Coronal dental lesions: effectiveness of prosthetic restorations in dental rehabilitation

Abstract

Background. Coronal tooth lesions represent a common pathology in dental practice, with an estimated prevalence of over 60% among adults. Coronal destruction caused by caries, erosion, abrasion, or trauma compromises dental function and aesthetics, requiring effective and durable prosthetic rehabilitation. Objective of the study: To comparatively evaluate the effectiveness of different types of prosthetic restorations used in the treatment of coronal tooth lesions, focusing on durability, functional stability, and medium-term aesthetic outcomes. Material and methods. The study included a retrospective analysis of 50 clinical cases treated between 2022– 2024 at the Department of prosthodontics “Ilarion Postolachi”, complemented by a literature review from PubMed and Scopus databases. Evaluated restorations included monolithic zirconia crowns, hybrid composite inlays/onlays, and metallic or mixed pinlays. The analyzed parameters were the degree of coronal destruction, type of restoration selected, marginal adaptation, complications at 6–12 months, and overall clinical success rate. Results. Zirconia crowns demonstrated a success rate of 88% at 12 months due to their superior mechanical strength and favorable marginal adaptation. Inlay/onlay restorations achieved a 72% success rate and were indicated for moderate defects. Pinlays showed 90% effectiveness in cases with thin residual tooth walls, reducing fracture risk by 25%. Conclusions. The selection of prosthetic restoration must be individualized according to the degree of coronal destruction and the patient’s functional and aesthetic needs. Zirconia crowns are recommended for extensive lesions due to their superior durability, while pinlays represent an effective solution for reinforcing structurally compromised teeth.