CAD/CAM氧化锆全瓷冠桥随访4年的临床分析

目的:回顾分析评价CAD/CAM氧化锆全瓷冠桥的修复效果.方法:为267位患者制做CAD/CAM氧化锆全瓷冠或桥681件,随访了205例患者的562件全瓷冠桥,随访时间2-6年.对修复体的崩瓷、全瓷冠的颜色与修复体的边缘密合度进行评价.结果:CAD/CAM氧化锆全瓷冠的崩瓷率3.31%,与修复体部位有明显相关性(P＜0.01),不同技术员完成的CAD/C氧化锆全瓷冠的颜色效果有明显不同(P＜0.001),不同颜色预备体的修复体后颜色效果没有明显差异(P＞0.05),CAD/CAM全瓷冠颜色达到好以上90.8%,CAD/CAM全瓷修复体的边缘密合度达到好的99.2%,长桥边缘密合度欠佳,修复体松动脱落0.35%,随访期间没有发现CAD/CAM全瓷修复体基底冠或桥支架折断.结论:CAD/CAM全瓷冠颜色接近天然牙,特别是预备体变色时是115床旨选的美学修复体,CAD/CAM全瓷冠边缘密合度好,整体崩瓷率可接受,但长桥边缘密合度需进一步提高,且磨牙的崩瓷率须进一步研究降低.     

Survival rates of IPS empress 2 all-ceramic crowns and fixed partial dentures: results of a 5-year prospective clinical study.

OBJECTIVE: The aim of this prospective clinical study was to evaluate the survival rates of IPS Empress 2 (Ivoclar Vivadent) all-ceramic crowns and fixed partial dentures (FPDs) after an observation period of up to 5 years. METHOD AND MATERIALS: Forty-three patients (19 women and 24 men) were included in this study. The patients were treated with a total of 58 adhesive bonded IPS Empress 2 restorations. A total of 27 single crowns were placed on molars and premolars, and 31 three-unit FPDs were placed in the anterior and premolar regions. Clinical follow-up examinations took place at 6, 12, 24, 36, 48, and 60 months after insertion. Statistical analysis of the data was calculated using the Kaplan-Meier method. RESULTS: Results of the 50-month analysis (interquartile range, 33 to 61 months) showed that the survival rate was 100% for crowns and 70% for FPDs. Six failures that occurred exclusively in the three-unit FPDs were observed. Framework fractures were recorded in three FPD units where the connector dimensions did not meet the manufacturer specifications. Only one FPD exhibited an irreparable partial veneer fracture, and 2 FPDs showed evidence of biologic failures. The accuracy of fit and esthetic parameters were clinically satisfactory for crowns and FPDs. CONCLUSION: The results of this 5-year clinical evaluation suggest that IPS Empress 2 ceramic is an appropriate material for the fabrication of single crowns. Because of the reduced survival rates, strict conditions should be considered before the use of IPS Empress 2 material for the fabrication of three-unit FPDs.     

Prospective clinical 5-year study of ceramic-veneered titanium restorations with the Procera system

STATEMENT OF PROBLEM: The biocompatibility of titanium has been well documented, but clinical outcomes of ceramic-veneered titanium restorations were not conclusive. PURPOSE: The study presents the results of a 5-year clinical study of individual crowns and fixed partial dentures (FPDs) veneered with a low-fusing ceramic of the Procera system. MATERIAL AND METHODS: All patients at one clinic who required crowns or FPDs during a 2-year period were invited to participate. A total of 260 patients received 333 ceramic-veneered Procera restorations (242 single crowns and 91 FPDs). Clinical registrations were performed annually, and the restorations were evaluated according to the California Dental Association rating system. At the 5-year follow-up, 198 (76%) patients were examined. Most of the loss of patients could be explained. RESULTS: Practically all Procera restorations were judged as satisfactory both at baseline and follow-up examinations. One artificial crown and 1 FPD were remade because of extensive fractures of ceramic veneers. Two FPDs had fractures of a soldered joint, but only 1 FPD was replaced. Some minor complications occurred, such as small porcelain fractures that could be polished (6% of single crowns, 13% of FPDs) and or loosened restorations that were recemented. Other recorded complications were not related to the Procera system but to dental caries, loosened posts and cores, and root fractures. CONCLUSION: Clinical outcomes over a 5-year period for ceramic-veneered titanium restorations with the Procera system were favorable.     

