Gunilla Pousette Lundgren1, Gun-Inger Morling Vestlund2, Göran Dahllöf3. 1. Department of Dental Medicine, Division of Orthodontics and Pediatric Dentistry, Karolinska Institutet, Stockholm, Sweden; Department of Pediatric Dentistry, Eastman Institute, Stockholm, Sweden. Electronic address: gunilla.pousette-lundgren@ki.se. 2. Department of Prosthetic Dentistry, Public Dental Service, Dalarna County, Falun, Sweden. 3. Department of Dental Medicine, Division of Orthodontics and Pediatric Dentistry, Karolinska Institutet, Stockholm, Sweden.
Abstract
OBJECTIVES: Amelogenesis imperfecta (AI) is a rare, genetically determined defect in enamel mineralization. Several problems are associated with AI: hypersensitivity, wear, restorations requiring replacement, gingivitis, aesthetic problems, and social avoidance. We conducted a randomized controlled trial of crown therapy in young individuals with AI showing excellent results. This study reports results from a long-term-follow-up with focus on quality, longevity and adverse events. METHODS: The RCT included 27 patients (aged 11-22 years) with severe AI in need of crown therapy and used a split-mouth technique. After placing 119 Procera® crowns and 108 IPS e.max Press crowns following randomization, we assessed longevity, quality, adverse events, and tooth sensitivity and calculated survival rates and success rates. RESULTS: We followed the original 227 crowns for 4.3-7.4 years (mean 5.5 ± 0.8). In all, 79% (193) crowns were followed for at least 5 years. The survival rate was 99.6% and the success rate, 94.7%; 95% of the crowns had excellent or acceptable quality. Due to suboptimal marginal integrity, 4% of the crowns required adjustment. Sensitivity problems decreased after crown therapy (p < 0.001). All adverse events occurred in patients aged 19-23 years and involved apical periodontitis (3% of teeth); all but two events were related to dental trauma in the actual tooth. CONCLUSIONS:Ceramic crown therapy in adolescents and young adults with severe forms of AI show excellent survival and success rates and longevity with few adverse events. CLINICAL SIGNIFICANCE: Ceramic crown therapy can be recommended for adolescents and young adults with severe forms of amelogenesis imperfecta.
RCT Entities:
OBJECTIVES:Amelogenesis imperfecta (AI) is a rare, genetically determined defect in enamel mineralization. Several problems are associated with AI: hypersensitivity, wear, restorations requiring replacement, gingivitis, aesthetic problems, and social avoidance. We conducted a randomized controlled trial of crown therapy in young individuals with AI showing excellent results. This study reports results from a long-term-follow-up with focus on quality, longevity and adverse events. METHODS: The RCT included 27 patients (aged 11-22 years) with severe AI in need of crown therapy and used a split-mouth technique. After placing 119 Procera® crowns and 108 IPS e.max Press crowns following randomization, we assessed longevity, quality, adverse events, and tooth sensitivity and calculated survival rates and success rates. RESULTS: We followed the original 227 crowns for 4.3-7.4 years (mean 5.5 ± 0.8). In all, 79% (193) crowns were followed for at least 5 years. The survival rate was 99.6% and the success rate, 94.7%; 95% of the crowns had excellent or acceptable quality. Due to suboptimal marginal integrity, 4% of the crowns required adjustment. Sensitivity problems decreased after crown therapy (p < 0.001). All adverse events occurred in patients aged 19-23 years and involved apical periodontitis (3% of teeth); all but two events were related to dental trauma in the actual tooth. CONCLUSIONS: Ceramic crown therapy in adolescents and young adults with severe forms of AI show excellent survival and success rates and longevity with few adverse events. CLINICAL SIGNIFICANCE: Ceramic crown therapy can be recommended for adolescents and young adults with severe forms of amelogenesis imperfecta.