Souza, Rodrigo Othavio de Assunção eMiranda, Larissa Mendonça de2025-01-242025-01-242024-09-26MIRANDA, Larissa Mendonça de. Desempenho clínico, discrepância marginal e interna de coroas monolíticas de zircônia ultratranslúcida, ensaio clínico controlado e randomizado: em até 2 anos. Orientador: Dr. Rodrigo Othavio de Assunção e Souza. 2024. 95f. Tese (Doutorado em Ciências Odontológicas) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2024.https://repositorio.ufrn.br/handle/123456789/61985Objective: To evaluate the clinical longevity, marginal discrepancy (MD), and internal discrepancy (ID) of monolithic posterior crowns made from two ceramic CAD/CAM materials (ultra-translucent monolithic zirconia and lithium disilicate), as well as the impact of oral rehabilitation on patient aesthetic satisfaction and quality of life. Material and methods: A total of 24 crowns were placed in 18 participants divided into two groups: Control (LD, Lithium Disilicate - IPS e.max CAD; Ivoclar AG) and Experimental (Zr, Zircon FitPlus-Talmax, Curitiba, Paraná). The crowns were evaluated before treatment (T0) and after 1 (T1), 6 (T2), 12 (T3), and 24 (T4) months using modified United States Public Health Service (USPHS) criteria, visual analog scales (VAS), and Oral Impacts on Daily Performances (OIDP). Ten units from each material were selected for ID and MD evaluation using the replica technique. The internal part of each crown was filled with a light-bodied addition silicone (X-light, 3M ESPE), followed by a small portion of heavy-bodied silicone (Express XT, 3M ESPE) inserted into the crown interior, making close contact with the light silicone. The silicone die was then sectioned into 8 hemi-faces. For ID analysis, the thickness of the light silicone was measured in four regions (O: occlusal, C: cusp, A: axial, CH: chamfer), with 5 measurements taken per region. For MD analysis, the discrepancy was measured at the margin, with 5 measurements taken on each hemi-face, totaling 20 measurements per crown. Replica measurements were performed under an optical stereomicroscope (Stereo Discovery V20) at 40x magnification with the aid of software. The Shapiro-Wilk normality test, oneway ANOVA for MD, and two-way ANOVA with Tukey's post hoc test (5%) for ID were performed. Survival analysis was carried out using Kaplan-Meier followed by the logrank test (α=.05). OIDP and USPHS data were analyzed descriptively, while VAS for aesthetic satisfaction was statistically evaluated using Mann-Whitney, Friedman, and Wilcoxon post hoc tests. Results: The mean age of the 18 participants was 38.5 years. Eleven crowns were fabricated in LD and 13 in Zr. The survival rate for zirconia was 92.3% and for lithium disilicate 100% after 60 months, with the control rate being 100%. The log-rank test showed no significant difference between the two groups (p=0.450). The Mann-Whitney test revealed no difference between the groups, regardless of satisfaction criteria and follow-up times (P>0.05). For both groups, aesthetic satisfaction in all criteria was significant (P<0.05). For MD, one-way ANOVA showed that the "ceramic" factor was not significant (p=0.297). MD was similar between the Zr (108.4±34.6 µm) and LD (95.7±13.6 µm) groups. For ID analysis, two-way ANOVA showed that only the "region" factor (p=0.00) was significant, with no influence from the type of ceramic (p=0.4). Analysis of the experimental groups revealed that ZrO (124.1±34.9A µm) and LDO (154.6±33.7A µm) were similar and showed higher ID values compared to other regions. Conclusion: The survival rate of lithium disilicate and zirconia crowns was similar, with acceptable clinical performance after 24 months of follow-up. MD and ID were similar between the materials evaluated, with values within clinically acceptable parameters. Additionally, for both materials, the occlusal region had the highest ID.Acesso AbertoCAD/CAMPorcelana dentáriaQualidade de vidaPrótese dentáriadoctoralThesisCNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA