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Periodontal outcome and additional clinical quality criteria of lithium-disilicate restorations (Empress 2) after 14 years

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Abstract

Objectives

To evaluate the clinical quality of tooth-supported crowns (SCs), implant-supported crowns (ISCs), and fixed dental prosthesis (FDPs) made of a lithium-disilicate glass-ceramic framework material (IPS Empress 2, Ivoclar Vivadent) after long-term use.

Materials and methods

Between 1997 and 1999, 184 restorations (106 SCs, 32 ISCs, 33 FDPs, 13 diverse restorations) were placed in 73 patients. In 2012/2013, all patients with functioning restorations were invited to participate in a clinical follow-up examination. To investigate the clinical quality, modified California Dental Association (CDA) criteria, periodontal health, and the patient’s opinion were evaluated.

Results

After 14 years on average, 50 restorations were available for evaluation of the CDA criteria and the patient’s opinion, and 24 restorations were available for the periodontal health evaluation. Surface, color, anatomic shape, and margin integrity were considered to be in the range of excellence in 54, 78, 96, and 88%, respectively. There were no unacceptable defects. Most patients (64%) were still entirely satisfied with their restorations. Mean probing depths were significantly higher on teeth with tooth-supported Empress 2 restorations than on control teeth (p = 0.0401). No significant relationship was found between surface quality and plaque accumulation (p = 0.9450, generalized linear mixed model) or between surface quality and periodontal probing ≥ 4 mm (p = 0.4184, generalized linear mixed model).

Conclusions

The clinical quality of the Empress 2 restorations that had survived 14 years on average was totally satisfactory with regard to esthetics, design, and patient’s opinion. The periodontal health of all-ceramic restored teeth requires further investigation.

Clinical significance

The practitioner’s choice of dental materials is based, at best, on long-term experience. With diminishing concerns about the clinical longevity of all-ceramic restorations, the grading of clinical quality based on esthetics, design, periodontal response, and patients’ opinions could, nowadays, serve as a measure for the efficiency of dental ceramic.

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Acknowledgements

The authors thank all the participating patients, the study nurse Kornelia Schmitz, technicians, and dentists for their kind and valuable cooperation.

Funding

The work was supported by the Ivoclar Vivadent, Schaan, Principality of Liechtenstein.

Author information

Author notes

  1. Daniel Edelhoff and Stefan Wolfart contributed equally to this work.

Authors and Affiliations

  1. Department of Prosthodontics and Biomaterials, Center of Implantology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany

    Maren Teichmann, Fabian Göckler & Stefan Wolfart

  2. Department of Medical Statistics, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany

    Marcia Rückbeil

  3. Dental laboratory Impladent GmbH, Kullenhofstraße 30, 52074, Aachen, Germany

    Volker Weber

  4. Department of Prosthodontics, School of Dentistry, Ludwig-Maximilians-University, Goethestr. 70, 80336, Munich, Germany

    Daniel Edelhoff

Authors
  1. Maren Teichmann
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  2. Fabian Göckler
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Corresponding author

Correspondence to Maren Teichmann.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent was obtained from all individual participants included in the study.

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Teichmann, M., Göckler, F., Rückbeil, M. et al. Periodontal outcome and additional clinical quality criteria of lithium-disilicate restorations (Empress 2) after 14 years. Clin Oral Invest 23, 2153–2164 (2019). https://doi.org/10.1007/s00784-018-2649-x

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  • DOI: https://doi.org/10.1007/s00784-018-2649-x

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