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Biomedical subjects

R Frankenberger

Publications and source records attributed to R Frankenberger.

At least 19 recordsLinked to original sources
PubMed2006

Antagonist enamel wears more than ceramic inlays.

Wear phenomena of ceramic inlays are not fully understood. The aim of the present study was to evaluate ceramic wear, antagonist enamel wear, and luting cement wear over 8 years. The two-fold null hypothesis was that there would be (1) no difference in wear behavior between ceramic and enamel, and (2) no influence of filler content of luting composites on composite wear. From 96 restorations, 36 Class II inlays from 16 participants were selected. For inlays with opposing enamel cusps (n=17), replicas of inlays and enamel were scanned with a 3-D laser scanner. Luting gaps of inlays (n=36) were analyzed with a profilometer, including 3-D data analysis. Ceramic and enamel wear increased between 4 and 8 years, with significantly higher values for enamel after 6 years (p<0.05). Luting gap wear increased continuously up to 8 years (p<0.05), with no influence of luting composites (p>0.05) and location of teeth (p>0.05).

Adult↗
PubMed2006

[Evaluation of the modern self-etching adhesives efficacy].

The durability of bonding efficacy of composites with hard tissues of a tooth was investigated at application of one-bottle adhesive with total etching and five self-etching adhesives. The efficiency of etching by 36% orthophosphoric acid and acid components of self-etching adhesives was estimated. The adhesion between substrate and composite was measured by method of microtensile bond strength (mTBS). The control of efficiency of etching and depth of the penetration was carried out with the confocal laser scanning microscopy. It was established, that self-etching adhesives are capable to guarantee bonding of composites with enamel and dentine at a level compared with adhesives of the 5th generation. Deep adhesives penetration in dentine tubules is not the key factor for creation of reliable bonding.

Acid Etching, Dental↗
PubMed2005

Ceramic inserts do not generally improve resin composite margins.

summary Ceramic inserts are reported to possibly reduce polymerization shrinkage for posterior resin composite fillings. The aim of the present investigation was to evaluate the effect of different insert systems before and after thermomechanical loading. Sixty sound human third molars received occlusomesial Class II cavities, 40 with proximal margins 2 mm above and 20 with proximal margins 1 mm below the cementum-enamel junction. The specimens were randomly assigned to one of the six experimental groups (n = 10). The enamel-bordered cavities were restored with Syntac classic and Tetric Ceram (ST), Syntac classic, Tetric Ceram and beta-quartz inserts (TB), Syntac classic, Tetric Ceram and Cerana inserts (TC), Syntac classic, Tetric flow and SonicSys approx inserts (TS). The dentin-limited cavities were filled with Syntac classic and Tetic Ceram (DT), Syntac classic, Tetric flow and SonicSys approx inserts (DS). Before and after thermomechanical loading (100 000 x 50 N, 2500 x 5 degrees C/55 degrees C), replicas were made and both interfaces tooth/composite and insert/composite were examined under a scanning electron microscope at 200x. The Cerana and SonicSys insert groups showed significantly less gaps in enamel (P < 0.05). With beta-quartz inserts, no reduction of gaps was found (P > 0.05). Marginal integrity in dentine-bordered specimens could not be improved with SonicSys inserts (P > 0.05). The bonding performance insert/composite was promising for all IPS Empress inserts (Cerana, SonicSys enamel) but worse for beta-quartz inserts. Regarding gap formation between resin composite and tooth, Cerana and SonicSys inserts significantly reduced gaps. The use of SonicSys inserts in deep proximal cavities cannot be recommended.

Ceramics↗
PubMed2004

Single-bottle adhesives behave as permeable membranes after polymerization. I. In vivo evidence.

