CLINICAL PERFORMANCE OF MONOLITHIC CAD/CAM SINGLE CROWNS OF POLYMER-INFILTRATED AND LITHIUM DISILICATE CERAMIC: PRELIMINARY RESULTS AFTER 12 MONTHS
Ceramics infiltrated by polymer; Lithium disilicate; Accession; Aesthetics; Oral health;
Objective: to evaluate, through a controlled, randomized and double-blind clinical trial, the clinical performance of posterior single monolithic crowns made of two types of ceramics, as well as the impact of rehabilitation on patients' aesthetic satisfaction and quality of life. Materials and Methods: A total of 20 patients who received 36 crowns were included in this study. All patients signed an informed consent form. The teeth under rehabilitation were allocated using a simple draw between the groups: Control Group: (LD- lithium disilicate) and Experimental group (PIC -Vita Enamic). Photographic, radiographic, and clinical information records were collected before, during, and after rehabilitation. The crowns of each group were assessed for clinical survival rate (modified USPSH criteria), aesthetic satisfaction (visual analog scale - VAS), quality of life (Oral Impacts on Daily Performances - OIDP), and type of failures (biological and technical). Data collection was performed by a single examiner calibrated and blinded to the type of material, at the follow-up times T0 (before the start of treatment), T1 (1 month), T2 (6 months), and T3 (12 months). The OIDP and USPHS criteria were analyzed descriptively. Aesthetic satisfaction was analyzed with the Man-Whitney/Friedman test/Wilcoxon post-tests. Survival analysis was performed using Kaplan-Meier followed by the log-rank test. The level of significance was set at (5%). Results: 36 crowns were placed on 20 patients with a mean age of 47.17 years (± 13.91), with 22 (56.4%) crowns from the control group (LD) and 14 (35.9%) for the group experimental (PIC). The Kaplan-Meier analysis revealed a survival rate of 83.5% for PIC and 86.2% for LD with no significant differences between them (P>0.05). Four failures were recorded, 2 in each group, two detachments after 1(PIC) and 6 months (LD), a tooth fracture (LD), and grade III mobility after (PIC) 12 months of follow-up. There was no significant difference in aesthetic satisfaction between the control group and the experimental group (Mann-Whitney, P>0.05). Aesthetic satisfaction was significantly higher after 1 (T1), 6 (T2), and 12 (T3) months when compared to baseline (T0) (Friedman test - P <0.05). Rehabilitation with single crowns had a positive impact on patients' quality of life. Conclusion: This study demonstrates that single monolithic crowns of PIC and LD presented a good clinical, aesthetic performance and with a positive impact on patients' quality of life after 12 months. A longer evaluation period is needed to draw more conclusions.