Tooth Fracture Clinical Trial
Official title:
Survival Rate of Adhesively Luted Veneers, an In-vivo Study
The aims of this clinical study are:
To evaluate the clinical performance between indirect composite and ceramic laminate veneers:
Main interests are:
- colour stability of the restoration (digital measurement in follow up)
- failure mode of the restoration
- wear of the restoration and antagonist
Hypothesis:
- The colour stability of indirect composite restorations will not be different from the
ceramic restorations.
- The indirect composite restorations will not be more prone to failure than the ceramic
restorations.
- Antagonist wear and restorative material wear will be similar for both ceramic and
composite.
Material and Methods The laminates will be fabricated according to a specified protocol. In
order to avoid possible noticeable differences in case of distinct levels of possible
discoloration, a modified split mouth design is employed where the central incisors and the
symmetric other teeth receive the same type of restoration. Randomization is based on the
paired teeth and it is performed using the flip of a coin for the choice of material.
Evaluation will be performed at baseline and at follow-up visits annually up to 2 years.
Patient recruitment: Patients will be recruited from the university clinic.
Intake: If the patient is included in the study following the inclusion and exclusion
criteria, the patient will be evaluated using the evaluation form. All the data will be
collected and impressions will be made. Using the impressions, a wax up will be made on stone
models indicating the restorations to be fabricated. With a transparent mould, the situation
will be duplicated in the mouth with spot etching and composite. By using this protocol
minimal loss of tooth material is guaranteed.
Tooth Preparation: After prophylaxis, the teeth will be prepared in a controlled manner using
special depth cutting laminate preparation burs (Intensive, Switzerland). The margins will
extend to half the way to the inter-proximal contact area. The shape of the cervical margins
will be maintained in chamfer form. The incisal edge will be prepared 1.5 mm to create an
overlap to the palatinal region for the translucency area in the laminate veneers.
Conditioning the tooth surface: Rubberdam will be placed. The preparation surfaces will be
etched with 35% phosphoric acid, rinsed thoroughly and dried followed by the application of
primer and the bonding agent.
Conditioning the existing restorations: The existing composite restaurations will be
conditioned using tribochemical silicacoating (CoJet, 30µm SiOx, 3M ESPE) in a Dentoprep
(Ronvig, Denmark) intraoral sandblaster. Following this the restauration will be conditioned
by silanisation.
Conditioning the composite veneers: The inner surfaces of the indirect composite laminates
will rinsed with alcohol and thereafter conditioned using tribochemical silicacoating (CoJet,
30µm SiOx, 3M ESPE) using an (Ronvig, Denmark) intra-oral sandblaster. The sandblasting will
be approx 13 sec until the inner surface of the restoration change colour visually. Following
this the inner surface will be conditioned by silanisation.
Conditioning the ceramic veneers: The inner surfaces of the ceramic laminates will be
conditioned with hydrofluoric acid 5% and rinsed in neutralizing agent, ultrasonically
cleaned and then silanized.
After insertion, the excess composite will be removed using handinstruments and finishing
burs under continuous water-cooling. Finally the margins will be polished using diamond
polishing-paste with a rotating rubber cup. The interproximal surfaces will be finished with
Sof-Lex polishing disks and strips.
Cementing the restorations: The cementation medium will be a dual-cure aesthetic adhesive
cement Variolink veneer. All adhesive restorations will be cemented using ultrasonic
insertion techniques. Cementation of the indirect restorations will be performed according to
a protocol presented in appendix 2: "Clinical procedures".
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