OBJECTIVES: This study tested the hypothesis that single-bottle total-etch adhesives are effective in reducing dentine permeability under in vivo conditions. METHODS: Crown preparations on vital human teeth were performed under local analgesia as part of the treatment plan for prosthetic rehabilitation. Four single-bottle adhesives (Single Bond, 3M ESPE; Excite DSC, Ivoclar Vivadent; Prime and Bond NT Dual-Cure, Dentsply DeTrey and One-Step, Bisco Inc.) were applied to the cut dentine after acid-etching. Polyvinyl siloxane impressions were taken, using an ultra-low viscosity impression material, of the smear layer-covered dentine before applying the adhesives to deep vital dentine, and after adhesive placement. Additional impressions were taken of the adhesive-sealed dentine following the removal of the provisional prostheses after a 7-10 day period. Epoxy resin replicas of the crown preparations were examined with scanning electron microscopy to evaluate the extent of dentinal fluid transudation during pre-bonded, immediately bonded and post-bonded periods. RESULTS: Dentinal fluid transudation from localised areas that were close to the dental pulp was universally observed from all epoxy resin replicas, irrespective of the adhesive employed. The transudation of dentinal fluid from the control smear layer-covered dentine of each crown preparation was comparatively mild when compared to the extent that was observed after total-etching and application of the single-bottle adhesive. Dentinal fluid droplets were specifically located over the surface of the adhesive layer. Continuous transudation of dentinal fluid occurred even after the removal of the provisional prostheses, and was considerably more profuse in subjects who opted for the fitting of the permanent prostheses without the use of a local anaesthetic solution. CONCLUSION: Single-bottle adhesives, because of their lack of a comparatively more hydrophobic bonding resin layer, behave as permeable membranes after polymerisation. They permit the continuous transudation of dentinal fluid and do not provide a hermetic seal in vital deep dentine. Although the relatively slow rate of diffusion of dentinal fluid is unlikely to result in post-operative cold sensitivity, it may interfere with the optimal polymerisation of dual-cured or auto-cured composites or resin cements in both direct and indirect restorations.

Adhesives↗
PubMed2003

Effect of preparation mode on Class II resin composite repair.

Complete removal of failed posterior resin composite fillings is time-expensive and involves the risk of removing sound tooth substance. In any case of failure within the composite material, intra-oral repair would be favourable. This in vitro study was conducted to examine the effect of different preparation and bonding modes on integrity of repaired restorations. Forty-eight direct Class II resin composite restorations (Syntac Classic/Tetric Ceram) were placed in extracted human third molars. The specimens were stored for 365 days and then replaced partially by removing the central part of the proximal box with all margins located in composite. The partial repairs were placed with the same materials after pre-treatment with a silicon carbide bur and Syntac Classic (n = 8). Preparation modes have been (i) box-only parallel, (ii) box-only with undercuts, (iii) box with undercuts and additional occlusal retention. The repairs were performed either with (i) Tetric Ceram or with (ii) Tetric Flow as thin lining covered with Tetric Ceram. Before and after thermomechanical loading (100 000 cycles of 50 N and 2500 cycles between +5 and +55 degrees C in an artificial mouth), marginal quality between aged and freshly applied composite was evaluated by SEM at x200 magnification and microleakage was observed by light microscopy at x50 magnification. Box-only preparations exhibited a better fatigue resistance than preparations with additional occlusal retention. This observation was independent from the presence of undercuts (P < 0.05). An intermediary layer of flowable resin composite tended to result in better marginal quality, however, not being statistically significant.

Biocompatible Materials↗
PubMed2001

Clinical performance of a condensable metal-reinforced glass ionomer cement in primary molars.

OBJECTIVE: Aim of the present study was to evaluate the clinical suitability of the condensable metal-reinforced glass ionomer cement Hi-Dense in classes I and II cavities of primary molars. METHODS: Seventeen children received a total of fifty four Hi-Dense fillings (nineteen class I and thirty five class II). The restorations were clinically assessed at baseline, after one and after two years of clinical service according to modified USPHS codes and criteria. The restorations were replicated in each recall and representative samples were qualitatively analysed under a SEM. RESULTS: Over the observation period of two years, five restorations failed due to total retention loss, two fillings needed replacement because of persisting hypersensitivity, one filling was lost because of an unsuccessful endodontic treatment, and four restorations remained intact until natural exfoliation (Two year survival rate: 92% for Class I and 66% for Class II). The SEM analysis of surfaces and marginal areas exhibited an inferior adhesive performance primarily in proximal areas, whereas a negative step formation due to wear was frequently observed in occlusal parts. CONCLUSIONS: The results clearly indicate that the condensable, metal-reinforced GIC Hi-Dense reveals no enhanced performance and lifetime expectancy for class II restorations in primary molars when compared to other non-resin-modified GICs.