Clinical long-term results of VITA In-Ceram Classic crowns and fixed partial dentures: A systematic literature review

PURPOSE: VITA In-Ceram Classic is a system designed to fabricate all-ceramic crowns and fixed partial dentures (FPDs) with a glass-infiltrated aluminum oxide core material. This systematic literature review gives an overview of the clinical performance of the VITA In-Ceram Classic Alumina, Spinell, and Zirconia restorations. MATERIALS AND METHODS: Based on a systematic literature review, an evidence-based selection and assessment of clinical studies of VITA In-Ceram Classic ceramics was carried out. RESULTS: A total of 299 publications were found, 21 of which met the inclusion criteria. Only a few meaningful studies of In-Ceram Alumina FPDs and In-Ceram Zirconia crowns and FPDs were found. The 5-year survival rate of In-Ceram Alumina crowns and In-Ceram Spinell crowns ranged from 91.7% to 100% and is similar to the survival rate of conventional metal-ceramic crowns. The 5-year survival rate of single-retainer In-Ceram Alumina resin-bonded FPDs (RBFPDs) was 92.3%, which is higher than that of 2-retainer RBFPDs. CONCLUSION: In-Ceram Classic Alumina can be recommended for anterior and posterior crowns as well as for anterior single-retainer RBFPDs. Further studies should be initiated to evaluate in detail the clinical performance of In-Ceram Classic Alumina FPDs. In-Ceram Classic Spinell can be recommended for anterior crowns, especially if highly esthetic results are requested. For In-Ceram Classic Zirconia crowns or FPDs no statement can be made presently because of insufficient data.     

Fixed partial dentures: all-ceramics,fibre-reinforced composites and experimental systems

The aim of this in vitro study was to compare the fracture strength of three-unit FPDs (fixed partial dentures) and three-unit inlay FPDs after a simulated 5-year oral wearing period. The restorations were made of a pressable all-ceramic (Empress 2) and two specially designed, experimentally fixed partial dentures combining ceramics with dental composite. Three-unit FPDs and inlay FPDs were manufactured and were adhesively luted onto human molars. After thermal cycling and mechanical loading in an artificial environment, the fracture strength was determined. Zircon-based milled ceramic (Lava) three-unit FPDs were used as a control. The zircon ceramic and the fibre-based ceramic three-unit FPDs showed median fracture values between 1000 and 1400 N. For composite veneered zircon FPDs a fracture strength of about 800 N and for all-ceramic Empress 2 of about 350 N could be determined. The results for the inlay FPDs were between 1300 N and 1400 N for FRC/ceramic, 1000 N for zircon/composite and 500 N for all-ceramic restorations. The all-ceramic showed higher fracture resistance applied as inlay FPDs. The described hybrid techniques combining ceramics and composites could represent an interesting procedure for further investigations and, eventually, clinical implication.     

A short-term clinical evaluation of IPS Empress 2 crowns

PURPOSE: The aim of this study was to evaluate the clinical performance of all-ceramic crowns made with the IPS Empress 2 system after an observation period of 12 to 60 months. MATERIALS AND METHODS: Seventy-nine IPS Empress 2 crowns were placed in 21 patients. The all-ceramic crowns were evaluated clinically, radiographically, and using clinical photographs. The evaluations took place at baseline (2 days after cementation) and at 6-month intervals for 12 to 60 months. Survival rate of the crowns was determined using Kaplan-Meier statistical analysis. RESULTS: Based on the US Public Health Service criteria, 95.24% of the crowns were rated satisfactory after a mean follow-up period of 58 months. Fracture was registered in only 1 crown. One endodontically treated tooth failed as a result of fracture at the cervical margin area. CONCLUSION: In this in vivo study, IPS Empress 2 crowns exhibited a satisfactory clinical performance during an observation period ranging from 12 to 60 months.     

Thirteen-year follow-up study of resin-bonded fixed partial dentures.

