CAD/CAM composite vs ceramic minimal invasive therapeutical intervention of severe non carious lesions: Clinical performance and quality of life improvement

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Dental erosion is recognized as a global public oral health problem leading to significant aesthetic and functional impairments of affected patients. Anterior and posterior teeth in the upper and lower jaw reveal extensive tooth substance loss. Restoring such teeth with conventional metal-ceramic full-coverage crowns frequently involves elective endodontic therapy, surgical crown lengthening procedures and major additional loss of tooth structure. Minimal invasive manually fabricated restorations were hence developed, but are ¿ due to their high costs ¿ not available to the majority of patients. New techniques based on computer aided design/manufacturing (CAD/CAM) could introduce an innovative approach for minimal invasive and yet affordable restorations, making oral health available to a wide patient population. To date, high-level evidence on their clinical behaviour is lacking. Therefore the present application proposes a randomized controlled non-inferiority multicentre prospective clinical trial. The mid-term performance of patients with severe erosive lesions after therapeutical intervention with minimal invasive CAD/CAM fabricated composite restorations will be compared to manually produced minimal invasive all-ceramic restorations. The impact on patient´s quality of life and patient-centred satisfaction with the aesthetic and functional treatment outcome will be addressed. If the new CAD/CAM approach shows comparable results to manually produced restorations, this technique could become the standard of care with a high accessibility to a wider patient clientele.