Cermet Cements↗
PubMed2001

Effect of surface treatment on fatigue behaviour between Tetric Ceram inlays and Variolink luting composite.

The effect of pre-treatment of composite inlays on bonding performance between a resin composite inlay and a luting composite has not been fully studied. The aim of the present study was to evaluate the influence of three different pre-treatment modes on fatigue bond strength and marginal adaptation. One hundred twenty resin composite discs (Tetric Ceram) were made as simulated inlays and randomly assigned to four groups (n=30): Without treatment (WT), hydrofluoric acid etching for 15 s + silanating (HF), roughening with a silicon carbide bur (SC), and silica coating + silanating (CO). Luting composite cylinders (Variolink II low) were bonded to the discs using Heliobond, and after 24 h in water at 37 degrees C, quasistatic shear bond strengths (n=l) and fatigue bond strengths (n=20; 5,000 cycles) were measured. Thirty-two third molars received occlusomesial Class II cavities (n=8), and direct resin composite inlays were luted with identical methods and materials. Before and after thermomechanical loading (100,000x50 N, 2,500 x +5 degrees C/+55 degrees C), replicas were made and examined (SEM, x200). CO and SC exhibited significantly higher bond strengths and adhesive fatigue limits than HF and WT (P<0.05). After thermomechanical loading, CO (98% continuous margin) and SC (95% continuous margin) demonstrated that they provide significantly more fatigue resistance than HF (88%).

Acid Etching, Dental↗
PubMed2001

Clinical performance and margin analysis of ariston pHc versus Solitaire I as posterior restorations after 1 year.

The resin composite Ariston pHc (pHc means pH control) was introduced as an alternative for fast amalgam replacement. The aim of the present study was to evaluate clinically the behaviour of this non-bonded resin composite material, promising the release of fluoride, calcium, and hydroxy ions, in comparison to a bonded resin composite (Solitaire I) in class I and II cavities. Ninety-nine cavities in 31 patients were restored in a controlled prospective clinical study. Fifty fillings were placed with Ariston pHc as per the manufacturer's instructions, i.e. neither with enamel etching nor with the use of rubber dam. The same patients received 49 Solitaire I restorations totally bonded with Solidbond using rubber dam. At baseline, after 6 months, and after 12 months, two investigators given the same instructions examined the restorations, according to modified USPHS codes and criteria. Forty selected restorations (20 Ariston, 20 Solitaire) were additionally analysed via replicas, using a stereo light microscope (SV 11, Zeiss, Germany) at 130x magnification. After 12 months, 95 restorations were rated clinically acceptable (6% failure rate for Ariston pHc; 2% for Solitaire). Statistically significant differences were computed for both materials regarding the criterion "filling integrity". Further statistically significant deterioration for Ariston pHc between the three evaluations has been detected for the criteria "tooth integrity" (enamel cracks) and "marginal adaptation" (gap formation/Friedman 2-way ANOVA; p<0.05). With Ariston the criterion "hypersensitivity" also increased significantly after 1 year in comparison to Solitaire. The microscopic margin analysis revealed significantly increasing marginal deficiencies over time for both materials regarding the criteria "perfect margin", "gap formation", and "negative step" (P<0.05; Friedman 2-way ANOVA).

Adult↗
PubMed2001

"No-bottle" vs "multi-bottle" dentin adhesives--a microtensile bond strength and morphological study.

