2017 Oregon Dental Conference Course Handout

Transcription

1 2017 Oregon Dental Conference Course Handout Steven Gold, DDS Course 8168: Soft Landings: An Evidencebased Approach to Minimizing CAD/CAM Catastrophes Saturday, April 8 8 am - 11 am

2 Soft Landings: An Evidence-based Approach to Minimizing CAD/CAM Catastrophes Contact: Steven A. Gold, D.D.S. Steven A. Gold, D.D.S. Part 1: Learning Objectives 1. Learn what the evidence in the peer-reviewed literature says about the clinical success of CAD/CAM restorations. 2. Learn why there are limitations to the peer-reviewed literature on CAD/CAM dentistry. 3. Learn what scientific evidence is exists comparing different commerciallyavailable CAD/CAM systems. 4. Learn what the literature shows us about the success of all-ceramic materials used in CAD/CAM dentistry. 5. Following the principles of evidence based dentistry, learn the foundations of a clinical protocol for CAD/CAM, including treatment planning, preparation design, scanning, restoration design, milling, and cementation. 6. By evaluating clinical mistakes, learn how to minimize or avoid them.

3 Part 2: Articles Referenced General Wittneben JG, Wright RF, Weber HP, Gallucci GO (2009) A systematic review of the clinical performance of CAD/CAM single-tooth restorations. Int J Prosthodont; 22(5): Fasbinder DJ(2006) Clinical performance of chairside CAD/CAM restorations. J AM Dent Assoc; 137 Suppl: 22s-31s Ahlholm P, Sipila K, Vallittu P, Jakonen M, Kotiranta U (2016) Digital Versus Conventional Impressions in Fixed Prosthodontics: A Review. J Prosthodont; doi: /jopr [Epub ahead of print] Conrad H, Seong W-J, Pesun I (2007) Current ceramic materials and systems with clinical recommendations: a systematic review. J Prosthet Dent; 98(5):

4 Materials Kelly JR, Benetti P. Ceramic materials in dentistry: historical evolution and current practice. Austr Dent J 2011;56:(1 Suppl):1-13. Fasbinder DJ (2012) Chairside CAD/CAM. An overview of restorative material options. Compend Contin Educ Dent; 33(1): 50, Belli R, Wendler M, de Ligny D, Ciddoni MR, Petschelt A, Peterlik H, Lohbauer U. (2017) Chairside CAD/CAM materials. Part 1: Measurement of elastic constants and microstructural characterization. Dent Mater; 33(1): Wendler M, Belli R, Petschelt A, Mevec D, Harrer W, Lube T, Danzer R, Lohbauer U. (2017) Chairside CAD/CAM materials. Part 2: Flexural strength testing. Dent Mater; 33(1):

5 Pieger S, Salman A, Bidra AS(2014) Clinical Outcomes of Lithium Disilicate Single Crowns and Partial Fixed Dental Prostheses: A Systematic Review. J Prosthet Dent 2014 Jul; 112(1): Ma L, Guess P, Zhang Y (2013) Load-bearing properties of minimally-invasive monolithic lithium disilicate and zirconia occlusal onlays. Dental Materials (2013); 29: Vanoorbeek S, Vandamme K, Lijnen I, Naert I(2010) Computer-Aided Designed/Computer-Assisted Manufactured Composite Resin Versus Ceramic Single-Tooth Restorations: A 3-Year Clinical Study. Int J Prosthodont(2010); 23(3): Lin, W.-S., Ercoli, C., Feng, C. and Morton, D. (2012), The Effect of Core Material, Veneering Porcelain, and Fabrication Technique on the Biaxial Flexural Strength

6 and Weibull Analysis of Selected Dental Ceramics. Journal of Prosthodontics, 21: doi: /j x x Restoration Type Martin N, Jedynakiewicz NM. (1999) Clinical performance of CEREC ceramic inlays: a systematic review. Dent Mater 1999;15: El-Mowafy O, Brochu JF. Longevity and clinical performance of IPS-Empress ceramic restorations: a literature review. J Can Dent Assoc 2002;68: Haselton DR, Diaz-Arnold AM, Hillis SL. Clinical assessment of high-strength allceramic crowns. J Prosthet Dent 2000;83:

7 Guess PC, Schultheis S, Bonfante EA, Coelho, PG, Ferencz, JL, Silva, NRFA. All- Ceramic Systems: Laboratory and Clinical Performance. Dent Clin N Am 2011;55: Marquardt P, Strub JR. Survival rates of IPS empress 2 all-ceramic crowns and fixed partial dentures: results of a 5-year prospective clinical study. Quintessence Int 2006;37(4): Dong JK, Luthy H, Wohlwend A, et al. Heat-pressed ceramics: technology and strength. Int J Prosthodont 1992;5(1):9-16. Kelly JR. Dental ceramics: current thinking and trends. Dent Clin N Am 2004;48:

8 Christel P, Meunier A, Heller M, et al. Mechanical properties and short-term in vivo evaluation of yttrium-oxide-partially-stabilized zirconia. J Biomed Mater Res 1989;23(1): Piconi C, Maccauro G. Zirconia as a ceramic biomaterial. Biomaterials 1999;20(1):1-25. Guess PC, Schultheis S, Bonfante EA, Coelho, PG, Ferencz, JL, Silva, NRFA. All- Ceramic Systems: Laboratory and Clinical Performance. Dent Clin N Am 2011;55: Kobayashi K, Kuwajima H, Masaki T. Phase change and mechanical properties of ZrO2-Y2O3 solid electrolyte after aging. Solid State Ionics 1981;3:

9 Tooth Preparation Muller V, Friedl KH, Friedl K, Hahnel S, Handel G, Lang R (2016) Influence of proximal box elevation technique on marginal integrity of adhesively luted Cerec inlays. Clin Oral Invesstig; [Epub ahead of print] Magne P(2005) Immediate dentin sealing: a fundamental procedure for indirect bonded restorations. J Esthet Restor Dent; 17(3): ; discussion 155. Scanning and Design Neves FD, Prado CJ, Prudente MS, Carneiro T, Zancope K, Davi LR, Mendonca G, Cooper LF, Soares CJ (2014) Micro-computed tomography evaluation of marginal fit of lithium disilicate crowns fabricated by using chairside CAD/CAM systems or the heat-pressing technique. J Prosthet Dent; 112(5):

10 Cementation Van den Breemer CR, Gresnigt MM, Cune MS (2015) Cementation of Glass- Ceramic Posterior Restorations: A Systematic Review. Biomed Res Int; 2015: doi: /2015/ Epub 2015 Oct 18. Part 3: Post Test 1. Which of the following is true about scanning and digital impressions? a. Digital impression accuracy is at the same level as conventional impressions for crowns. b. Digital impression accuracy is at the same level as conventional impressions for full arch impressions. c. Digital impressions have been proven inaccurate and should not be used for tooth restorations. d. Digital impressions are only compatible with chairside CAD/CAM units and cannot be used for laboratory fabricated restorations. 2. According to the most current systematic review on clinical performance, what is the 5 year survival rate for single-tooth CAD/CAM restorations? a. 98.5% b. 95.6% c. 91.6% d. 82%

11 3. The chairside CAD/CAM material with the highest flexural strength is: a. Zirconia b. Lithium disilicate c. Polymer-infiltrated reinforced glass network d. Lithium silicate/phosphate 4. Which of the following types of restorations demonstrate a clinical survival rate of less than 90%? a. Inlays and onlays b. Fixed partial dentures c. Anterior single unit crowns d. Posterior single unit crowns 5. Which of the following is not an advantage of CAD/CAM restorations? a. Conservation of tooth structure b. Single appointments for restorations possible c. Minimal cost investment and learning curve d. No provisional restoration needed 6. Which of the following is a desired feature of tooth preparations for CAD/CAM restorations? a. Sharp internal line angles b. A 0.5 mm deep shoulder-bevel margin c. Proximal margins in contact with adjacent teeth d. Continuous enamel margins 7. True or False: There are abundant clinical studies showing that immediate dentin sealing increases the clinical survival rate of all ceramic restorations. a. True b. False

12 8. True or False: Restorations produced by the CEREC system show better marginal fit than those produced by the E4D system. a. True b. False 9. Which of the following is not part of the official balloonists prayer? a. Fair winds b. Friendly fields c. Soft landings d. Cold Champagne Part 4: Answer Key 1. a 2. c 3. a 4. b 5. c 6. d 7. b 8. a 9. d, although all certainly are important