| Objective The purpose of the study was to evaluate the preliminary clinical results of sol-gel coated self-glazed zirconia(SZ)in minimally invasive restorations(MIRs)based on an in vitro study of this new zirconia with enamel bonding.Methods Part I:The effect of sol-gel coating on the bond strength of SZ to enamel was evaluated in vitro in comparison with conventional milled zirconia treated by airborne-particle abrasion(CZa)and heat-pressed lithium disilicate glass-ceramics treated by etching and silanization(LDe).All ceramic specimens were bonded to the etched bovine enamel with resin cement.Shear bond strength test were then carried out on the bonded specimens and the surface morphology was observed by scanning electron microscopy.Part II:Patients who received sol-gel coated SZc2(SG)and pressable or milled lithium disilicate glass-ceramics(PG or MG)MIRs between June 2018 and December 2021 were included.Clinical outcomes of the restorations were assessed according to the modified United States Public Health Service criteria at baseline(restorations were cemented),and at follow-up time point.Overall patient satisfaction was assessed using visual analogue scale(VAS),and analyzed by one-way ANOVA.The chi-square test was carried out to compare the difference in the success and survival rates between SZ,PG,and MG MIRs(P<0.05).Results Part Ⅰ:Shear bond strength of both sol-gel coated SZ groups with different strategies(SZc1 and SZc2)was 20.00±7.07 MPa and 18.32 ± 3.63 MPa,respectively,which was comparable to that of LDe,18.44 ± 2.27 MPa(P>0.05)and significantly higher than that of CZa,11.72 ± 1.48 MPa,and SZ,3.06±1.66 MPa(P<0.05).Lots of voids between zirconia clusters were observed on the bonding surface of SZc1,yet that of SZc2 showed homogeneous honeycomb nanoporous structure.All groups exhibited mixed failure except SZ,and the fracture surfaces of SZc1,SZc2,and LDe showed better wettability than CZa.Part II:A total of 55 patients restored with 117 MIRs were included in the study(mean follow-up,16.4±4.0 months).All restorations performed well at baseline,except for 2 SG veneers which were color mismatched(rated Bravo).The follow-up results showed that besides 2 color mismatched SG veneers,slight marginal discrepancy(rated Bravo)was found in 1 MG veneer,and 1 PG inlay partially fractured with marginal secondary caries(rated Charlie).No debonding or marginal discoloration occurred in MIRs at the follow-up examination.The survival rates of SG,PG,and MG MIRs were 100%,97.4%,and 100%,with success rates were 94.7%,97.4%,and 97.6%,respectively.The mean VAS scale of SG,PG,and MG was 95.08 ± 1.43,94.14 ± 2.48,and 93.65 ± 2.84 respectively,none of which were significantly different(P>0.05).Conclusions Sol-gel coating could effectively improve the bond strength of SZ to enamel.The sol-gel coated SZ MIRs exhibited comparable preliminary clinical outcomes to PG and MG MIRs,which could be considered as a feasible option for minimally invasive restorative treatment. |
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