| Objective In this study,chairside CAD/CAM CEREC AC system combined with IPS e.max CAD ceramics was used to complete crown restoration after root canal treatment of molars and 3-year follow-up.Applying minimally invasive restoration and multidisciplinary knowledge to provide therapeutic basis for clinical crown restoration,thus achieving the goal of long-term preservation of root canal for endodontically treated teeth(ETT).Methods Select patients who needed root canal treatment and crown restoration due to molar pulpitis from the Department of Endodontics of Tianjin Stomatology Hospital.A total of 114 patients and 137 teeth were collected.Root canal treatment and systematic periodontal therapy were applied to diseased teeth.According to the thickness of tooth tip,onlay or overlay was selected for crown restoration.No operation,gingival edge lifting operation or crown lengthening operation were selected according to the position of the pit edge.According to the different treatment protocols,they could be divided into 6 groups: Group A1: onlay+ no surgery,Group A2: onlay+ gingival edge lifting,Group A3: onlay+ crown lengthening,Group B1: overlay+ no surgery,Group B2: overlay+ gingival edge lifting,Group B3: overlay+ crown lengthening.After the crown restoration treatment was completed,the diseased teeth were reexamined at each 6 months.After the restoration treatment was completed,the image data and oral photos of the diseased teeth before,during,after treatment and follow-up were collected.A total of 137 prostheses were evaluated according to the modified USPHS standard(restoration integrity,marginal suitability and adjacency relation)and periodontal examination index(debris index and bleeding index).The cumulative survival rate of the restoration and analyze the factors affecting the restoration failure.To investigate the effects of two crown restoration methods,onlay and overlay,and tooth edge lifting scheme(gingival edge lifting or crown lengthening)on survival rate.SPSS 22.0 software was used to process and analyze the collected data.Results 1.In this experiment,137 teeth(114 patients)were studied for root canal treatment and crown restoration,with a total of 137 restorations,including 60 in the onlay group and 77 in the overlay group.2.More than 95% of restoration integrity score,marginal suitability score and adjacency relation score reached the A-level standard,respectively.More than 90% of the bleeding index reached a score of 0 and 1.More than 89% of the debris index reached a score of 0 and 1.At the follow-up every 6 months,there was no statistical difference in the index between the onlay group and the overlay group(P> 0.05).3.Of 137 restorations in 3 years,9 failed,including 5 fractured restorati ons,2 loss restorations,1vertical root fracture(VRF),1 fractured tooth,with 36-month survival rate of 93.0%.Group A: 6 onlay restorations failed,with a 36-month survival rate of 89.6%.Group B: 3 overay restorations failed,with a 36-month survival rate of 95.7%.Through Log Rank test,the results showed that there was no significant difference in survival rates between the onlay group and the overlay group(P> 0.05).4.The 36-month survival rate of Group A1 is 90.9%,Group A2 is 84.2,Group A3 and Group B1 are all 100%,Group B2 is 94.3%,Group B3 is 92.2%.There was no significant difference in survival rates between the six groups(P> 0.05).Conclusions 1.The main reasons for the failure of crown restoration were fracture and loss of prosthesis,vertical root fracture and tooth fracture,and fracture of restoration is the main failure cause.2.The clinical efficacy of onlay and overlay restorations is the same by observing 3-year indexes and 3-year survival rate.The clinical efficacy of onlay and overlay restorations after root canal treatment is good.3.There was no statistical difference in the clinical efficacy of onlay and overlay groups combined with gingival edge lifting or crown lengthening.5.The clinical application effect of chairside CEREC AC system combined with IPS e.max CAD ceramics was good... |
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