A Clinical Study on Cast Ceramic Onlay Restoration of Young Permanent Molars after Pulpotomy

ZHOU Bing; ZHANG Shuai; QU Yijing; LIU Minghui; WANG Juan; LIU Shengjin; GUO Jie

doi:10.3639/j.issn.2095-3097.2025.09.017

Abstract：Objective To investigate the impact of cast ceramic onlay restoration following vital pulp therapy on the functional and aesthetic outcomes of young permanent molars.Methods A total of 90 children(95 teeth)with extensive defects after pulpotomy of young permanent molars in the Department of Stomatology of Cangzhou People's Hospital from December 2020 to July 2023 were enrolled.Based on the restoration method,they were divided into three groups:the onlay group(30 cases,32 teeth)received cast ceramic onlays,the preformed crown(PMC)group(30 cases,32 teeth)underwent preformed crown restoration,and the resin group(30 cases,31 teeth)underwent direct composite resin filling.Restoration efficacy and aesthetic outcomes[including integrity of the restoration,marginal adaptation,color matching,and wear grading of the opposing occlusal surface],as well as occlusal function[food impaction grading and bite force on both the affected and contralateral sides]were compared among the three groups at 3,6,and 12 months post-restoration.Results At 3 and 6 months after restoration,there were no statistically significant differences among the three groups in aesthetic outcomes or food impaction grading(P>0.05).However,the bite force on the affected side in both the onlay and preformed crown groups was higher than that in the resin group(P<0.05).At 12 months post-restoration,the proportions of grade A ratings for restoration integrity and color matching were higher in the onlay group and the preformed crown group compared to the resin group(P<0.05);The onlay group also demonstrated a higher proportion of grade A ratings for marginal adaptation,grade A food impaction grading,and greater bite force on the affected side compared to both the preformed crown and resin groups(P<0.05),while the preformed crown group outperformed the resin group in these aspects(P<0.05).Conclusion Cast ceramic onlay restoration after pulpotomy in young permanent molars provides better recovery of occlusal function and aesthetic outcomes.