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Ten-year survival of pressed, acid-etched e.max lithium disilicate monolithic and bilayered complete-coverage restorations: Performance and outcomes as a function of tooth position and age.
J Prosthet Dent. 2019 May; 121(5):782-790.JP

Abstract

STATEMENT OF PROBLEM

Long-term clinical data on the survival of pressed lithium disilicate glass-ceramic restorations and the effect that different technical and clinical variables have on survival are lacking.

PURPOSE

The purpose of this clinical study was to examine the 10-year survival of pressed lithium disilicate glass-ceramic restorations and the relationship between clinical parameters on outcomes.

MATERIAL AND METHODS

Five hundred and fifty-six patients, ranging in age from 17 to 97 years, from a private clinical practice were enrolled. All participants required single-tooth replacement or repair in any area of the mouth, including single crowns, 3-unit fixed partial dentures, cantilevered anterior restorations, and foundation restorations. Together, the longevity of 1960 complete-coverage restorations was studied. Participants were offered the options of gold, conventional metal-ceramic, or lithium disilicate restoration. Participants who chose glass-ceramic restorations were included in the study. The overall survival of the glass-ceramic restorations was assessed by using clinical factors determined at recall, and the effect of various clinical parameters was evaluated by using Kaplan-Meier survival curves to account for attrition bias and other reasons for failure. The statistical significance of differences between parameters was determined using the log-rank test (α=.05).

RESULTS

A total of 556 patients electing lithium disilicate restorations were evaluated. The mean age of patients at the time of restoration placement was 62 years, with a range of 17 to 97 years. Men comprised 39.5% of the patients, and women, 60.5%. Many patients required more than one restoration. Seven failures (bulk fracture or large chip requiring replacement) were recorded for the 1960 complete-coverage lithium disilicate restorations, with the average time of failure being 4.2 years. The total time at risk computed for the units was 5113 years, providing an estimated failure risk of 0.14% per year. The 10-year estimated cumulative survival was 99.6% (95% confidence : 99.4-99.8).The estimated cumulative survival rate of 1410 monolithic and 550 bilayered e.max complete-coverage restorations was 96.5% and 100%, respectively, at 10.4 and 7.9 years (P<.05). Seven failures were recorded for the monolithic complete-coverage restoration units placed. The total time at risk for these monolithic units was 3380 years, providing an estimated risk of 0.2% per year. Failures were primarily in molar teeth (5 of 7) and occurred in both arches (3/2). No failures were recorded for the bilayered complete-coverage restorations. The total time at risk computed for the bilayered units was 1733 years, providing an estimated risk of 0% per year.

CONCLUSIONS

Pressed lithium disilicate restorations in this study survived successfully over the 10.4-year period studied with an overall failure rate below 0.2% per year and were primarily confined to molar teeth. The risk of failure at any age was minimal for both men and women.

Authors+Show Affiliations

Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass; Private practice, Boston, Mass. Electronic address: kenmalament@mac.com.Assistant Professor, Department of Dental Public Health, School of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.Professor, Biomimetics and Biophotonics, King's College London Dental Institute, London, United Kingdom; Chair, Biomaterials and Biomimetics, NYU College of Dentistry, New York, NY.Professor and Chair, Department of Basic Science and Craniofacial Biology, Senior Vice Provost for Engineering and Technology, NYU College of Dentistry, New York, NY.Professor Emeritus, Mayo Foundation for Medical Education and Research, Mayo Graduate School, Rochester, NY.Professor and Chair, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30955942

