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

牙侵蚀是公认的全球公共口腔健康问题，导致患者严重的审美和功能障碍。上颚和下颚的前牙和后牙显示牙齿物质大量流失。用传统的金属陶瓷全覆盖冠修复这些牙齿通常涉及选择性牙髓治疗、手术冠延长手术和主要的牙齿结构损失。因此，微创人工制造修复体被开发出来，但由于其高昂的成本，大多数患者无法使用。基于计算机辅助设计/制造（CAD/CAM）的新技术可以引入一种微创且经济实惠的修复方法，使广大患者能够获得口腔健康。迄今为止，缺乏关于其临床行为的高水平证据。因此，本申请提出一项随机对照非劣效性多中心前瞻性临床试验。采用微创CAD/CAM复合材料修复体进行治疗干预后，严重糜烂病变患者的中期表现将与手工制作的微创全陶瓷修复体进行比较。将讨论对患者生活质量的影响以及以患者为中心的审美和功能治疗结果满意度。如果新的CAD/CAM方法显示出与手工制作修复体相当的结果，该技术可能成为更广泛的患者客户的高可及性护理标准。

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.