The clinical performance of CAD/CAM-fabricated hybrid ceramic restorations in cases with severe wear: A 3-year clinical trial

Clinical Snapshot

Key Findings

• P Value: Not reported for survival analysis

• Effect Size: 88.0% survival rate at 36 months

• Primary Outcome: 3-year survival rate of hybrid ceramic restorations

• Nnt Or Sensitivity: Complication rates: 5.2% dislodgement, 4.3% marginal chipping, 3.4% extensive fracture requiring replacement

• Confidence Interval: Not reported in abstract

Clinical Application

Requires CAD/CAM technology and expertise in digital dentistry, readily available in Australian specialist practice Relevant to Australian prosthodontic practice; hybrid ceramics increasingly used for complex rehabilitation cases. Consider PBS item numbers for complex prosthodontic procedures and specialist referral pathways Adult patients with severe tooth wear requiring extensive prosthetic rehabilitation

Abstract

PURPOSE: To evaluate the clinical use of CAD/CAM hybrid ceramics in patients with severe tooth wear. METHODS: Forty-nine patients with severe tooth wear underwent prosthetic management with 116 hybrid ceramic restorations. The restorations were evaluated at 1 week and at 3, 6, 12, 18, 24, 30, and 36 months after placement. The amount of wear on the restorations, antagonist teeth, and opposite teeth was compared using digital superimposition analysis. A questionnaire was used to evaluate participants' satisfaction with the restorations. Complications were recorded, and survival rates were estimated using Kaplan-Meier analysis. RESULTS: The clinical performance of the restorations was stable for esthetic, functional, and biological parameters up to 3 years, except for greater changes in "surface and margin staining" and "fracture and retention." There was no significant difference in the amount of progressive wear among the restorations, antagonist teeth, and opposite side teeth until 18 months; however, the wear on the restorations increased gradually up to 36 months. Higher scores and identical satisfaction results were obtained for the chewing efficiency and cleanability during the observation period. The most common complications were restoration dislodgement (5.2%) and partial marginal chipping (4.3%), which were clinically repaired. Four restorations (3.4%) were extensively fractured and replaced. The estimated survival rate of the hybrid ceramic restorations at 3 years was 88.0%. CONCLUSIONS: The clinical use of hybrid ceramic restorations in patients with severe tooth wear improved chewing efficiency and esthetics, provided adequate resistance for load-bearing, and delivered a stable treatment outcome after functional use.

References

1. 1.Yang, T. C., Shen, C. M., Chen, H. C., & Tseng, C. C. (2026). The clinical performance of CAD/CAM-fabricated hybrid ceramic restorations in cases with severe wear: A 3-year clinical trial. Journal of Prosthodontic Research. https://doi.org/10.2186/jpr.JPR_D_24_00267