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Wear Characteristics and Clinical Performance of Lithium Silicate Versus Monolithic Zirconia Crowns.

Wear Characteristics and Clinical Performance of Lithium Silicate Versus Monolithic Zirconia Crowns. (Randomized Controlled Clinical Trial)

Status
UNKNOWN
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03530020
Enrollment
22
Registered
2018-05-21
Start date
2019-02-01
Completion date
2020-02-01
Last updated
2019-01-03

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Enamel and Ceramics Wear

Keywords

monolithic zirconia, tooth wear, all ceramic crown

Brief summary

The aim of the present study is to evaluate the wear characteristics and clinical performance of lithium silicate crowns in comparison to monolithic zirconia crowns. The quality of the overall restorations as well as gingival tissues will be also evaluated according to modified United States Public Health Service (USPHS) criteria: (Marginal adaptation, color match, anatomic form, integrity of restoration, secondary caries, retention, tooth sensitivity, gingival index and periodontal index) at baseline, 6 months and 1 year

Detailed description

Recently advances in ceramics have greatly improved the mechanical and optical properties of restorative materials to overcome the drawbacks of all ceramic restorations over decades such as fracture, chipping, crack, wear and delamination of veneer ceramics. Up to date despite the popularity of all ceramic restoration, the clinicians have been worried about the wear of tooth enamel antagonist to ceramic materials. The wear properties of the ceramic restoration can affect the rate of wear of the antagonist enamel. So the wear resistance of ceramic restoration must be the same as enamel. Explanation for choice of the comparator: Monolithic zirconia attracts many dentists worldwide due to its excellent mechanical properties, biocompatibility and appreciate aesthetics. Some in vivo studies demonstrated the clinical success of monolithic zirconia restorations as an antagonist to natural enamel with good marginal adaptation, accepted contour, occlusion and minimum gingival response. Batson et al. studied the quality of CAD/CAM fabricated single tooth restorations (Ten zirconia restorations were compared to 12 metal ceramic and 10 lithium disilicate counterparts) .They found that were no significant differences between the studied crown systems. No difference of the gingival response among the different crown systems. Eighty percent of zirconia crowns needed no occlusal adjustment; also it showed the least amount of marginal discrepancy. Lohbauer et al. evaluated the amount of wear on the antagonist occlusal surfaces of clinically placed monolithic zirconia premolar and molar crowns using optical profilometry after 2 years of cementation, they found that the mean volume loss for enamel antagonist contacts (n = 7) was measured to 361 μm and the mean of the maximum vertical loss to 204 μm. The mean volume loss for pure ceramic contacts (n = 10) was measured to 333 μm and the mean of the maximum vertical loss to 145 μm. Mundhe et al.compared the wear of enamel opposing polished zirconia, glazed metal ceramic crowns and natural enamel as a control, one year after the cementation. They found that the occlusal wear of the antagonistic enamel one year after the cementation of metal ceramic crowns ranged from 69.20 ± 4.10 to 179.70 ± 8.09 μm, whereas, for zirconia crowns, it was from 42.10 ± 4.30 to 127.00 ± 5.03 μm. Stober et al. reported that after 2 years of cementation of the monolithic zirconia crowns, Mean and maximum vertical loss of enamel in occlusal contact areas caused by monolithic zirconia (46 and 151 μm, respectively) was approximately double that caused by contralateral antagonistic enamel (19-26 and 75-115 μm, respectively). A lithium silicate glass ceramic (obsidian ceramic) is newly introduced to the market. After crystallization, it exhibits an ideal combination of esthetics and strength with translucency that mirrors the vitality of natural teeth for fabrication of full anatomic anterior and posterior crowns. Obsidian ceramic restorations are highly resistant to chipping unlike other ceramics, due to their monolithic composition and average flexural strength of 385 MPa. Also Obsidian Milling Block owes its good wear resistance due to a very high content of ultrafine nanometer-size crystalline structure.

Interventions

OTHERmonolithic zirconia crowns

full anatomical monolithic crowns

OTHERlithium silicate crowns

lithium silicate glass ceramics are highly resistance to chipping

Sponsors

Cairo University
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)

Intervention model description

Patient will receive a restoration with superior function, esthetics, and excellent clinical performance.

