Abstract
This paper explores the planning and execution of indirect partial-coverage restorations and will outline practical recommendations for maximising the outcomes for minimally invasive (MI) approaches to indirect restorations, with a special focus on vital teeth, endodontically-treated teeth and worn dentitions. Throughout the paper, the supporting evidence for each rationale for partial-coverage restorations will be considered, as well as the risks and benefits of adopting an MI approach to indirect restorations.
Key points
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Partial coverage indirect restorations are less commonly prescribed by dental practitioners compared to full-coverage crowns.
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Improvements in material science and digital technologies are opening increased possibilities for aesthetic adhesive partial-coverage indirect restorations.
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This article highlights recent developments in the evidence base for these restorations as well as an algorithm supporting decision-making in fixed prosthodontics.
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References
Schwendicke F, Frencken J E, Bjørndal L et al. Managing carious lesions: consensus recommendations on carious tissue removal. Adv Dent Res 2016; 28: 58-67.
Schwendicke F, Splieth C, Breschi L et al. When to intervene in the caries process? An expert Delphi consensus statement. Clin Oral Investig 2019; 23: 3691-3703.
Zöchbauer H. Number of dental restorations worldwide. Market Research Ivoclar Vivadent. 2011.
Christensen G J. The case for onlays versus tooth-coloured crowns. J Am Dent Assoc 2012; 143: 1141-1144.
Jum'ah A, Creanor S, Wilson N, Burke F, Brunton P. Dental practice in the UK in 2015/2016. Part 3: aspects of indirect restorations and fixed prosthodontics. Br Dent J 2019; 226: 192.
Austin R S, Chan M. Digital Restoration Design based on Biologic Principles. In Rekow E D (ed) Digital dentistry: a comprehensive reference and preview of the future. Berlin: Quintessence Publishing, 2018.
Kelleher M, Bomfim D, Austin R. Biologically Based Restorative Management of Tooth Wear. Int J Dent 2012; DOI: 10.1155/2012/742509.
Doherty R. Pascal Magne: 'It should not be about aesthetics but tooth-conserving dentistry'. Br Dent J 2012; 213: 189.
Richards D. Evidence-based dentistry. London: Quintessence Publishing; 2019.
Edelhoff D, Sorensen J A. Tooth structure removal associated with various preparation designs for anterior teeth. J Prosthet Dent 2002; 87: 503-509.
Afrashtehfar K I, Emami E, Ahmadi M, Eilayyan O, Abi-Nader S, Tamimi F. Failure rate of single-unit restorations on posterior vital teeth: a systematic review. J Prosthet Dent 2017; DOI: 10.1016/j.prosdent.2016.08.003.
Afrashtehfar K I, Ahmadi M, Emami E, Abi-Nader S, Tamimi F. Failure of single-unit restorations on root filled posterior teeth: A systematic review. Int Endod J 2017; 50: 951-966.
Pjetursson B E, Sailer I, Makarov N A, Zwahlen M, Thoma D S. All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part II: Multiple-unit FDPs. Dent Mater 2015; 31: 624-639.
Jung R E, Zembic A, Pjetursson B E, Zwahlen M, Thoma D S. Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years. Clin Oral Implants Res 2012; 23: 2-21.
Ng Y L, Mann V, Gulabivala K. Tooth survival following non-surgical root canal treatment: a systematic review of the literature. Int Endod J 2010; 43: 171-189.
Nixdorf D R, Moana-Filho E J, Law A S, McGuire L A, Hodges J S, John M T. Frequency of persistent tooth pain after root canal therapy: a systematic review and meta-analysis. J Endod 2010; 36: 224-230.
Torabinejad M, Corr R, Handysides R, Shabahang S. Outcomes of nonsurgical retreatment and endodontic surgery: a systematic review. J Endod 2009; 35: 930-937.
Teughels W, Merheb J, Quirynen M. Critical horizontal dimensions of interproximal and buccal bone around implants for optimal aesthetic outcomes: a systematic review. Clin Oral Implants Res 2009; 20: 134-145.
