Clinical Case Report Of All-ceramic Onlays For Restoration Of Pulpless Posterior Dental Defects

Objective: Tooth defect is a common and frequently-occurring disease in stomatology.The maximum treatment and retention of posterior teeth caused by dental caries,trauma is an important guarantee for normal chewing function of the oral cavity.Due to increased brittleness and decreased perception of external load,the pulpless posterior teeth are more prone to fracture.Therefore,the application of inlays,onlays,full crowns and post-core crowns in the restoration of the pulpless posterior teeth,especially those with a wide range of dental defects,is of great significance to improve the fracture resistance,the success rate of restoration and the improvement of oral function.In recent years,with social progress and economic development,patients’ restoration needs have shifted from focusing on function to taking into account both function and aesthetics.Thanks to the improvement of ceramic material performance and the improvement of bonding technology reliability,the amount of tooth preparation for IPS e.Max Press onlay,It is more in line with the stress characteristics of the tooth,the porcelain material has high abrasion resistance,good biocompatibility and stable color,etc.The advantages of more and more clinicians are concerned and selected.Increasing the success rate of repair,while obtaining long-term stable treatment effects has always been the goal of clinicians.In this study,we planned to use IPS e.Max Press onlays to repair pulpless posterior dental defects.Through regular follow-up observation,we evaluated the effect of the restoration treatment using the modified US Public Health Service(USPHS)evaluation criteria.Methods: A total of 38 patients with dental defects undergoing IPS e.Max Press onlays in the Department of Prosthodontics,Stomatological Hospital Affiliated to School of Stomatology,Dalian Medical University from October2019 to November 2020 were included in this study(16 males and 22females;Aged 20-67);40 posterior teeth(including 7 premolars and 33 molars)were involved;A total of 40 prostheses were included,including 31 full-tip overlay onlays and 9 partial tip overlay onlays.All the patients were indicated for hyperinlay repair,and the repair and treatment plan was determined after full communication between doctors and patients and informed consent of patients.According to the degree of tooth defect,individualized onlay design was carried out for each affected tooth,and the restoration was completed according to the conventional treatment steps and standard operating procedures.3 ～ 15 months follow-up observation,the improvement of the U.S.Public Health Service,the US Public Health Service,USPHS)evaluation criterion,respectively,from the restoration of the color,shape,edge coloring,restoration suitability,restoration of wear,gums,adjacency relations,these a few respects with with high casting porcelain inlay repair without pulp after fang body defect to evaluate the short-term clinical effect.Inclusion criteria: The abutment had received complete root canal therapy,and X-ray filling was performed;No obvious absorption of alveolar bone or less than 1 /3 of root length;Normal occlusal relationship;Good oral hygiene,no untreated periodontitis;The patients were in good general condition and good compliance.The patients informed their consent to participate in this study and were willing to cooperate with long-term follow-up.Results: In this study,all the patients with inlay repair were revisited on schedule without loss of follow-up,and the follow-up rate was100%.Follow-up observation from 3 to 15 months after repair showed that all the other indicators were grade A,except 1 case with slightly loosened adjacency and grade B,3 cases with edge staining and 4 cases with color of the prosthesis,and the proportion of all evaluation indexes of grade A was more than 90%,achieving good clinical repair effect.Conclusion: IPS e.Max Press onlays are a minimally invasive and reliable method for repairing pulpless posterior dental defects,which has good short-term clinical effect and is worthy of clinical application.However,the long-term clinical effect remains to be further observed.