OBJECTIVE: The technique of resin-bonded fixed partial dentures (RBFPD) is a well-accepted clinical technique to replace missing teeth. The survival rates reported in the literature vary widely, and the conclusions are sometimes conflicting. This study presents the clinical long-term performance of silicoated RBFPDs and also determines the main cause of failure. METHOD AND MATERIALS: Sixty-one patients with a total of 74 RBFPDs were either examined or requested to complete a questionnaire regarding their fixed partial dentures. Sixty-four were placed in the anterior region, and 10 in the posterior region. No more than one missing tooth in the posterior area and two missing teeth in the anterior region were replaced with RBFPDs. A retentive preparation was made on the abutment teeth. All the RBFPDs were adhesively seated. RESULTS: Eighteen RBFPDs failed after a mean observation time of 7.8 years (nine retention losses of one or more retainers, six carious lesions, and three veneer fractures occurred). Seven RBFPDs were rebonded, whereas the remaining 11 failures had to be replaced with conventional FPDs. Fifty-six RBFPDs were primary restorations, and seven secondary RBFPDs were used after the loss of the primary restoration. A mean survival rate better than 69% after a 13-year observation period was calculated. Including the rebonded restorations, a mean functional survival rate of 83% was estimated. A total of 18 failures (24.3%) of all restorations were observed, the main cause being loss of retention. CONCLUSION: Silicoated RBFPDs are a viable treatment means with an acceptable success expectancy.     

Vita In-Ceram全瓷修复体2年临床观察

目的 探讨Vita In-Ceram Alumina渗透陶瓷全瓷修复体的修复效果,为临床应用提供参考。方法 45例门诊患者,修复体共194件,其中上颌124件,下颌70件。前牙全冠165个,后牙全冠21个,前牙固定桥8个。通过3－24个月的观察,采用美国加利福尼亚科学会的质量评价体系对Vita In-Ceram Alumina渗透陶瓷前、后牙全冠与前牙固定桥修复进行临床效果评价。结果 对45例患者186颗全冠与8个前牙固定桥的临床观察结果表明,Vita In-Ceram Alumina渗透陶瓷全冠具有良好的边缘密合性,色泽稳定,强度高,其失败率为0．01％。应用Vita In-Ceram Alumina渗透陶瓷制作的前牙固定桥,效果满意。结论 Vita In-Ceram Alumina渗透陶瓷修复是一种效果良好的全瓷修复方式。     

Short-Term Results of IPS-Empress Full-Porcelain Crowns

Purpose A leucite-reinforced, glass-ceramic material was recently introduced for clinical use. In this clinical trial, IPS-Empress material was tested in the form of full-porcelain crowns. Materials and Methods Thirty-four patients were restored with 78 full-porcelain crowns. After etching the crowns with hydrofluoric acid, they were silanized and luted using dentin bonding agents and resin composite cement, which was primarily a dual-cured type. The 41 anterior and 37 posterior crowns were evaluated clinically with a mirror and probe, radiographically, and using clinical photographs, according to the modified United States Public Health Service criteria. Restorations having neither charlie nor delta criteria were defined as successful, and their survival rate was calculated according to Kaplan-Meier analysis. Results The mean observation period for the 78 restorations was 19.7 ± 8.5 months. Seventy-four crowns were defined as successful. Four restorations failed because of fractures. Three of the four failures occurred in the first 2 months after cementation. The survival rate was estimated to be 95% successful after 2 years in service. Eighty percent of the crowns demonstrated an excellent esthetic result. Conclusions The initial clinical results of this esthetic full-porcelain crown system are encouraging. However, because of fatigue phenomena for all ceramic materials, a longer observation period is needed to provide a definitive prognosis about the long-term clinical behavior.     

CAD/CAM氧化锆全瓷冠修复临床疗效评价

目的：探讨CAD／CAM氧化锆全瓷冠的修复效果。方法：选择82例（192颗患牙）,分别在CAD／CAM氧化锆全瓷冠粘接后1、3、6、12个月进行随访观察。采用美国公共健康协会的修订标准对修复体的临床效果进行评价。结果：观察期间失访4例,随访78例共181件修复体,结果显示CAD／CAM全瓷冠颜色达到好以上91．2％,CAD／CAM氧化锆全瓷冠的崩瓷率2．76％,与修复体部位有明显相关性（P〈0．01）,在粘接12个月后有1个修复体的边缘密合度欠佳,所有复诊患者在12个月的临床观察中均未见边缘着色,继发龋和基牙松动。结论：氧化锆全瓷修复体具有良好的稳定性和生物相容性,近期临床效果满意。     