Ng Y L, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature - Part 2. Influence of clinical factors. Int Endod J 2008; 41: 6-31.
Ng Y L, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature - part 1. Effects of study characteristics on probability of success. Int Endod J 2007; 40: 921-939.
Afrashtehfar K I, Tamimi F. An online tool that provides access to evidence-based literature on dental restorations: www.crownorfill.com. J Prosthet Dent 2017; 118: 696-697.
Collares K, Corrêa M B, Laske M et al. A practice-based research network on the survival of ceramic inlay/onlay restorations. Dent Mater 2016; 32: 687-694.
Schwass D R, Lyons K M, Purton D G. How long will it last? The expected longevity of prosthodontic and restorative treatment. NZ Dent J 2013; 109: 98-105.
Olley R C, Andiappan M, Frost P M. An up to 50-year follow-up of crown and veneer survival in a dental practice. J Prosthet Dent 2018; 119: 935-941.
Walton T R. The up to 25-year survival and clinical performance of 2,340 high gold-based metal-ceramic single crowns. Int J Prosthodont 2013; 26: 151-160.
Shillingburg H T, Hobo S, Whitsett L D, Jacobi R, Brackett S. Fundamentals of fixed prosthodontics. 3rd ed. Chicago: Quintessence Publishing, 1997.
Edelhoff D, Stimmelmayr M, Schweiger J, Ahlers M O, Güth J-F. Advances in materials and concepts in fixed prosthodontics: a selection of possible treatment modalities. Br Dent J 2019; 226: 739-748.
Christensen G J. Clinicians Report. 2018. Available at (accessed September 2020).
3M. Notice: Change in Indication - Lava Ultimate Restorative. 2015. Available at https://multimedia.3m.com/mws/media/1198023O/lava-ultimate-restorative-change-of-indication-notice.pdf (accessed September 2020).
Shembish F A, Tong H, Kaizer M et al. Fatigue resistance of CAD/CAM resin composite molar crowns. Dent Mater 2016; 32: 499-509.
Ray H, Trope M. Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration. Int Endod J 1995; 28: 12-18.
Al-Nuaimi N, Patel S, Austin R S, Mannocci F. A prospective study assessing the effect of coronal tooth structure loss on the outcome of root canal retreatment. Int Endod J 2017; 50: 1143-1157.
Lin C-L, Chang Y-H, Liu P-R. Multi-factorial analysis of a cusp-replacing adhesive premolar restoration: a finite element study. J Dent 2008; 36: 194-203.
Şişmanoğlu S. Restoration of Endodontically Treated Teeth: A Review of Direct Restorative Approach. Aurum J Health Sci 2019; 2: 21-40.
Krifka S, Anthofer T, Fritzsch M, Hiller K, Schmalz G, Federlin M. Ceramic inlays and partial ceramic crowns: influence of remaining cusp wall thickness on the marginal integrity and enamel crack formation in vitro. Oper Dent 2009; 34: 32-42.
Loomans B, Opdam N, Attin T et al. Severe Tooth Wear: European Consensus Statement on Management Guidelines. J Adhes Dent 2017; 19: 111-119.
Varma S, Preiskel A, Bartlett D. The management of tooth wear with crowns and indirect restorations. Br Dent J 2018; 224: 343.
Loomans B, Kreulen C, Huijs-Visser H et al. Clinical performance of full rehabilitations with direct composite in severe tooth wear patients: 3.5 Years results. J Dent 2018; 70: 97-103.
Mesko M E, Sarkis-Onofre R, Cenci M S, Opdam N J, Loomans B, Pereira-Cenci T. Rehabilitation of severely worn teeth: A systematic review. J Dent 2016; 48: 9-15.
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Bomfim, D., Rahim, N. & Austin, R. Biomechanical planning for minimally invasive indirect restorations. Br Dent J 229, 425–429 (2020). https://doi.org/10.1038/s41415-020-2170-x
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DOI: https://doi.org/10.1038/s41415-020-2170-x