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Published on: December 20, 2024
Gold vs. CAD/CAM ceramic partial-crowns: 20-year randomized clinical study.
Fabian Cieplik1, Julia L Pfister2, Karl-Anton Hiller2
1Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany; Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
This 20-year study found that ceramic partial crowns (PCCs) have similar survival rates to gold crowns (CGPCs). While both restorations performed acceptably, CGPCs showed slight advantages in specific criteria.
Area of Science:
- Dental Materials Science
- Restorative Dentistry
- Clinical Prosthodontics
Background:
- Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) partial ceramic crowns (PCCs) are widely used.
- Long-term clinical data comparing PCCs with traditional cast gold partial crowns (CGPCs) are limited.
- A 20-year follow-up is crucial to assess the longevity and performance of dental restorations.
Purpose of the Study:
- To compare the cumulative survival and clinical performance of CAD/CAM PCCs versus CGPCs over 20 years.
- To test the hypothesis that CGPCs and PCCs exhibit similar long-term outcomes.
- To provide systematic clinical data on the 20-year service of these partial crown types.
Main Methods:
- A prospective, randomized, split-mouth study involving 29 patients.
- Each patient received one CGPC and one PCC.
- Examinations at 20 years utilized modified USPHS and FDI criteria, with Kaplan-Meier survival analysis.
Main Results:
- Cumulative survival rates were 69% for CGPCs and 53% for PCCs, without statistical significance.
- All evaluated restorations met acceptable clinical standards (USPHS: Alpha/Bravo; FDI: 1-3).
- Both crown types showed deterioration in surface luster and marginal discoloration; PCCs had worse marginal adaptation over time.
Conclusions:
- Both PCCs and CGPCs demonstrated acceptable clinical results after 20 years.
- CGPCs showed slight advantages in specific criteria like surface staining and marginal adaptation.
- PCCs offer similar long-term survival to CGPCs with only slightly inferior performance, supporting their clinical recommendation.