287件 CAD/CAM二氧化锆全瓷修复体3年临床疗效观察

目的：探讨 CAD／CAM氧化锆全瓷修复体的临床疗效及失败原因。方法：对206例患者、287件 CAD／CAM氧化锆全瓷修复体进行3年前瞻性随访研究,按照美国加州牙科协会（CDA）制定的标准,通过 Kaplan-Meier 生存分析、Log-Rank 检验及卡方检验,统计累积生存率,分析修复体类型、修复牙位、基牙桩核与否等因素对全瓷修复体生存率的影响。结果：观察期内CAD／CAM二氧化锆修复体有5件发生瓷崩裂,4件出现明显牙龈炎症,3件基牙发生根尖周炎;修复体3年累积生存率为95．7％。其中单冠、联冠、固定桥的3年累积生存率分别为96．3％、93．6％、95．7％（P ＞0．05）,前牙组与后牙组的3年累积生存率分别为94．5％、96．3％（P ＞0．05）,基牙桩核组与非桩核组3年累积生存率分别为95．0％、96．1％（P ＞0．05）。结论：CAD／CAM二氧化锆修复体3年累积生存率较高,修复体类型、修复牙位及基牙桩核与否对其生存率影响均无显著性差异;瓷崩裂是最常见的失败原因。     

Targis高嵌体修复无髓后牙缺损的观察

目的：考察Targis瓷聚体作高嵌体修复无髓后牙缺损的临床效果。方法：对47例患者的53个经完善根管治疗术的后牙缺损，采用Targis高嵌体修复。根据改良的USPHS修复体评价标准，分别于修复后1、2,3年对Targis高嵌体进行随访复查。结果：Targis高嵌体的颜色协调性、边缘适合性和边缘着色在观察期内无明显改变，也未见继发龋和余留牙体的折裂，其累计成功率为94．3％。结论：Targis瓷聚体用于无髓后牙缺损的高嵌体修复效果良好，为牙体缺损的美观修复提供了新的选择，但其远期效果有待进一步观察。     

Clinical application of all-ceramic fixed partial dentures and crowns.

The esthetic demands of patients have increased considerably during recent years. Due to this increasing interest in esthetics, as well as concerns about toxic and allergic reactions, the use of all-ceramic restorations has increased. One of the systems introduced for all-ceramic restorations is the IPS Empress system. This article examines one all-ceramic restoration system, IPS Empress, and presents patient cases in which all-ceramic crowns and fixed partial dentures have been utilized.     

Clinical evaluation of an all-ceramic restorative system: 24-month report

PURPOSE: To clinically evaluate an all-ceramic restorative system (Finesse All-Ceramic) when used in conjunction with an ultra-low fusing porcelain (Finesse) using bonded esthetic resin cements (Enforce & Calibra). METHODS: 40 posterior and anterior crowns, 20 all-ceramic inlays and onlays, and 26 veneers were placed in 43 patients. Standard ceramic preparations were performed followed by conventional polyvinylsiloxane (Aquasil) impression techniques using cord retraction. The bonded resin cement was used to place the restorations following manufacturer's instructions. A majority of restorations (95-100%) were evaluated to be optimal at baseline (B), 6, 12, and 24 months using a modified Ryge criteria for the following categories: color match, marginal adaptation, porcelain staining, secondary caries, postoperative sensitivity, and retention. RESULTS: There were sufficient shades available to obtain desired esthetic result with 98% of all restorations being rated Alfa for shade match to Vita Lumin shade guide. The overall 2-year success rate (inlay/onlays, crowns, and veneers) was 98.75%.     

A Clinical Report and Overview of Scientific Studies and Clinical Procedures Conducted on the 3M ESPE Lava™ All-Ceramic System

The Lava All-Ceramic System (3M ESPE Dental Products, St. Paul, MN) is a high-strength zirconia system, which can be utilized to create all-ceramic crowns and fixed partial dentures (FPDs) for use in the anterior and posterior regions of the oral cavity. The following study offers an overview of previously conducted scientific studies and clinical procedures that feature the Lava All-Ceramic System as well as a more general overview of zirconia ceramics. A clinical report demonstrates the use of the Lava All-Ceramic System with the restoration of 2 single crowns.     

