RESUMEN
OBJECTIVE: Endocrowns can be fabricated from various materials as a treatment option for endodontically treated teeth. This mixed cohort study aimed to demonstrate the clinical efficacy of endocrowns made of feldspathic, zirconia lithium silicate, and lithium disilicate ceramics using a chairside CAD/CAM system. METHODS: The present study compared the clinical outcomes of 141 endocrown restorations in posterior teeth of 85 patients in a two-year follow-up. The efficacy of restorations was evaluated in three aspects: esthetics, biological response, and function, with the aid of the FDI guideline, and presented as descriptive analyses. Additionally, the data were analyzed using Chi-square and Spearman correlation tests. The significance level was set at pâ¯=â¯0.05. RESULTS: The study findings revealed that the type of restorations (feldspathic, zirconia lithium silicate, and lithium disilicate) (p > 0.05) and underlying teeth (molars and premolars) (p > 0.05) play no part in restorations' failure. Caries' recurrence is primarily responsible for the failure of the endocrowns. Secondary caries and radiolucency were observed in four teeth (2.83%). The clinical efficacy of 126 restorations (89.36%) fell into the category of "clinically excellent" and "clinically good." Ten restorations (7.09%) were classified as "clinically sufficient/satisfactory," and only five restorations (3.54%) needed replacement due to having "clinically unsatisfactory" and "clinically poor" quality. CONCLUSIONS: With endocrowns made of the mentioned ceramics showing a high success rate and durability in the short term, they can be considered a safe choice for restoring endodontically treated teeth. It is worth noting that caries were the most common reason for the failure of the restorations. CLINICAL SIGNIFICANCE: Endocrowns made of different ceramics have been proven reliable restorations for endodontically treated molars and premolars.
RESUMEN
AIMS: The primary aim of the present study was to measure the discrepancy between the virtual and the actual position of the single-unit implants placed via a digitally-designed fully-guided surgical template using a flapless surgical technique. Prefabricated provisional restorations and periodontal factors were evaluated after the immediate loading of implants and 3 months after the surgery, respectively. MATERIALS AND METHODS: Fourteen implants in nine patients were virtually planned after importing intraoral scans and cone-beam computed tomography (CBCT) records into 3D planning software. Accordingly, fully-guided surgical templates, customized abutments, and provisional restorations were designed and fabricated. The implant position after the surgery was compared with its virtual counterpart in terms of angular and apical linear deviations. Implants were immediately loaded after the surgery, and the occlusal level of the delivered provisional restorations was compared with their designed positions. Early implant failure, bleeding on probing, and peri-implant pockets were documented on the 3-month follow-up. RESULTS: A mean angular deviation of 5.07 ± 2.06° and a mean apical linear deviation of 1.74 ± 0.63 mm resulted. Two out of 14 implants failed within the first 3 months of the surgery, and the occlusal level difference was calculated for nine prefabricated provisional restorations. CONCLUSIONS: DIONAVI protocol has been evaluated regarding its accuracy, and an estimation of the expected deviation is presented to the clinicians using this protocol. However, before widespread use, immediate-loading protocols and provisional restorations must be studied further. TRIAL REGISTRATION: IRCT, IRCT20211208053334N1. Registered 6 August 2022.