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Published on: December 20, 2024
Polymer-Infiltrated Ceramic Network Versus Smart Bioactive Self-Curing Composite for Cervical Restorations in
Maria Timoshina1, Sergey Mironov1, Alexey Dorofeev1
1Borovskiy Institute of Dentistry, Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya St., Moscow 119991, Russia.
Polymer-infiltrated ceramic network (PICN) inlays demonstrated superior 24-month performance over self-curing composites for cervical restorations in professional ballet dancers. PICN achieved significantly better marginal integrity and zero failures, outperforming conventional materials in this high-stress group.
Area of Science:
- Dental Materials Science
- Restorative Dentistry
- Biomaterials
Background:
- Professional ballet dancers experience high occlusal loads, leading to increased cervical defects.
- Conventional composite restorations frequently fail under these demanding conditions.
- This study evaluated novel restorative materials for high-stress cervical defects.
Purpose of the Study:
- To compare the 24-month clinical performance of polymer-infiltrated ceramic network (PICN) inlays versus self-curing bioactive composites for cervical restorations.
- To assess marginal integrity, failure rates, and secondary outcomes in a high-risk population.
Main Methods:
- A 24-month randomized clinical trial (RCT) involving 20 professional ballet dancers with 40 cervical defects (carious and abfraction).
- Paired split-mouth design comparing PICN inlays against self-curing composite restorations using United States Public Health Service (USPHS) criteria and dye penetration tests.
- Evaluations conducted at 6, 12, and 24 months, assessing marginal integrity, secondary caries, hypersensitivity, and Oral Health Impact Profile-14 (OHIP-14).
Main Results:
- PICN restorations maintained superior marginal integrity (91% carious, 89% abfraction) compared to self-curing composites (70% carious, 50% abfraction) at 24 months.
- Zero failures were observed for PICN restorations, while self-curing composites showed failure rates of 20% (carious) and 30% (abfraction).
- Kaplan-Meier survival analysis favored PICN (log-rank p = 0.001), with a 24-month survival probability of 100% versus 75% for the self-curing composite.
Conclusions:
- PICN hybrid ceramic offers superior marginal integrity and durability for cervical restorations in professional ballet dancers, demonstrating a 0% failure rate over 24 months.
- PICN inlays are recommended for abfraction defects in this high-risk population, though caution is advised for general population extrapolation.
- Self-curing composites may be considered when light curing is challenging, but patients must be informed of the increased risk of restoration failure.