Fiber-reinforced composite crowns and FPDs: a clinical report

PURPOSE: This clinical study reports on the results of single molar crowns, three-unit inlay fixed partial dentures (FPD), and complete-coverage FPDs made of the glass-fiber composite system Targis/Vectris with an observation period up to 4.4 years. MATERIALS AND METHODS: In total, 38 restorations were inserted in 19 patients. Of these, 17 were adhesively fixed three-unit inlay FPDs, five were conventionally cemented complete-coverage three-unit FPDs, and 16 were single molar crowns (six adhesively, ten conventionally cemented). The mean observation period was 2.5 +/- 1.0 years. Events like fracture of the framework or veneer, loss of cementation, signs of wear, and outward discoloration were noted and rated according to modified Ryge criteria. RESULTS: During the observation time, neither loss of cementation nor framework fracture were noted. However, six facings (36%) of the inlay FPDs fractured. The number of cases with discoloration or wear increased over time for all types of restorations. The wear culminated in fiber exposure of two molar crowns (24 months) and one inlay FPD (54 months). One of the five complete-coverage FPDs was replaced at the request of the patient (discoloration). The cumulative survival rate after 36 months was estimated to be 82% for molar crowns and 72% for inlay FPDs. CONCLUSION: Fiber-reinforced composite restorations need further improvement of the veneering composites. Because of the increasing wear, discoloration, fractures of the facings, and fiber exposure, fiber-reinforced composites should only be used for provisional restorations.     

Fracture resistance of lithium disilicate-, alumina-, and zirconia-based three-unit fixed partial dentures: a laboratory study

PURPOSE: The purpose of this study was to determine the fracture resistance of three-unit fixed partial dentures (FPD) made of new core ceramics. MATERIALS AND METHODS: A base metal three-unit master FPD model with a maxillary premolar and molar abutment was made. Tooth preparation showed 0.8-mm circumferential and 1.5-mm occlusal reduction and a chamfer margin design. FPDs were constructed with a uniform 0.8-mm-thick core ceramic and a porcelain veneer layer. In-Ceram Alumina, In-Ceram Zirconia, and DC-Zirkon core ceramics were machined by a computer-aided design/manufacturing system, whereas IPS Empress 2 core ceramic was indirectly built up using the fabrication technology of waxing and heat pressing. FPDs of IPS Empress were heat pressed as complete restorations without core material. To ensure standardized dimensions, the FPDs were controlled at different points. All FPDs were cemented with ZnPO4 on the master model and loaded on a universal testing machine until failure. The failure load and mode of failure were recorded. RESULTS: The highest failure loads, exceeding 2,000 N, were associated with FPDs of DC-Zirkon. FPDs of IPS Empress and In-Ceram Alumina showed the lowest failure loads, below 1,000 N, whereas intermediate values were observed for FPDs of IPS Empress 2 and In-Ceram Zirconia. Differences in mean values were statistically significant. CONCLUSION: The high fracture resistance evaluated for FPDs made of DC-Zirkon underscores the remarkable mechanical properties of high-performance ceramic, which could be useful for highly loaded all-ceramic restorations, especially in the molar region.     

All-ceramic fixed partial dentures. Studies on aluminum oxide- and zirconium dioxide-based ceramic systems

