Clinical Performance of Hybrid Computer-aided Design/Computer-aided Manufacturing (CAD/CAM) Onlay Restorations

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Background: Hybrid Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) materials have gained popularity in restorative dentistry due to their esthetic properties and favorable mechanical characteristics. However, clinical data evaluating the mid-term performance of indirect hybrid onlay restorations and their correlation with non-invasive fluorescence-based diagnostic tools remain limited. Aim: This study aimed to assess the 18-month clinical performance of indirect hybrid CAD/CAM onlay restorations using the World Dental Federation (FDI) criteria and to examine the diagnostic utility of Quantitative Light-induced Fluorescence (QLF) imaging in evaluating marginal adaptation, discoloration, and secondary caries. Materials and Methods: Thirty patients (aged 18-53) with a total of 33 maxillary or mandibular molar teeth restored using Grandio Blocs (VOCO, Germany) were retrospectively included. Restorations were clinically evaluated at baseline and 18 months using the FDI criteria (esthetic, functional, biological domains) by two calibrated, blinded observers. Standardized photographs, periapical radiographs, and QLF images were analyzed. QLF imaging was performed with Qraypen C® to quantify fluorescence loss (ΔF) and red fluorescence (ΔR) at restoration margins. Statistical analysis was conducted to determine the correlation between FDI scores and fluorescence parameters. Comparisons between baseline and 18-month FDI scores were performed using the Wilcoxon signed-rank test. The correlation between FDI evaluation scores and fluorescence parameters was assessed using the Spearman's rank correlation coefficient.A p-value of \<0.05 was considered statistically significant for all tests.

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