title: Long-term behavior of double crown retained dentures with metal and metal-free secondary crowns and frameworks made of Vectris(©) on all-ceramic primary crowns: a prospective, randomized clinical trial up to 14 years.
abstract: OBJECTIVE
  This prospective randomized clinical trial aimed to evaluate the long-term behavior of metal-free double crown retained dentures with secondary crowns and dental frameworks made of the fiber-reinforced composite Vectris(©) on all-ceramic primary crowns (IPS Empress 2(©)) over a period of up to 14 years and to subsequently evaluate patient satisfaction. For the control group, electroplated gold copings and metal frameworks were used.
  
  
  METHODS
  A total of 29 patients were treated with a total of 37 prostheses on 165 primary crowns. Of these 37 prostheses, 27 were allotted to the control group and 10 to the test group. The mean observation time was 91 ± 57 months; patient satisfaction surveys were conducted over 77 ± 59 months.
  
  
  RESULTS
  Success rates in both groups were compared using Kaplan-Meier survival curves and log-rank test. Up to about 3 years, both types of prostheses exhibited similar success rates. Afterwards, a massive decrease in the Vectris(©) curve could be noted, whereas the metal curve dropped only slightly. This difference was also statistically significant (p = 0.032361). There was a comparable susceptibility to damages in both groups: 88.9 % (control) and 90 % (test), respectively, of the prostheses had to be repaired within the period of investigation (p = 0,121). Damages of the Vectris(©) secondary crowns could be detected significantly more often compared to the electroformed gold copings (p < 0.00005). Patient satisfaction with the restorations was comparably high in both groups.
  
  
  CONCLUSIONS
  Metal-free secondary crowns and denture frameworks made with the glass fiber-reinforced composite material Vectris(©) showed a lower survival rate than the electroplated gold copings and metal frameworks. Primary crowns made of IPS Empress 2(©) had insufficient stability. Exclusively high-strength zirconia ceramics should be recommended for this indication.
  
  
  CONCLUSIONS
  Both clinical and statistical data indicated the superiority of the restorations made with electroplated secondary crowns and metal framework. Therefore, the use of Vectris(©) cannot be recommended for the fabrication of double crown retained removable dentures as permanent restorations.
authors.affiliation: Department of Prosthetic Dentistry, School of Dentistry, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60596, Frankfurt, Germany. Tugba.Erim@med.uni-frankfurt.de.
authors.forename: T
authors.initials: T
authors.lastname: Zahn
authors.affiliation: , Dres. Zahn, Wiesenbornstr. 10, 61350, Bad Homburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Zahn
authors.affiliation: Department of Prosthetic Dentistry, School of Dentistry, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60596, Frankfurt, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Janko
authors.affiliation: Department of Prosthetic Dentistry, School of Dentistry, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60596, Frankfurt, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Weigl
authors.affiliation: Department of Conservative Dentistry, School of Dentistry, Johann Wolfgang Goethe University, Frankfurt, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Gerhardt-Szép
authors.affiliation: Department of Prosthetic Dentistry, School of Dentistry, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60596, Frankfurt, Germany.
authors.forename: H C
authors.initials: HC
authors.lastname: Lauer
mesh_terms: D000538:Aluminum Silicates; D002516:Ceramics; D003442:Crowns; D003776:Dental Porcelain; D019232:Dental Restoration Failure; D003779:Denture Design; D003781:Denture Retention; D003778:Dentures; D005260:Female; D005898:Glass; D006046:Gold; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies
chemical_list: D000538:Aluminum Silicates; C075815:IPS-Empress ceramic; D008670:Metals; C009753:fiberglass; D003776:Dental Porcelain; D006046:Gold
keywords: Ceramic primary crown; Double crown; Electroplated gold coping; Intraoral luting; Patient satisfaction; Vectris©