Clinical Effects Observation Of Ceramage Polymerid Porcelain Inlays Or Onlays In Pulpless Posterior Tooth Defects

Background: Tooth defect is a common and frequently-occurring disease in oral clinic.It is very important to treat and repair the posterior teeth defects caused by caries,abrasion and trauma to the maximum extent for the stable maintenance of oral occlusal relationship and the effective play of masticatory efficiency.The pulpless posterior teeth are more fragile,less sensitive to chewing load and higher risk of fracture after root canal therapy.Therefore,the prosthodontic treatment through inlays or onlays,full crowns or post-core crowns is of great significance to increase the fracture resistance of pulpless posterior teeth,improve the success rate of restoration and restore oral function.In recent years,along with social progress and economic development,the prosthesis made by ideal restorative materials needs to achieve the dual consideration of restoration both function and aesthetics.At present,the reliability of bonding technology has been improved,restoration materials are developing rapidly,porcelain resin composite materials have been increasingly used in dental prosthetics because they can improve the brittleness of glass-ceramic and make up for the shortcomings of composite resin in wear resistance and color stability.Ceramage polymerid porcelain inlays or onlays are more and more popular with dentists because of their advantages such as lower dental preparation,conforming to tooth stress characteristics,elastic modulus similar to tooth,less polymerization shrinkage,simple bonding process and easy repair,etc.Repairing tooth defects of pulpless posterior teeth is an important daily clinical work of dental restoration workers.It is a goal to strive of dentists to provide patients with a long-term stable and optimal prosthesis.Objective: This study intends to use Ceramage polymerid porcelain inlays or onlays to repair the defects of pulpless posterior teeth.Through regular follow-up observation,the effect of restoration will be evaluated by using the modified American Public Health Service(USPHS)evaluation standard and combining with patient satisfaction.Materials and methods: From October 2021 to December 2022,29 patients with pulpless posterior tooth defects who were treated with Ceramage polymerid porcelain inlays or onlays in the Department of Prosthodontics,Stomatological Hospital Affiliated to School of Stomatology,Dalian Medical University were selected for inclusion in this study(including 12 males and 17 females,aged 16-53 years);33affected teeth(including 9 premolars and 24 molars);A total of 33 prostheses(including 7 inlays and 26 onlays).All cases met the indications for inlays or onlays restoration of pulpless posterior tooth defects.The final treatment plan was determined after full communication between doctors and patients and signing of informed consent.Personalized tooth preparation of inlays or onlays was carried out according to the degree of tooth defect,and the restoration was completed in strict accordance with the standard treatment process and bonding procedure.After a follow-up visit of 3 to 12 months,using the modified USPHS evaluation standard,the same doctor completed the clinical examination and evaluation of the affected tooth(including color of the prosthesis,edge tightness,degree of edge coloring,integrity of the teeth,degree of wear of the prosthesis,retention of the prosthesis,degree of secondary caries,and adjacent relationship)and periodontal(including gingival index,plaque index,degree of tooth mobility,and degree of alveolar bone absorption).At the same time,the patients’ satisfaction with the aesthetics,functionality and wearing comfort of the prosthesis should be understood,so as to comprehensively evaluate the short-term clinical effect of Ceramage polymerid porcelain inlays or onlays in repairing the defects of pulpless posterior teeth.Results: In this study,29 patients with Ceramage polymerid porcelain inlays or onlays completed follow-up within 3 to 12 months,with a follow-up rate of 100%.Evaluation of clinical restorative effect:(1)Tooth index: in 33 restorations,except 2cases,the edges of the restorations were slightly stained,but could be removed by polishing;1 case was slightly loose adjacent;A total of 3 cases were rated as Grade B,and all the evaluation indicators of the remaining cases were Grade A,accounting for91%.None of the indicators in all cases showed grade C evaluation;(2)Periodontal indicators: Among the 33 restorations,except for one case of thin plaque on the tooth surface of the marginal gingival area that can be scraped by the probe tip,which was rated as Grade B,all the other patients had good oral hygiene,healthy gums around the restorations,no bleeding during probing,and sterile plaque in the marginal gingival area.All the evaluation indicators of the remaining were Grade A,with Grade A accounting for 97%.None of the indicators in all cases showed grade C and D evaluation.Patient satisfaction survey: all patients were satisfied with the aesthetics,functionality and wearing comfort of the prosthesis.Conclusion:The application of Ceramage polymerid porcelain inlays or onlays to repair the defect of pulpless posterior teeth can achieve good short-term clinical restoration effect,which is a reliable minimally invasive restoration method,but the long-term clinical effect still needs further observation.