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

Fluorescence-based assessment of restoration margins using Qraypen C® device to measure autofluorescence loss (ΔF) and red fluorescence (ΔR). Imaging was performed during routine 18-month follow-up to detect micro-leakage or marginal biofilm activity.

Restorations were evaluated both at baseline (1-week recall) and at 18-month follow-up using the FDI World Dental Federation Clinical Evaluation Criteria, which allow structured and sensitive assessment of indirect restorations across three domains: Functional properties (e.g., marginal adaptation, fracture, retention, occlusion), Biological properties (e.g., recurrent caries, hypersensitivity, pulp status), Esthetic properties (e.g., marginal discoloration, surface texture, shade matching). Each criterion was scored on a 5-point ordinal scale: 1 = Clinically excellent / very good, 2 = Good (minor corrections), 3 = Satisfactory (acceptable with no significant clinical impact), 4 = Unsatisfactory (repair required), 5 = Clinically poor (replacement required). Scores of 1-3 were considered clinically acceptable, while scores of 4 or 5 indicated restorative failure.