Clinical Update Quiz

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Each month, the clinical update is published online and in the Victorian Dentist. There are 11 clinical updates per year, corresponding with the distribution of the Victorian Dentist from February to December. This service is available to ADAVB and ADATas members only. Members can log in to view and answer the clinical update questions. If you answer at least eight out of 10 questions correctly, you will receive one hour of scientific CPD.

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Comparison of 16.9-year survival of pressed acid etched e.max lithium disilicate glass-ceramic complete and partial coverage restorations in posterior teeth

Full title: Comparison of 16.9-year survival of pressed acid etched e.max lithium disilicate glass-ceramic complete and partial coverage restorations in posterior teeth: Performance and outcomes as a function of tooth position, age, sex, and thickness of ceramic material

Malament KA, Margvelashvili-Malament M, Natto ZS, Thompson V, Rekow D, Att W. J Prosthet Dent. 2021;126(4):533-45. doi.org/10.1016/j.prosdent.2020.08.013.

Compiled by Dr Nirav Bhatia

Introduction

Due to increase in life expectancy, the number of retained natural teeth at an older age is being seen worldwide. Dental caries and tooth wear cause loss of tooth structure that requires restoration. Based on the amount of lost tooth structure, either a complete or a partial coverage restoration is chosen.

Concerns have been raised about aggressive preparation needed for complete coverage restorations. Thus, restorative dentistry has favoured minimally invasive procedures to preserve tooth structure. Nevertheless, which type of ceramic restoration, complete or partial, performs better over a long time is unclear.

Lithium disilicate was introduced to the dental market in the early 2000s as IPS e.max Press (Ivoclar Vivadent AG) and has become a popular material for anterior restorations. However, its flexural strength of 470MPa and fracture toughness of 2.54MPa have led to questioning the use of lithium disilicate restorations in the posterior region. It is thought that e.max with a thickness less than 1mm is more susceptible to catastrophic fracture, which leads to more invasive tooth preparations or avoidance of the material.

The purpose of this study was to compare long-term clinical survival and the clinical factors influencing the outcomes of adhesively bonded e.max complete and partial coverage restorations, and to evaluate the performance of e.max restorations in posterior teeth. The null hypotheses were that there is no difference in the survival rate of pressed e.max complete or partial coverage restorations in posterior teeth, and that none of the confounding variables has an influence on the long-term outcome.

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