Margvelashvili-Malament Mariam, Thompson Van, Malament Kenneth A
Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA.
Private Practice, Boston, Massachusetts, USA.
J Esthet Restor Dent. 2025 May;37(5):1248-1254. doi: 10.1111/jerd.13422. Epub 2025 Jan 25.
Minimally invasive dentistry is being widely practiced. The center stone is to be as conservative as possible to minimize unnecessary removal of healthy tooth structure. In prosthodontics the patients have generalized and combined nature of diseases. This narrative literature review analyzed available evidence on minimally invasive treatment protocols in fixed prosthodontics and raised awareness on the importance of longevity of treatments and secondary prevention.
The long-term clinical survival of ceramic and resin composite materials was reviewed. Loss of tooth vitality after prosthodontic treatment was also explored. And finally, treatment options for patients with severe wear were examined. The search of the literature resulted in evidence of superior survival of ceramic restorations over resin composites. The literature is also clear that ceramic partial coverage inlay and onlay restorations have excellent long-term clinical performance in posterior dentition. Glass ceramic lithium disilicate showed to be an adequate material not only for anterior but also for posterior dentition, including the patients with severe wear.
Minimally invasive dentistry as applied in fixed prosthodontics needs updates in its concepts to account for secondary prevention and longevity of chosen treatment techniques.
This narrative review article critically reviews available evidence on long-term clinical performance of minimally invasive and traditional treatment concepts and materials in fixed prosthodontics. Awareness is raised for secondary prevention and longevity of chosen treatments.
微创牙科正在广泛应用。其核心在于尽可能保守，以减少对健康牙体组织的不必要去除。在口腔修复学中，患者的疾病具有广泛性和综合性。这篇叙述性文献综述分析了固定修复学中微创治疗方案的现有证据，并提高了对治疗持久性和二级预防重要性的认识。
回顾了陶瓷和树脂复合材料的长期临床生存率。还探讨了口腔修复治疗后牙齿活力丧失的情况。最后，研究了重度磨损患者的治疗选择。文献检索结果表明，陶瓷修复体的生存率优于树脂复合材料。文献也明确指出，陶瓷部分覆盖嵌体和高嵌体修复在后牙列中具有出色的长期临床性能。二硅酸锂玻璃陶瓷不仅适用于前牙列，也适用于后牙列，包括重度磨损患者。
固定修复学中应用的微创牙科需要更新其概念，以考虑二级预防和所选治疗技术的持久性。
这篇叙述性综述文章批判性地回顾了固定修复学中微创和传统治疗概念及材料长期临床性能的现有证据。提高了对二级预防和所选治疗持久性的认识。
