2-years clinical outcome of indirect CAD-CAM chairside overlay restorations

Objectives: Indirect restorations are daily employed as a minimally invasive solution to restore teeth strongly damaged by caries or fractures, with the purpose to preserve sound tissue while restoring function. The aim of this study is to retrospectively investigate in vivo the clinical performance of indirect restorations over time in correlation with three factors: quantity of residual enamel, endodontic treatment and material employed for the restoration. Methods: All teeth were restored using three materials: Grandio Blocs, Voco, Cuxhaven; Cerasmart, GC, Tokyo; E-Max Cad, Ivoclar Vivadent, Shaan. Overall cumulative survival rates were calculated and compared among three variables: quantity of residual enamel, endodontic treatment and material employed. Qualitative evaluation of all surviving restorations was performed using the modified United States Public Health Service (USHPS). Statistical analysis for the obtained data was performed with Chi-square tests and significance was set for p < 0.05. Results: A total of 213 indirect restorations in 142 patients was included. The majority of restoration received Alpha1 and Alpha2 values for the USHPS parameters. Small percentage of failures was determined. Teeth with a percentage of enamel >75% and vital teeth performed better in terms of color match and radiographic examination. Materials did not influence the clinical outcome. Statistical difference was found in the variable color matching when employing Cerasmart (p <0.05). Conclusions: Materials employed in indirect restorations did not influence the clinical outcome. Failure in color matching was related to low percentage in enamel and absence of vitality. Cerasmart showed a better color match over time.