Clinical Performance of Lithium Disilicate Glass-Ceramic CAD/CAM Crowns Provided by Predoctoral Students at the University of Toronto
Bibliographic record
Abstract
The clinical success of monolithic lithium disilicate glass-ceramic (LDGC) crowns manufactured with computer-aided design (CAD) / computer-aided manufacturing (CAM) technology provided by predoctoral students has not yet been investigated. The aims of this retrospective clinical study were to evaluate the clinical performance of monolithic posterior LDGC CAD/CAM (IPS e.max CAD, Ivoclar Vivadent) crowns fabricated with conventional and digital workflows provided by predoctoral students at the Faculty of Dentistry, University of Toronto. In addition, it assessed the effect of different patient and operator-related factors on their longevity. Furthermore, their clinical performance was compared to the metal-ceramic (MC) posterior crowns. Clinical assessment of the crowns and supporting periodontal structures was performed following the modified California Dental Association criteria. Intra-oral photographs, periapical and bitewing radiographs were taken for further assessment by two evaluators. In part 1 of this study, the clinical performance of 210 LDGC-CAD/CAM crowns fabricated with polyvinyl siloxane impressions for 6 years was evaluated. Crowns were milled in-house with CEREC Bluecam system using IPS e.max CAD blocks. Twenty-eight complications were observed (12-technical, 11-biological, and 5-esthetic). The 6-year survival and success rates were 93% and 86.4%, respectively. In part 2, the clinical performance of 40 chairside LDGC-CAD/CAM posterior crowns fabricated with digital impressions was evaluated. Impressions were taken with the Omnicam system and crowns were milled using a CEREC MC-XL machine. Three complications were observed (1-biological and 2-technical). The 4-year survival and success rates were 92.6% and 89.7%, respectively. In part 3, the clinical performance of 112 MC crowns for up to 10 years was evaluated. The 10-year survival and success rates were 87.1% and 81.0%%, respectively. Esthetic problems accounted for the majority of complications. In part 4, the clinical performance of LDGC-CAD/CAM was compared to MC crowns using split-mouth design for 6 years. Twelve complications were observed in the MC crown group (9-esthetic, 2-technical and 1-biological) in comparison to 2 complications in the LDGC-CAD/CAM crown group (1-technical and 1-esthetic). The 6-year survival rates for MC crowns and LDGC-CAD/CAM crowns were 90.8% and 96%, respectively, whereas, the success rates were 83.4% and 96%, respectively. LDGC-CAD/CAM crowns proved to be a predictable, reliable and viable alternative to the “gold standard” MC crowns.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".