Prospective clinical evaluation of 765 partial glass-ceramic posterior restorations luted using photo-polymerized resin composite in conjunction with immediate dentin sealing

ObjectivesTo evaluate the clinical performance of partial glass-ceramic (IPS e.max Press) posterior restorations.Materials and methodsA total of 765 restorations in 158 patients were placed between 2008 and 2018 and evaluated in a prospective study during regular dental care visits between 2015 and 2018. The restorations were luted with a conventional photo-polymerized resin composite (HFO) in conjunction with an Immediate Dentin Sealing procedure (IDS). Intra-oral photographs and radiographs were made and evaluated using USPHS criteria.ResultsThe mean observation time was 53.3 months (range 3-113 months). Three absolute failures occurred (tooth fractures, n=2; apical re-infection, n=1) all leading to the loss of the restored tooth. Repairable and salvageable failures occurred in 9 teeth (endodontic complications, n=7; secondary caries, n=1; debonding, n=1). The survival and success rates according to Kaplan-Meier after 5 years cumulated to 99.6% and 98.6%, respectively. Location (premolar/molar and mandibula/maxilla), pre-restorative endodontic status (vital/devitalised) and extension of the indirect ceramic restoration (number of sides and cusps involved) did not significantly affect the cumulative success rate (log rank test, p>0.05). The condition of the vast majority of the restorations remained unaffected for 5 years.ConclusionsPartial glass-ceramic posterior restorations (pressed lithium disilicate (IPS e.max press, Ivoclar Vivadent) luted by means of a conventional photo-polymerized resin composite in conjunction with the use of an IDS procedure have an excellent medium-term prognosis.Clinical relevancePartial glass-ceramic posterior restorations can be considered as a highly reliable treatment option. Location and extension of the restoration and pre-restorative endodontic status do not affect success rate.