BACKGROUND: The development of refined, tougher, and stronger ceramic core materials in recent years has led to the wider use of new, strong all-ceramic systems based on oxide ceramics. Results from in-vitro studies investigating the use of oxide ceramics in shorter all-ceramic fixed partial dentures (FPDs) have been positive, but clinical studies and additional in-vitro studies are needed to confirm the advisability of such procedures. AIMS: One aim of this thesis was to investigate whether alumina-based and zirconia-based material systems are adequate for use in shorter (< or = five-unit) FPDs and to evaluate the clinical results. Additional aims were to investigate how to achieve optimal fracture strength in an all-ceramic FPD by varying the try-in procedure, the cervical shape of the abutments, and the support of the FPD (abutment teeth or dental implants). The final aim was to compare the strength of a zirconia material system with that of an alumina equivalent with known long-term clinical performance. MATERIALS AND METHODS: Two clinical studies investigating one alumina-based and one zirconia-based material system were performed. Twenty posterior, three-unit FPDs (glass-infiltrated alumina) were followed for 5 years and 20 three-five-unit FPDs (HIP zirconia) for 2 years. Long-term follow-ups were made after 11 +/-1 (glass-infiltrated alumina) and 3 years (HIP zirconia). In three in-vitro studies, the following variables were investigated: (1a) the flexural strength of porcelain specimens depending on whether they were exposed to saliva before the glaze firing (n=20) or first after the glaze firing (n=20), (1b) the fracture strength of three-unit all-ceramic FPDs (glass-infiltrated alumina) supported by abutments prepared with cervical shoulder preparations (n=9) and abutments with cervical chamfer preparations (n=9), (2) the fracture strength of crowns (n=30) made of a zirconia material system (densely sintered zirconia) and of crowns (n=30) of an alumina material system (densely sintered alumina) that had undergone three different pre-treatment modalities (water storage only; water storage and cyclic pre-loading; water storage, cyclic pre-loading, and thermocycling), (3) the fracture strength of all-ceramic FPDs (densely sintered alumina) supported by simulated teeth (n=12) or by dental implants (n=12). RESULTS: The success rate of the clinical alumina study was 90% after 5 years. Six (+/-1) years later (after a total of 11 +/-1 years), the success/survival rate was 65%. In the second clinical study, the success rates of the 2- and 3-year follow-ups were 100%. In the three in-vitro studies, the following results were found: (1a) the mean flexural strength of the specimens in the group that was exposed to saliva first after glazing was significantly higher (P < 0.001) than that of the specimens in the group that was exposed to saliva before glazing, (1b) the FPDs luted on shoulder preparations resisted higher loads than the FPDs luted on chamfer preparations (P = 0.051), 2) total fractures were more frequent in the alumina than in the zirconia group (P < 0.001), 3) FPDs loaded on implants resisted higher loads (mean = 604 N, SD=184 N ) than FPDs loaded on abutment teeth (mean= 378 N, SD=152 N, P = 0.003). CONCLUSIONS: This thesis justifies the use of shorter alumina- (< or = three-unit) and zirconia-based (< or = five-unit) FPDs as the clinical results are acceptable. The clinical performance of alumina is, however, not as good as that of comparable high-gold alloy based porcelain-fused-to-metal FPDs concerning fracture resistance. Within the limitations of the in-vitro studies: Saliva exposure of porcelain before glaze firing should be avoided to optimize the strength of the porcelain. Shoulder preparations can be beneficial for the strength of all-ceramic FPDs compared to chamfer preparations, as can support by dental implants compared to abutment teeth. The fracture mode of alumina crowns (total fractures) differs from that of zirconia crowns (veneer fractures), suggesting that the zirconia core is stronger than the alumina core.     

CAD/CAM氧化锆及Empress全瓷冠修复三年临床效果比较

目的:比较CAD/CAM氧化锆及Empress全瓷冠修复3年的临床效果。方法:选择350例患者共838个全冠修复体(其中CAD/CAM氧化锆全冠428颗、Empress铸瓷全冠410颗),平均观察期36.2±5月,随访检查基牙和修复体情况,分别对两组全瓷冠的存留率和修复成功率进行统计学分析。结果:观察期内共有41颗全瓷冠(19颗为氧化锆,22颗为Empress铸瓷)完全失败,需重新制作。氧化锆全瓷冠和Empress铸瓷全冠的存留率分别为95.1%和95.8%,成功率分别为90.7%和91.2%,其差异均无统计学意义。结论:CAD/CAM氧化锆和Empres铸瓷全冠均能满足临床需要,有较好的修复效果。     

Short-term clinical evaluation of a resin-modified glass-ionomer luting cement.

OBJECTIVES: Resin-reinforced glass-ionomer cements were developed by adding resin components to conventional glass-ionomer cement. This improved physical properties and bonding characteristics. FujiCEM is the first paste-paste-type resin-modified glass-ionomer luting cement that enables consistent mixture. The purpose of this study was to evaluate the short-term clinical performance of FujiCEM, which was used for final cementation of indirect restorations, such as inlays, crowns, and fixed partial dentures. METHOD AND MATERIALS: A total of 290 restorations (165 crowns, 71 inlays, 15 onlays, 36 fixed partial dentures, 3 implant superstructures) were placed in 268 patients (137 males, 131 females) with a mean age of 54.4+/-13.0 years. Restorations were luted with FujiCEM mixed for 10 seconds after the teeth surfaces were treated with a conditioner containing 10% citric acid and 2% ferric chloride for 20 seconds, washed, and dried with gentle air flow. Out of the investigated 337 teeth, 99 (29%) teeth were vital, and 238 (71%) were nonvital. These restorations were followed up for a period of 21 months. All the restorations were evaluated for postoperative sensitivity, secondary caries, gingival condition, and pocket depth. RESULTS: No clinical failures (eg, dislodgment, secondary caries, irritation of soft tissue, and postoperative sensitivity) were observed. CONCLUSION: FujiCEM had promising clinical performance with inlays, crowns, onlays, fixed partial dentures, and implant superstructures at 21 months after service.