Clinical performance of metal-free polymer crowns after 3 years in service.
OBJECTIVE
To investigate the influence of location and preparation design on the survival and complication rate of metal-free polymer crowns within a prospective clinical study.


METHODS
After randomization, a total of 114 (68 posterior and 46 anterior) single crowns were prepared, either with a chamfer finishing line or with a shoulder combined with occlusal reduction of at least 1 mm. Build-ups were made with a composite material, using the corresponding dentin adhesive. After making impressions with polyether material, polymer crowns were manufactured on stone dies and adhesively luted with resin cement. Follow-ups were scheduled after 1 month, 1 year, 2 years and 3 years. Documentation included failures and other complications, as well as ratings of esthetic and functional performance. After 3 years, data from 100 single crowns were statistically evaluated.


RESULTS
Within a minimal observation period of 3 years, 10 complications occurred, including 3 total fractures, 3 partial fractures and 3 decementations. Only 4 crowns (3 total fractures +1 partial fracture) had to be replaced, whereas 2 partial fractures could be repaired and all loosened crowns could be recemented. Kaplan-Meier survival analysis did not show any influence of location or preparation design on the complication rate. Esthetic and functional evaluation by the patients revealed a high acceptance of single polymer crowns, indicated by medians of 9-10 on a 10-point-scale.


CONCLUSIONS
Within the 3 year observation period, it can be concluded that 0.5 mm chamfer and shoulder preparation ensure that the stability of metal-free polymer crowns for anterior and posterior teeth is acceptable. Long-term stability and wear behavior has still to be evaluated.
Rammelsberg
Peter
P
Department of Prosthetic Dentistry, Ruprecht Karls University, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany. peter_rammelsberg@med.uni-heidelberg.de
Spiegl
Katrin
K
Eickemeyer
Grit
G
Schmitter
Marc
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003188:Composite Resins / Q000737:chemistry*; D003442:Crowns; D019232:Dental Restoration Failure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D013997:Time Factors
C498018:Artglass (dental composite); D003188:Composite Resins