Two-year evaluation of periodontal parameters following deep-margin-elevation and CAD/CAM partial lithium disilicate restorations – a prospective controlled clinical trial

IF 4.8 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry Pub Date : 2025-06-18 DOI:10.1016/j.jdent.2025.105901

Tim Hausdörfer , Philipp Kanzow , Tina Rödig , Annette Wiegand , Clemens Lechte

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Abstract

Objectives

This prospective clinical trial evaluated periodontal parameters at proximal deep-margin-elevation (DME) restoration margins 2 years after placement and compared them with baseline values and with supragingival/equigingival margins (control) on the opposite proximal surface of the same tooth.

Methods

One-sided subgingival proximal defects in (pre-)molars were restored using composite DME and CAD/CAM-manufactured lithium disilicate partial restorations. Periodontal parameters (bleeding on probing (BOP), probing depths (PD), plaque index (PI)) were recorded after ceramic insertion (baseline) and at 2-year follow-up, and compared between DME and control (Fisher’s exact test and Wilcoxon signed rank test, p < 0.05).

Results

Sixty-eight patients with 77 restorations were included; 51 patients with 57 restorations were re-evaluated at 2 years. Two restorations were replaced (ceramic fracture, secondary caries), and one tooth developed apical periodontitis. Periodontal parameters were not significantly different at baseline. After 2 years, BOP increased significantly at the DME (p_adj. = 0.010), but not at controls (p_adj. = 0.517); but BOP was not significantly different between DME and control (p_adj. = 0.110). PD was significantly higher in DME vs. control (p_adj_. = 0.015), but remained stable in both groups over the 2-year period (DME: p_adj_. = 0.171, control: p_adj_. = 0.517). PI increased significantly in both groups (p_adj. < 0.001), but did not differ between both sides (p_adj. = 0.341).

Conclusion

Proximal DME was associated with increased gingival inflammation at 2-year recall compared to baseline.

Clinical significance

DME is a promising approach for restoring teeth with deep proximal defects, but proximal DME is associated with increased gingival inflammation. The periodontal situation remains stable after the first year of placement.

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深度边缘提升和CAD/CAM部分二硅酸锂修复后牙周参数的两年评估-一项前瞻性对照临床试验

目的：本前瞻性临床试验评估放置2年后近端深缘提升（DME）修复边缘的牙周参数，并将其与基线值以及同一牙齿近端对面的龈上/等龈边缘（对照组）进行比较。方法采用DME复合材料和CAD/ cam制备的二硅酸锂局部修复体修复单侧磨牙龈下近端缺损。牙周参数（探诊出血（BOP）、探诊深度（PD）、菌斑指数（PI））在植入后（基线）和2年随访时被记录下来，并在DME和对照组之间进行比较(Fisher精确检验和Wilcoxon符号秩检验，p <；0.05)。结果共纳入68例患者77个修复体；51例患者的57个修复体在2年时被重新评估。两个修复体被替换（陶瓷骨折，继发性龋齿），一个牙齿发生根尖牙周炎。牙周参数在基线时无显著差异。2年后，DME （padj）的防喷器显著增加。= 0.010)，但对照组没有(padj。= 0.517);DME与对照组间BOP差异不显著。= 0.110)。DME组PD明显高于对照组。= 0.015)，但两组在2年期间保持稳定(DME: padj。= 0.171，对照组：padj。= 0.517)。两组PI均显著升高（p < 0.05）。& lt;0.001)，但两组间无差异（0.001）。= 0.341)。结论与基线相比，近端DME与2年回忆时牙龈炎症增加有关。edme是修复近端深度缺损的一种很有前途的方法，但近端DME与牙龈炎症增加有关。牙周情况在第一年后保持稳定。

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来源期刊

Journal of dentistry 医学-牙科与口腔外科

CiteScore

7.30

自引率

11.40%

发文量

349

审稿时长

35 days

期刊介绍： The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis. Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research. The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.