Citation

Malament, Kenneth A., et al. "Ten-year Survival of Pressed, Acid-etched E.max Lithium Disilicate Monolithic and Bilayered Complete-coverage Restorations: Performance and Outcomes as a Function of Tooth Position and Age." The Journal of Prosthetic Dentistry, vol. 121, no. 5, 2019, pp. 782-790.
Malament KA, Natto ZS, Thompson V, et al. Ten-year survival of pressed, acid-etched e.max lithium disilicate monolithic and bilayered complete-coverage restorations: Performance and outcomes as a function of tooth position and age. J Prosthet Dent. 2019;121(5):782-790.
Malament, K. A., Natto, Z. S., Thompson, V., Rekow, D., Eckert, S., & Weber, H. P. (2019). Ten-year survival of pressed, acid-etched e.max lithium disilicate monolithic and bilayered complete-coverage restorations: Performance and outcomes as a function of tooth position and age. The Journal of Prosthetic Dentistry, 121(5), 782-790. https://doi.org/10.1016/j.prosdent.2018.11.024
Malament KA, et al. Ten-year Survival of Pressed, Acid-etched E.max Lithium Disilicate Monolithic and Bilayered Complete-coverage Restorations: Performance and Outcomes as a Function of Tooth Position and Age. J Prosthet Dent. 2019;121(5):782-790. PubMed PMID: 30955942.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ten-year survival of pressed, acid-etched e.max lithium disilicate monolithic and bilayered complete-coverage restorations: Performance and outcomes as a function of tooth position and age. AU - Malament,Kenneth A, AU - Natto,Zuhair S, AU - Thompson,Van, AU - Rekow,Dianne, AU - Eckert,Steven, AU - Weber,Hans-Peter, Y1 - 2019/04/05/ PY - 2018/07/29/received PY - 2018/11/27/revised PY - 2018/11/27/accepted PY - 2019/4/9/pubmed PY - 2019/11/27/medline PY - 2019/4/9/entrez SP - 782 EP - 790 JF - The Journal of prosthetic dentistry JO - J Prosthet Dent VL - 121 IS - 5 N2 - STATEMENT OF PROBLEM: Long-term clinical data on the survival of pressed lithium disilicate glass-ceramic restorations and the effect that different technical and clinical variables have on survival are lacking. PURPOSE: The purpose of this clinical study was to examine the 10-year survival of pressed lithium disilicate glass-ceramic restorations and the relationship between clinical parameters on outcomes. MATERIAL AND METHODS: Five hundred and fifty-six patients, ranging in age from 17 to 97 years, from a private clinical practice were enrolled. All participants required single-tooth replacement or repair in any area of the mouth, including single crowns, 3-unit fixed partial dentures, cantilevered anterior restorations, and foundation restorations. Together, the longevity of 1960 complete-coverage restorations was studied. Participants were offered the options of gold, conventional metal-ceramic, or lithium disilicate restoration. Participants who chose glass-ceramic restorations were included in the study. The overall survival of the glass-ceramic restorations was assessed by using clinical factors determined at recall, and the effect of various clinical parameters was evaluated by using Kaplan-Meier survival curves to account for attrition bias and other reasons for failure. The statistical significance of differences between parameters was determined using the log-rank test (α=.05). RESULTS: A total of 556 patients electing lithium disilicate restorations were evaluated. The mean age of patients at the time of restoration placement was 62 years, with a range of 17 to 97 years. Men comprised 39.5% of the patients, and women, 60.5%. Many patients required more than one restoration. Seven failures (bulk fracture or large chip requiring replacement) were recorded for the 1960 complete-coverage lithium disilicate restorations, with the average time of failure being 4.2 years. The total time at risk computed for the units was 5113 years, providing an estimated failure risk of 0.14% per year. The 10-year estimated cumulative survival was 99.6% (95% confidence : 99.4-99.8).The estimated cumulative survival rate of 1410 monolithic and 550 bilayered e.max complete-coverage restorations was 96.5% and 100%, respectively, at 10.4 and 7.9 years (P<.05). Seven failures were recorded for the monolithic complete-coverage restoration units placed. The total time at risk for these monolithic units was 3380 years, providing an estimated risk of 0.2% per year. Failures were primarily in molar teeth (5 of 7) and occurred in both arches (3/2). No failures were recorded for the bilayered complete-coverage restorations. The total time at risk computed for the bilayered units was 1733 years, providing an estimated risk of 0% per year. CONCLUSIONS: Pressed lithium disilicate restorations in this study survived successfully over the 10.4-year period studied with an overall failure rate below 0.2% per year and were primarily confined to molar teeth. The risk of failure at any age was minimal for both men and women. SN - 1097-6841 UR - https://www.unboundmedicine.com/medline/citation/30955942/Ten-year_survival_of_pressed,_acid-etched_e.max_lithium_disilicate_monolithic_and_bilayered_complete-coverage_restorations:_Performance_and_outcomes_as_a_function_of_tooth_position_and_age L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3913(19)30071-X DB - PRIME DP - Unbound Medicine ER -