Retrospective Clinical Evaluation Of IPS E.max Press Ceramic Restorations In The Posterior Teeth

Objectives: To evaluate the clinical performance of IPS e.max Press(Ivoclar Vivadent)all-ceramic restorations in posterior teeth and its application in endodontically treated posterior teeth.Materials and Methods: Seventy-seven patients whose teeth had been restored with 109 IPS e.max Press all-ceramic restorations in endodontic department of Guangxi Medical University during the period of August 2013 to December 2018 were enrolled in this study.Clinical evaluations such as integrity of restorations,marginal adaptation,marginal discoloration,surface texture,recurrent caries,etc.were carried out together with patient satisfaction survey.In addition,the analysis and evaluation of the radiographic signs for periodontal and periapical diseases were also carefully recorded.The analysis standard was based on the modified United States Public Health Service(USPHS criteria)and the results were statistically analyzed.Kaplan-Meier survival rate analysis was used to calculate the cumulative survival rates of all-ceramic restorations,Log-rank analysis was used to analyze the relationship between survival rate and possible influence factors such as restoration type,tooth position and vitality status while Cox regression was used to evaluatesome risks factors such as different impression and fabricating methods,and follow-up time that might influence the survival rate of restorations.Results:1.The results of Kaplan-Meier survival rate analysis showed that one year survival rate of the all-ceramic CAD/CAM restorations was 96.8 %while five years survival rates had dropped to 79.8%.The survival rate of ceramic restorations illustrated as a decreasing trend with an increasing functional period.According to Log-Rank analysis,there was no statistical significance between the restoration types,tooth positions,vitality of abutment teeth and the survival rate of all-ceramic restorations(P>0.05).Moreover,Cox regression analysis illustrated that there was no statistical significance between different types of restorations and the survival rates(P>0.05),however,longevity of follow-up time,different impression and fabricating techniques were found to have a statistical significance with the survival rate of all-ceramic restorations(P< 0.05).2.Patients’ satisfaction survey: According to the results of questionnaire,overall satisfaction rate was more than 96% in restoration color and appearance,98% in comfort and 100% satisfaction in the number of visits.Conclusions:1.Overall success rate and patient satisfaction rate of IPS e.max Press ceramic restorations were found to be satisfactory.2.Different impression taking and fabrication methods have a certain impact on the survival rate of the restorations.3.The study did not find that different restoration types,tooth position and vitality of the teeth have significant impact on the survival rate of the IPS emax press ceramic restorations.