title: Clinical performance of large, all-ceramic CAD/CAM-generated restorations after three years: a pilot study.
abstract: BACKGROUND
  Adhesively luted all-ceramic restorations preserve and stabilize weakened tooth structure, but there is little published information about the clinical performance of large, all-ceramic restorations.
  
  
  METHODS
  In this pilot study, the authors placed 58 large, single-tooth, all-ceramic restorations in 26 patients using a computer-aided design/computer-aided manufacturing, or CAD/CAM, system (CEREC 2, Sirona Dental Systems GmbH, Bensheim, Germany). They documented the maximum height of the restoration and remaining cementoenamel junction, or CEJ. In 21 cases, rubber dam isolation was not possible during adhesive luting. They re-evaluated the restorations after three years according to the U.S. Public Health Service criteria.
  
  
  RESULTS
  After three years, the authors rated 56 (97 percent) of the 58 restorations as Bravo or better in regard to marginal integrity, secondary caries (four could not be rated), discoloration and anatomical form. One restoration was rated as Charlie because of poor marginal integrity, and one restoration had to be replaced owing to a bulk fracture. The authors rated the adequacy of proximal contact and occlusal relationships as acceptable-to-good for all restorations. Neither the extent of the remaining enamel at the cavity margin nor application of a rubber dam had any statistically significant influence (chi2 test, P > .05) on the clinical performance of the restorations after three years.
  
  
  CONCLUSIONS
  At the three-year recall appointment, the authors found that the adhesively luted all-ceramic restorations had successfully repaired large coronal defects, irrespective of the cavity margin location (that is, coronal or apical to the CEJ).
  
  
  CONCLUSIONS
  Tooth-colored, all-ceramic CAD/CAM-generated restorations are an alternative to conventional restorations if large coronal defects need to be treated.
authors.affiliation: Policlinic of Prosthetic Dentistry, University of Erlangen-Nuremberg, Germany. sven.reich@rzmail.uni-erlangen.de
authors.forename: Sven M
authors.initials: SM
authors.lastname: Reich
authors.forename: Manfred
authors.initials: M
authors.lastname: Wichmann
authors.forename: Heiner
authors.initials: H
authors.lastname: Rinne
authors.forename: Adrian
authors.initials: A
authors.lastname: Shortall
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017076:Computer-Aided Design; D003442:Crowns; D001840:Dental Bonding; D003776:Dental Porcelain; D019232:Dental Restoration Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007284:Inlays; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019228:Tooth Crown / Q000473:pathology
chemical_list: D003776:Dental Porcelain