PURPOSE: To compare the adhesive capability of the new adhesive Prompt L-Pop (ESPE) with that of two total-etch adhesive systems-EBS Multi (ESPE) and Prime&Bond NT (Dentsply). METHODS: Extracted human molars were bonded and prepared for microtensile dentin bond strength (microTBS) testing using Prompt L-Pop, EBS Multi, and Prime&Bond NT combined with Pertac II (composite) or Hytac Aplitip (compomer). Prompt L-Pop was applied using five different protocols: (1) as an "all-in-one" self-conditioning adhesive, as per manufacturer's instructions (LP); (2) as a self-etching primer combined with a separate bonding resin (LP/self-etch 2-step); (3) as a classical primer used upon etching dentin with phosphoric acid, followed by a bonding resin (LP/total-etch 3-step); (4) as a multi-application "all-in-one" self-conditioning adhesive (LP/multi-coat) to leave a visibly glossy dentin surface; and (5) as a filled adhesive, upon adding quartz fillers to its composition (LP/filled). After 24h of storage in water at 37 degrees C the microTBS were measured in an Instron machine. Corresponding interfaces of the same specimens were micromorphologically analyzed using SEM and TEM. RESULTS: When used with a composite resin, LP/filled and LP/multi-coat resulted in significantly higher microTBS than LP. The addition of an extra adhesive bonding resin (LP/self-etch 2-step) had no effect on bond strength. The use of Prompt L-Pop as a primer of a fourth-generation adhesive (LP/total-etch 3-step) replacing the EBS Multi primer, resulted in lower bond strengths than those of the original EBS Multi. LP/multi-coat showed similar microTBS to Prime&Bond NT (P&BNT). When used with a compomer, LP exhibited higher bond strengths than when used with the resin composite and was as effective as the experimental groups LP/filled and LP/multi-coat and the control group P&BNT. The SEM evaluation showed an inconsistent hybrid layer for the LP specimens, whereas in both the LP/filled and LP/multi-coat specimens a hybrid layer was clearly evident. Under the TEM all groups displayed dentin hybridization with dissolved smear plugs in the specimens that had been conditioned with Prompt L-Pop without a separate etching step. In many tubules of specimens conditioned with LP (as per manufacturer's instructions), fillers of the resin composite were present within the dentinal tubules. CONCLUSIONS: When combined with a resin composite, Prompt L-Pop resulted in statistically lower bond strengths when applied in one layer than when applied in multiple layers. Prompt L-Pop also resulted in higher bond strengths when used with a polyacid-modified composite resin than with a composite resin. When applied in multiple coats, Prompt L-Pop results in bond strengths that are not statistically different from those of Prime&Bond NT, a total-etch adhesive.

Acid Etching, Dental↗
PubMed2001

Effect of solvent and rewetting time on dentin adhesion.

OBJECTIVE: The purpose of this in vitro study was to determine the influence of solvent and rewetting time on microtensile dentin bond strengths of four dentin adhesives. METHOD AND MATERIALS: Sixty human molar specimens were divided into four dentin adhesive treatment groups: (1) a water-based total-etch dentin adhesive, EBS Multi; (2) an ethanol-based total-etch adhesive, Excite; (3) an acetone-based total-etch adhesive, Prime & Bond NT; and (4) an ethanol- and water-based total-etch adhesive, Single Bond. For each dentin adhesive, three specimens were assigned to five dentin moisture conditions. Specimens were tested in the tensile mode. RESULTS: When adhesives were applied to moist dentin, bond strengths varied from 26.2 MPa for Prime & Bond NT to 29.5 MPa for Single Bond without any statistical differences. When applied to dentin that had been dried for 15 seconds, Prime & Bond NT and Excite resulted in the lowest mean bond strengths, but they were statistically similar to each other (7.9 and 8.3 MPa, respectively). Single Bond resulted in a mean bond strength of 12.7 MPa, which was significantly lower than that of EBS Multi (24.1 MPa). For the latter, all mean bond strengths were statistically similar when some amount of moisture was present on the surface. For the other three adhesives, mean bond strengths returned to the range obtained on moist dentin only when dentin was rewet for 30 seconds. CONCLUSION: Bond strengths upon rewetting depend on the type of solvent in the bonding system, and rewetting time.

Acid Etching, Dental↗
PubMed2000

New trends in dentin/enamel adhesion.