Eligibility

Sex/Gender
ALL
Age
21 Years to 50 Years
Healthy volunteers
Yes

Inclusion criteria

* All subjects are required to be: 1. Age range of the patients from 21-50 years old; able to read and sign the informed consent document, illiterate patient will be avoided. 2. Patients able physically and psychologically to tolerate conventional restorative procedures. 3. Patients with no active periodontal or pulpal diseases, having teeth with good restorations. 4. Patients with teeth problems indicated for full coverage restoration (e.g. moderate to severe discoloration, coronal fracture where partial coverage would lack retention, malposed or malformed teeth). 5. Patients with root canal treated teeth requiring full coverage restorations. 6. Presence of an opposing natural tooth which is non-restored or minimally restored. (Minimally restored is defined as teeth which have no restoration greater than a Class II a restoration) 7. The opposing arch doesn't have a full coverage restoration or a partial denture. 8. Patients willing to return for follow-up examinations and evaluation.

Exclusion criteria

<!-- --> 1. Patients with poor oral hygiene. 2. Patients with psychiatric problems or unrealistic expectation (patient that has phobia from dental treatments or needle bunch). 3. Patients have no opposite occluding dentition in the area intended for restoration 4. Patients suffer from Para functional habits or temporomandibular disorders. (as those patient may have wear which will affect the results)

Design outcomes

Primary

MeasureTime frameDescription
Wear of all ceramic crowns and color matching12 month(Wear of ceramic crowns) of the two groups will be assessed using the 3D optical profilometer.
color matching12 monthColor match of the two groups will assessed using the modified United States public health service (USPHS) criteria as follows: * Alpha (Excellent) ideal. * Bravo (Acceptable) less than ideal but no modifications required * Charlie (Acceptable but modifications needed) staining or other shade modifications required. * Delta (Unacceptable) remake.

Secondary

MeasureTime frameDescription
anatomic form12 monthof the two groups will assessed using the modified United States public health service (USPHS) criteria as follows: * Alpha (Excellent) ideal. * Bravo (Acceptable) less than ideal but no modifications required * Charlie (Acceptable but modifications needed) modifications required. * Delta (Unacceptable) remake.
integrity of restoration12 monthof the two groups will assessed using the modified United States public health service (USPHS) criteria as follows: * Alpha (Excellent) ideal. * Bravo (Acceptable) less than ideal but no modifications required * Charlie (Acceptable but modifications needed) modifications required. * Delta (Unacceptable) remake.
secondary caries12 monthof the two groups will assessed using the modified United States public health service (USPHS) criteria as follows: * Alpha (Excellent) ideal. * Bravo (Acceptable) less than ideal but no modifications required * Charlie (Acceptable but modifications needed) modifications required. * Delta (Unacceptable) remake.
Wear of enamel antagonist to all ceramic crowns12 monthwear of antagonist enamel of the two groups will be assessed using the 3D optical profilometer.
opposing tooth sensitivity12 monthof the two groups will assessed using the modified United States public health service (USPHS) criteria as follows: * Alpha (Excellent) ideal. * Bravo (Acceptable) less than ideal but no modifications required * Charlie (Acceptable but modifications needed) modifications required. * Delta (Unacceptable) remake.
gingival condition12 monthGingival index by Visual inspection using Score from 0-3
periodontal condition12 monthPeriodontal index by Periodontal probe using Score from 0-4
retention12 monthof the two groups will assessed using the modified United States public health service (USPHS) criteria as follows: * Alpha (Excellent) ideal. * Bravo (Acceptable) less than ideal but no modifications required * Charlie (Acceptable but modifications needed) modifications required. * Delta (Unacceptable) remake.
Marginal adaptation12 monthof the two groups will assessed using the modified United States public health service (USPHS) criteria as follows: * Alpha (Excellent) ideal. * Bravo (Acceptable) less than ideal but no modifications required * Charlie (Acceptable but modifications needed) modifications required. * Delta (Unacceptable) remake.

Countries

Egypt

Contacts

Primary Contactrasmia salem, msc
rasmia.salem@yahoo.com01024340442

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026