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Clinical evaluation of chairside Computer Assisted Design/Computer Assisted Machining nano-ceramic restorations:
Dennis J Fasbinder1, Gisele F Neiva1, Donald Heys1
1Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan.
Summary
Nano-ceramic onlays demonstrate comparable 5-year clinical performance to leucite-reinforced ceramic onlays, with a lower fracture rate. This study confirms their durability for chairside CAD/CAM restorations.
Area of Science:
- Dental Materials Science
- Biomaterials Engineering
- Restorative Dentistry
Background:
- Chairside Computer Assisted Design/Computer Assisted Machining (CAD/CAM) restorations utilize various ceramic materials.
- A new category of resilient nano-ceramic materials offers potential advantages in durability and handling.
- Long-term clinical data on these novel nano-ceramic materials is limited.
Purpose of the Study:
- To evaluate the 5-year clinical performance of nano-ceramic (Lava Ultimate/3M) onlays fabricated chairside using CAD/CAM.
- To compare the clinical outcomes of nano-ceramic onlays with leucite-reinforced ceramic onlays.
- To assess the impact of self-etch versus total etch cementation techniques on onlay retention and performance.
Main Methods:
- A 5-year longitudinal, randomized clinical trial involving 120 patients.
- Sixty chairside CAD/CAM onlays were fabricated from leucite-reinforced ceramic and 60 from nano-ceramic material.
- Onlays were cemented using either a self-etch or a total etch adhesive resin cement, with equal distribution between groups.
Main Results:
- Postoperative sensitivity was transient, resolving within 4 weeks for all onlays.
- Four leucite-reinforced ceramic onlays and one nano-ceramic onlay fractured over the 5-year period.
- No debonding was reported, regardless of the cementation technique (self-etch or total etch).
Conclusions:
- Both self-etch and total etch cementation techniques yield similar clinical outcomes for CAD/CAM onlays, with no adhesive failures.
- Nano-ceramic onlays exhibited a lower incidence of fracture compared to leucite-reinforced ceramic onlays.
- Nano-ceramic onlays demonstrated comparable clinical performance to glass-ceramic onlays over 5 years of service.
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