Five year evaluation of the complications observed in porcelain fused to metal (PFM) crowns placed at a university hospital.

OBJECTIVE: To determine the frequency of complications in crowns cemented over a 5-year period in a tertiary care hospital and also to report the survival of these crowns. METHODS: The retrospective cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from March 2017 to March 2018 and comprised porcelain fused-to-metal crowns placed on the anterior or posterior teeth that were fabricated at the institutional laboratory and were placed in institutional dental clinics in the preceding 5 years. Porcelain-fused to-metal The crowns were clinically and radio-graphically evaluated in a duration of two months for presence/absence of complications. Factors associated with the failure of the crowns, their survival and the impact of covariates, like gender, flossing and bruxism, on the survival time were determined. Data was analysed using SPSS 22. RESULTS: There were 150 crowns related to 107 patients who had a mean age of 45.0±11.4 years. The most common complication observed was open proximal contacts 9(6%) followed by de-cementation 8(5.3%), porcelain chipping 9(6%) and abutment fracture 2(1.3%). The 5-year survival rate of the crowns was 127(84.7%). The mean follow-up time was 57.2±1.0 months. Overall, year-wise survival of PFM crowns for one year till five years was 147 (98%), 144 (96%), 135 (90%), 130 (86%) and 119 (79%) respectively. CONCLUSIONS: The porcelain-fused-to-metal crowns had a high 5-year survival rate. Open proximal contacts represented the most common complication.

Three-year prospective clinical performance of a one-step self-etch adhesive and a nanofiller hybrid resin composite in Class V lesions.

PURPOSE: This 3-year prospective clinical study evaluated the clinical performance of a one-step self-etching adhesive (Futurabond NR) in combination with a nanohybrid composite (Grandio) for the treatment of different Class V cavities. METHODS: 122 restorations were placed in 42 patients (mean age of 54 +/- 13.2 years) evaluated according to modified Ryge-criteria at baseline, 6 months, 1, 2 and 3 years. The lesions comprised 91 Class V non-caries cervical lesions (NCCL) and 31 Class V cavities due to caries or restoration replacement. While carious lesions as well as restoration replacement required preparation of dentin, it was not roughened in case of NCCL. Macro-mechanical retention with undercuts was not used. The statistical analysis was carried out based on Bonferroni adjusted McNemar test (global alpha = 0.05) including the criteria marginal adaptation, color match, surface texture, anatomical form, retention and clinical acceptance and pain. The occurrence of secondary caries, preoperative and postoperative sensitivity was also examined. RESULTS: After 3 years of clinical service the restorations showed a significant deterioration of all studied parameters. After 3 years, 65% of the restorations were rated as excellent or acceptable in terms of clinical acceptance, 9% appeared tolerable and 26% were rated as not acceptable which mainly resulted from restoration losses. Within the observed timeframe the retention rate decreased to 75%, which means that 30 out of the 122 restorations were partially or completely lost. There was a difference in the 3-year retention rate of NCCL (71%) and the caries/restoration replacement group (87%) but it was not statistically significant.