Computer-aided designed/computer-assisted manufactured composite resin versus ceramic single-tooth restorations: a 3-year clinical study.
OBJECTIVE
No clinical evidence has been provided to suggest that metal-free all-composite resin indirect restorations are a functional and esthetic alternative to all-ceramic restorations. The aim of this study was to evaluate the clinical performance of single-tooth computer-aided design/computer-assisted manufacturing (CAD/CAM)-generated all-composite resin and all-ceramic crowns after 3 years of function.


METHODS
In a prospective trial, 200 all-composite resin and all-ceramic crowns were rated over a 3-year period. Restorations were evaluated at 3 weeks and 1 and 3 years after insertion by the California Dental Association quality evaluation index, the patient's self-assessment, marginal fit, periodontal parameters, volume loss, and wear patterns of the veneering material. Statistical analysis was performed using t tests (a = .05).


RESULTS
Cumulative survival and success rates after 3 years were 87.9% and 55.6% for all-composite resin and 97.2% and 81.2% for all-ceramic crowns, respectively (P < .05 for success rates). Restoration loosening occurred exclusively for all-composite resin crowns cemented on a cast post. All-ceramic restorations demonstrated satisfactory esthetic results. All-composite resin crowns resulted in significantly more mean total volume loss and mean vertical wear at occlusal contact areas after 6 months and 3 years of function. The clinical performance of the CAD/CAM-generated all-ceramic crowns used in this study was similar to that of other all-ceramic CAD/CAM systems.


CONCLUSIONS
For up to 3 years of function, all-composite resin single-tooth restorations have inferior success rates compared to all-ceramic restorations. Due to the inferior esthetics and wear resistance of all-composite resin crowns, all-ceramic crowns remain the preferred treatment for CAD/CAM-generated metal-free single-tooth restorations.
Vanoorbeek
Sara
S
Department of Prosthetic Dentistry, School of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, K U Leuven, Belgium.
Vandamme
Katleen
K
Lijnen
Inge
I
Naert
Ignace
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D002484:Cementation; D003188:Composite Resins / Q000737:chemistry*; D017076:Computer-Aided Design; D003442:Crowns; D000044:Dental Abutments; D018772:Dental Marginal Adaptation; D003764:Dental Materials / Q000737:chemistry*; D003776:Dental Porcelain / Q000737:chemistry*; D017267:Dental Prosthesis Design; D019232:Dental Restoration Failure; D019554:Dental Restoration Wear; D003801:Dental Veneers; D004955:Esthetics, Dental; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D010512:Periodontal Index; D011176:Post and Core Technique; D011446:Prospective Studies; D019279:Resin Cements / Q000737:chemistry; D013499:Surface Properties; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
D003188:Composite Resins; D003764:Dental Materials; D019279:Resin Cements; D003776:Dental Porcelain