Clinical evaluation of chairside Computer Assisted Design/Computer Assisted Machining nano‐ceramic restorations: Five‐year status

Abstract

Objectives

This investigation was a longitudinal, randomized clinical trial to measure the clinical performance of a nano‐ceramic material (Lava Ultimate/3M) for chairside Computer Assisted Design/Computer Assisted Machining (CAD/CAM) fabricated restorations.

Materials and Methods

One hundred and twenty chairside CAD/CAM onlays were restored with a CEREC system randomly assigned to 60 leucite‐reinforced ceramic (IPS EmpressCAD/Ivoclar Vivadent AGBendererstrasse 2FL‐9494 SchaanLiechtenstein) onlays and 60 nano‐ceramic (Lava Ultimate/3M) onlays. Equal groups of onlays were cemented using a self‐etch and a total etch adhesive resin cement. The onlays were recalled for a period of 5 years.

Results

At 1 week postoperatively, 10% of the onlays cemented with both the self‐etch and total etch adhesive resin cements were reported as slightly sensitive. However, all patients were asymptomatic by the 4th week without treatment. Four leucite‐reinforced onlays and one nano‐ceramic onlay fractured and required replacement.

Conclusions

Adhesive retention with a self‐etch or total etch cementation technique resulted in a similar clinical outcome with no reported debonds. The nano‐ceramic onlays had a lower incidence of fracture compared to the leucite‐reinforced ceramic onlays with both having a very low risk of fracture. Nano‐ceramic onlays performed equally as well as glass ceramic onlays over 5 years of clinical service.

Clinical Significance

Ceramic materials have been a mainstay for chairside CAD/CAM restorations for the past 30 years and a new category of resilient ceramics with a resin matrix has been introduced reported to offer ceramic‐like durability and esthetics with resin‐like efficiency in handling. There are no long‐term clinical studies on the performance of these materials. This is a 5‐year randomized clinical trial on the performance of nano‐ceramic onlays.