Missing Tooth Clinical Trial
Official title:
Clinical Assessment Of Inlay Retained Bridge Designs (Tub Shaped And Inlay Shaped) In Missing Posterior Teeth Cases.
The interest in partial coverage retainers such as inlays and onlays have increased
drastically because these restorations are able to provide a more conservative option
requiring minimal tissue removal thus preserving healthy tooth structure to a maximum extent.
If patient rejects an implant treatment and enough sound tooth structure is available it
would be desirable to restore a missing tooth with Inlay-Retained Fixed Partial Denture
instead of full coverage retained one .
The use of all-ceramic materials for inlays and onlays in restorative dentistry is becoming
more popular , the proper selection of restorative materials, careful preparation design and
adequate adhesion between tooth/restorative material interfaces considered important factor
to prevent failures .
Zirconia was introduced into dentistry in the 1990s.The high initial strength and fracture
toughness of zirconia results from a physical property of partially stabilized zirconia known
as transformation toughening. On the other hand, its white color, similar to the color of
natural teeth and its ability to transmit light makes it useful in aesthetically important
areas .
Inlay Fixed Partial Denture restoration may have increased the risk of fracture due to the
relative small size of restorations compared to the complete coverage restoration. An
unfavorable distribution of stresses between the ceramic inlay and tooth structure may result
in marginal deterioration around the inlay or its failure.
The direction of forces on the occlusal surface of Inlay Fixed Partial Denture may lead to
the phenomenon of submargination, ceramic fracture, wear at interface and postoperative
hypersensitivity which remain a problem that require further investigation. One of the most
important factors in the success and longevity of a restoration is to have an accurate
marginal fit. Ideally, the cemented restoration should precisely meet the finish line of the
prepared tooth. In reality, clinical perfection is challenging to achieve and to verify.
The tub-shaped inlay preparation design this consists of an occlusal proximal reduction
featuring a 3.5-4 mm width bucco-lingually, 3-3.5mm depth occluso-gingivally and 7-7.5 mm
length mesio distally for molars and 2.3-2.8mm width buccolingually, 3-3.5 mm depth occluso
gingivally and 3.5-4mm length mesiodistally for premolars. when necessary, superficial
extensions may also be made on the preparations so that the occlusal fossa included in the
preparation area and then the susceptibility for plaque accumulation will be diminished.
Participant timeline
The visits will be designated as follows:
Visit 1: one week after allocation, preoperative records, face-to-face adherence reminder
session, clinical examination, radiographic examination, intraoral photography and primary
impressions for diagnostic cast construction .
Visit 2: one week after the first visit, teeth preparations, secondary impression and
temporization .
Visit 3: one week after the second visit, try in for the restoration will be done.
Visit 4: one week after the try in, final cementation of the restoration.(GC resin cement)
Visit 5: follow up after twelve months from the cementation visit.
The aim of the study is to assess the fracture resistance of two inlay retained bridge
designs (tub shaped and inlay shaped) in missing posterior teeth cases. Based on previous
papers by Ohlmann et al., 2008 7 and İzgi et al.,2011 4 indicate that the failure rate among
controls is 52%. If the true failure rate for experimental subjects is 99%, we will need to
study 12 in each group to be able to reject the null hypothesis that the failure rates for
experimental and control subjects are equal with probability (power) 0.8. The Type I error
probability associated with this test of this null hypothesis is 0.05. We will use an
uncorrected chi-squared statistic to evaluate this null hypothesis. This number is to be
increased to 15 in each group (25% more than the calculated) to compensate for possible
losses during follow up. The sample size was calculated by PS: Power and Sample Size
Calculation software Version 3.1.2 (Vanderbilt University, Nashville, Tennessee, USA).
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