diagnosed with bruxism. The success rate was determined using Kaplan-Meier survival analysis. RESULTS The mean observation time was 102 ± 60 months. Ninety-five failures were recorded. The main reason for failure was fracture of the ceramic (33.68%). The estimated survival rate was 97.3% after 5 years, 93.5% at 10 years, and 78.5% at 20 years. Nonvital teeth showed a significantly higher risk of failure (P < .0001). There was a 2.3-times greater risk of failure associated with existing parafunction (bruxism, P = .0045). Cementation using Variolink showed significantly fewer failures than Optec Cement (P = .0217) and Dual Cement (P = .0099). No significant differences were found for type of restoration and distribution in the mouth. CONCLUSION All-ceramic restorations offer a predictable and successful restoration with an estimated survival probability of 93.5% over 10 years. Significantly increased failure rates are associated with bruxism, nonvital teeth, and specific cementation agents.

[1]  S. Zeger,et al.  Longitudinal data analysis using generalized linear models , 1986 .

[2]  J. Bulman,et al.  Statistics In Dentistry , 1997 .

[3]  W. Chee,et al.  Polyvinyl siloxane impression materials: a review of properties and techniques. , 1992, The Journal of prosthetic dentistry.

[4]  S. Hillis,et al.  Clinical assessment of high-strength all-ceramic crowns. , 2000, The Journal of prosthetic dentistry.

[5]  G. Sjögren,et al.  Clinical evaluation of all-ceramic crowns (Dicor) in general practice. , 1999, The Journal of prosthetic dentistry.

[6]  Jan W V van Dijken,et al.  A prospective 15-year evaluation of extensive dentin-enamel-bonded pressed ceramic coverages. , 2010, Dental materials : official publication of the Academy of Dental Materials.

[7]  K. Anusavice.  Degradability of Dental Ceramics , 1992, Advances in dental research.

[8]  P. Lambrechts,et al.  A prospective ten-year clinical trial of porcelain veneers. , 2004, The journal of adhesive dentistry.

[9]  G. Sjögren,et al.  Clinical examination of leucite-reinforced glass-ceramic crowns (Empress) in general practice: a retrospective study. , 1999, The International journal of prosthodontics.

[10]  H Schäffer.  [Preparation of galvanized silver models in inlay, crown and bridge technics]. , 1986, Die Quintessenz der Zahntechnik.

[11]  M. Friedman.  A 15-year review of porcelain veneer failure--a clinician's observations. , 1998, Compendium of continuing education in dentistry.

[12]  M. Fradeani,et al.  An 11-year clinical evaluation of leucite-reinforced glass-ceramic crowns: a retrospective study. , 2002, Quintessence international.

[13]  Á. Della Bona,et al.  The clinical success of all-ceramic restorations. , 2008, Journal of the American Dental Association.

[14]  A. Jokstad,et al.  Assessment of the periapical and clinical status of crowned teeth over 25 years. , 1997, Journal of dentistry.

[15]  Igor J Pesun,et al.  Current ceramic materials and systems with clinical recommendations: a systematic review. , 2007, The Journal of prosthetic dentistry.

[16]  Brodbeck Ur.  Six years of clinical experience with an all-ceramic system. , 1995 .

[17]  Herbert T.Shillingburg...,et al.  Fundamentals of fixed prosthodontics , 1979 .

[18]  H. Weber,et al.  Plaque retention on teeth restored with full-ceramic crowns: a comparative study. , 1986, The Journal of prosthetic dentistry.

[19]  S. Broderson.  Anterior guidance--the key to successful occlusal treatment. , 1978, The Journal of prosthetic dentistry.

[20]  S. Socransky,et al.  Survival of Dicor glass-ceramic dental restorations over 20 years: Part IV. The effects of combinations of variables. , 2010, The International journal of prosthodontics.

[21]  S. Socransky,et al.  Survival of glass-ceramic materials and involved clinical risk: variables affecting long-term survival. , 2003, Practical procedures & aesthetic dentistry : PPAD.

[22]  J. R. Kelly,et al.  Dental ceramics: what is this stuff anyway? , 2008, Journal of the American Dental Association.

[23]  T. Donovan.  Factors essential for successful all-ceramic restorations. , 2008, Journal of the American Dental Association.

[24]  J Robert Kelly,et al.  Dental ceramics: current thinking and trends. , 2004, Dental clinics of North America.

[25]  K A Malament,et al.  Survival of Dicor glass-ceramic dental restorations over 16 years. Part III: effect of luting agent and tooth or tooth-substitute core structure. , 2001, The Journal of prosthetic dentistry.

[26]  E. Williamson,et al.  Anterior guidance: its effect on electromyographic activity of the temporal and masseter muscles. , 1983, The Journal of prosthetic dentistry.

[27]  L. J. Wei,et al.  The Robust Inference for the Cox Proportional Hazards Model , 1989 .

[28]  R. Hickel,et al.  Buonocore Memorial Lecture. Review of the clinical survival of direct and indirect restorations in posterior teeth of the permanent dentition. , 2004, Operative dentistry.

[29]  Markus B Blatz,et al.  Long-term clinical success of all-ceramic posterior restorations. , 2002, Quintessence international.