Akademik Veri Yönetim Sistemi
Journal of Prosthetic Dentistry, 2025 (SCI-Expanded, Scopus)
Statement of problem: The long-term clinical performance of computer-aided design and computer-aided manufacturing (CAD-CAM) materials in indirect Class II restorations remains unclear, as most studies have reported only short-term or in vitro outcomes. Purpose: The purpose of this single-blind randomized clinical trial was to evaluate the 5-year performance of indirect Class II restorations using lithium disilicate glass-ceramic, polymer-infiltrated ceramic, and composite resin with nanoscale filler. Material and methods: A total of 41 participants received 60 restorations using Cerasmart (CS; GC), Vita Enamic (VE; VITA Zahnfabrik), or IPS e.max CAD (IEC; Ivoclar AG) blocks. Restorations were evaluated at 1 week, 1 year, and 5 years using World Dental Federation (FDI) criteria. Kruskal-Wallis and Friedman tests with Bonferroni adjustment were applied (α=.05); missing data were handled with multiple imputation (intention-to-treat [ITT]). Results: At 5 years, 42 restorations were available for evaluation (69% follow-up). Acceptable outcomes (FDI scores 1-3) were observed in 55% (CS), 65% (VE), and 60% (IEC), with no significant group differences (adjusted P>.05). IEC showed better color match and less marginal staining (adjusted P<.001), confirmed in both complete-case and ITT analyses. ITT further revealed differences in surface gloss and anatomic form (adjusted P≤.007). Functional and biological parameters showed no between-group differences, though ITT indicated progressive within-group deterioration in CS and VE over time (adjusted P<.001). Conclusions: All materials demonstrated generally acceptable 5-year biological and functional performance, though clinical acceptability ranged between 55% and 65%. IEC provided superior long-term esthetic stability.