Potential complications of CAD/CAM-produced resin composite crowns on molars: A retrospective cohort study over four years

Abstract

Purpose Evaluation of the clinical performance of computer-aided design/computer-aided manufacturing-produced resin composite crowns (CAD/CAM composite crowns) on molars with a particular focus on placement location. Methods A retrospective cohort study was performed based on the clinical records of patients with CAD/CAM composite crowns on molars (June 2016 to March 2021). The hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated based the Cox proportional hazard model to evaluate the effect of tooth location on complication type and occurrence. Covariates included crown location (maxilla/mandible, distalmost tooth/not distalmost tooth, and first molar/second or third molar) and endodontically treated (nonvital) or untreated (vital) tooth. Results Overall, 362 crowns were evaluated (mean follow-up: 378 days, median: 286 days), and 106 crowns (29.3%) showed complications, most frequently crown debonding. The cumulative success and survival rates were 70.9% and 93.7%, respectively, after 1 year and 49.5% and 86.5%, respectively, after 3 years. There was no significant difference in the HRs and log-rank tests in the Kaplan–Meier curves based on crown location parameters (P > 0.05). However, placement on vital teeth was associated with higher risks than on nonvital teeth (HR, 1.55; 95% CI, 1.03–2.23). In addition, the cement as a covariate yielded a high HR. Conclusions The location of CAD/CAM composite molar crowns is unlikely a risk factor for complications; therefore, these crowns can be clinically applied to all molars. However, the application of such molar crowns to vital teeth and the use of a cement other than adhesive resin cement present risks.

Shade, Aging and Spatial-Dependent Variation of Elastoplastic and Viscoelastic Characteristics in a Dental, Submicron Hybrid CAD/CAM Composite

“…The initial concerns about the clinical necessity and suitability of CAD/CAM RBCs have already been addressed [ 21 , 22 ], and their functionality in the oral environment has been confirmed. The next development step was to expand the color and translucency portfolio in such a way that the CAD/CAM RBCs are in no way inferior to their light-curing counterparts in terms of aesthetics.…”

Clinical report of six-month follow-up after cementing PEEK crown on molars

“…Clinical complications occurred in 29.3% of the 362 molar CADCAM resin crowns, of which 74.5% were debonding and 4.7% were fractures. Crown debonding of the molars most frequently occurred in the early stages, within the first 6 months 38 . The most common complications for composite crowns were a fracture of the crown and loss of retention for metal-ceramic crowns 39 .…”

“…However, to our knowledge, no www.nature.com/scientificreports/ prior studies have reported a relationship between PEEK and gingivitis, but PEEK has been reported to prevent bacterial adhesion 37 . Similar studies include retrospective cohort studies of metal-ceramic crowns and CAD/ CAM-produced resin composite crowns 38,39 . Clinical complications occurred in 29.3% of the 362 molar CAD-CAM resin crowns, of which 74.5% were debonding and 4.7% were fractures.…”

Bonding Characteristics of Silane Coupling Agent and MMA-Containing Primer to Various Composite CAD/CAM Blocks

“…However, their applicability is hampered by the fact that it is difficult to achieve an adequate bonding with resin cements, with several studies reporting on clinical outcomes related to crown debonding [ 7 , 8 , 9 , 10 ]. The most recent study revealed that 362 CAD/CAM composite crowns were assessed over an average follow-up period of 378 d. Among these, 106 crowns exhibited clinical issues, with crown debonding accounting for 74.5% of the cases.…”

“…Notably, a relatively higher rate of debonding was observed in the post-fitting period. Furthermore, after the reattachment of the debonded crowns, only 16% of them (12 crowns) experienced subsequent debonding, while the rest remained intact for an extended period [ 7 ]. A similar pattern was reported by Kabetani et al, who found that 50% of debondings occurred within the first 4 months after cementation of CAD/CAM composite crowns.…”