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When missing tooth structure or teeth are replaced, minimal biologic risk should be involved to re-establish function and esthetics. The increased use of the adhesive technique and preservation of dental tissues have greatly impacted conservative tooth preparation design. The development use of zirconia technology and all-ceramic systems has opened the potential for fabrication inlays zirconia bridges with durability and good aesthetics.
The purpose of this study is to clinically evaluate the placement of inlay bridge made of a Y-TZP framework veneered with a pressed ceramic and bonded with a completely adhesive approach in the replacement of a single missing tooth.
This study evaluates the use of inlay bridge made of Zirconia and all ceramic systems with three designs in the replacement process of one single tooth (i.e. a missing premolar or molar.) The first design is going to be fabricated with CAD/CAM Zirconia and the occlusal surface from e-max press.
The second design is going to be fabricated with CAD/CAM Zirconia and the occlusal surface from e-max press and the internal surface coated with glaze layer to improve the adhesion.
The third design is going to be fabricated with CAD/CAM Zirconia and the occlusal surface from e-max press and the internal surface coated with a layer of e-max ceramic press to improve the adhesion.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Zirconia and E-max Press | No Intervention | The first design is going to be fabricated with CAD/CAM Zirconia and the occlusal surface from E-max Press. | |
| Zirconia and E-max Press and Glaze | Experimental | The second design is going to be fabricated with CAD/CAM Zirconia and the occlusal surface from E-max Press and the internal surface coated with a glaze layer to improve adhesion. |
|
| Zirconia and E-max Press twice | Experimental | The third design is going to be fabricated with CAD/CAM Zirconia and the occlusal surface from E-max Press and the internal surface coated with an E-max Press layer to improve adhesion. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Glaze layer | Procedure | A coating of a glaze layer will be used at the inner surface of the bridge to improve adhesion |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in marginal fit | To examine if there is a gap between inlay margins and tooth cavity margins .It will be measured by a probe. | Immediately within five minutes following cementation (T1), 3 months (T2), 6 months (T3), 12 months (T4) following application |
| Change in Material Integrity | To examine macroscopically the presence of cracks or fractures in the veneering ceramic (retainers or pontics) or any fractures at the connectors. | Immediately within five minutes following cementation (T1), 3 months (T2), 6 months (T3), 12 months (T4) following application |
| Change in the Retention Status | The resistance of a prosthesis to displacement will be measured. | Immediately within five minutes following cementation (T1), 3 months (T2), 6 months (T3), 12 months (T4) following application |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Marginal Color Matching | Examination will be done macroscopically to detect the presence of any difference in color between the margins of the tooth and inlays | Immediately within five minutes following cementation (T1), 3 months (T2), 6 months (T3), 12 months (T4) following application |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Sensitivity | The presence of any spontaneous or stimulated pain will be assumed. | Immediately within five minutes following cementation (T1), 3 months (T2), 6 months (T3), 12 months (T4) following application |
| Change in Patients' Satisfaction |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mansour Abo Alkasab, DDS MSc | PhD student in Fixed Prosthodontics, University of Damascus Dental School, Damascus, Syria | Principal Investigator |
| Jihad Abo Nassar, DDS MSc PhD | Associate Professor of Fixed Prosthodontics, University of Damascus Dental School, Damascus, Syria | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Fixed Prosthodontics, University of Damascus Dental School, Damascus, Syria | Damascus | DM20AM18 | Syria |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19407162 | Background | Coelho PG, Bonfante EA, Silva NR, Rekow ED, Thompson VP. Laboratory simulation of Y-TZP all-ceramic crown clinical failures. J Dent Res. 2009 Apr;88(4):382-6. doi: 10.1177/0022034509333968. | |
| 21594233 | Background | Cura C, Ozcan M, Isik G, Saracoglu A. Comparison of alternative adhesive cementation concepts for zirconia ceramic: glaze layer vs zirconia primer. J Adhes Dent. 2012 Feb;14(1):75-82. doi: 10.3290/j.jad.a21493. |
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| E-max Press layer | Procedure | A coating of E-max Press layer will be used at the inner surface of the bridge to improve adhesion |
|
A questionnaire will be used to detect the level of satisfaction regarding function and shade
| Immediately within five minutes following cementation (T1), 3 months (T2), 6 months (T3), 12 months (T4) following application |
| Change in Shade | The shade is going to be determined using Vita(R) shade guide. | Immediately within five minutes following cementation (T1), 3 months (T2), 6 months (T3), 12 months (T4) following application |
| 17165297 | Background | Monaco C, Ferrari M, Caldari M, Baldissara P, Scotti R. Comparison of 2 bonding systems and survival of fiber-reinforced composite inlay fixed partial dentures. Int J Prosthodont. 2006 Nov-Dec;19(6):577-85. |
| 17052467 | Background | Raigrodski AJ, Chiche GJ, Potiket N, Hochstedler JL, Mohamed SE, Billiot S, Mercante DE. The efficacy of posterior three-unit zirconium-oxide-based ceramic fixed partial dental prostheses: a prospective clinical pilot study. J Prosthet Dent. 2006 Oct;96(4):237-44. doi: 10.1016/j.prosdent.2006.08.010. |
| 25862408 | Background | Sanli S, Comlekoglu MD, Comlekoglu E, Sonugelen M, Pamir T, Darvell BW. Influence of surface treatment on the resin-bonding of zirconia. Dent Mater. 2015 Jun;31(6):657-68. doi: 10.1016/j.dental.2015.03.004. Epub 2015 Apr 7. |
| 22166107 | Background | Valentino TA, Borges GA, Borges LH, Platt JA, Correr-Sobrinho L. Influence of glazed zirconia on dual-cure luting agent bond strength. Oper Dent. 2012 Mar-Apr;37(2):181-7. doi: 10.2341/10-220-L. Epub 2011 Dec 14. |
| 26561926 | Background | Chaar MS, Kern M. Five-year clinical outcome of posterior zirconia ceramic inlay-retained FDPs with a modified design. J Dent. 2015 Dec;43(12):1411-5. doi: 10.1016/j.jdent.2015.11.001. Epub 2015 Nov 10. |
| 21736862 | Result | Monaco C, Cardelli P, Ozcan M. Inlay-retained zirconia fixed dental prostheses: modified designs for a completely adhesive approach. J Can Dent Assoc. 2011;77:b86. |