The acid-etch-technique has provided an ideal surface for bonding to enamel by using 30-40% phosphoric acid. The resulting etch pattern is characterized by the profuse formation of microporosities which allow the penetration of monomers into those porosities to form resin tags that provide micromechanical retention. Successful attempts of bonding to dentin in a similar fashion have been reported more recently. Due to the specific properties of dentin, such as its tubular structure and its intrinsic wetness, bonding to dentin has not yet reached the ideal characteristics. In spite of the existing deficiencies in dentin adhesion, the increasing demand for esthetic restorations has generated intensive research on new esthetic materials with special focus on amalgam alternatives. The bonding mechanism of recent dentin bonding agents is based on the penetration of ambiphilic molecules into acid-etched dentin to form a lacework of dentin collagen and polymerized monomers. Dentin adhesive systems that contain a multitude of different bottles of different colors and shapes belong to the past. Because clinicians are increasingly eager to try new materials, the actual tendency calls for simplification of the bonding procedure e.g. one-bottle adhesive systems and all-in-one no-bottle materials. In spite of simpler materials, a separate etching step is still needed for one-bottle systems. Nevertheless, manufacturers of these simplified one-bottle materials recommend their use to bond polyacid-modified composites (compomers) without a separate etching step. The most recent addition to the group of simplified adhesives is the all-in-one no-bottle adhesives; one of these all-in-one systems, Prompt L-Pop (ESPE) has resulted in very promising laboratory results when used on enamel. In spite of the uncertainty about the capacity of all-in-one adhesives to etch enamel adequately in vivo, scanning electron microscopy studies have resulted in an enamel-etching pattern morphologically similar to that corresponding to phosphoric acid-etched enamel. While all-in-one adhesive systems have been reported to result in very satisfactory dentin bond strengths, results from other laboratories suggest that bonding to dentin with all-in-one adhesive systems will need to be somewhat improved. Clinical studies, which are the ultimate test for the acceptance of dentin adhesives, are now underway in several centers. Six-month data showed a very good clinical performance for this ultra-simplified all-in-one adhesive system.

Acid Etching, Dental↗
PubMed2000

Adhesive luting of indirect restorations.

PURPOSE: To describe the potential of adhesive luting procedures with respect to (1) material characteristics and classifications, (2) film thickness, (3) overhang control, (4) bonding to different inlay materials, (5) adhesion to tooth substrates and the problem of hypersensitivities, (6) wear of luting composites, and (7) clinical performance. MATERIALS AND METHODS: A literature review of relevant studies of various in vitro and in vivo studies enables an overview of possibilities and limitations of adhesively luted indirect restorations. RESULTS: (1) Resin-based composites are the material of choice for adhesive luting. Both material properties and wear behavior of fine particle hybrid-type resin-based composites are superior to other materials. The use of compomers is questionable due to hygroscopic expansion and possible crack formation as proven for IPS Empress caps in vitro and in vivo. (2) Recent luting cements exhibit excellent flow characteristics with mean film thicknesses ranging between 8 microm and 21 microm. The ultrasonic insertion technique is recommended for viscous luting composites or conventional restorative composites utilizing their thixotropic properties. (3) For successful overhang control, good fit of the restoration (during luting) and high radiopacity of the cement (after luting) are indispensable. Overhang control is estimated easier when the ultrasonic insertion technique is applied. (4) The pre-treatments of ceramic inlays using hydrofluoric acid or silica coating result in effective bonding; for pre-treatment of resin-based composite inlays, silica coating is promising as well. (5) Bonding to enamel and dentin is proven clinically acceptable, but it should be performed with multi-step systems providing separate primers and bonding agents producing a perfect internal seal with almost no hypersensitivities. Dual-cured multi-step bonding agents provide the most promising potential. (6) The viscosity and filler content of the resin composite used for luting does not influence the wear characteristics within the marginal luting area in vivo. However, the ultrasonic insertion technique involving high viscosity materials provides enhanced handling characteristics for luting of tooth-colored inlays. (7) Clinical results with tooth-colored inlays and veneers are promising over periods of up to 10 yrs, including use in severely destroyed teeth.

Acid Etching, Dental↗
PubMed1999

Fatigue behaviour of different dentin adhesives.

The aim of this in vitro study was to compare quasistatic and cyclic fatigue dentin bond strength of modern adhesive systems representing different generations. One hundred and fifty cavities were made in discs of freshly extracted human third molars and filled with direct resin composite restorations. Dentin adhesives of different generations (SY = Syntac Classic, multi-step system with self-etching primer; SE = Syntac Classic with additional phosphoric acid etching prior to application of the self-etching primer; SB = Scotchbond Multi-Purpose Plus, multi-step system with total etching; PE = Prime & Bond 2.1, single-step system with and without [PB] total etching) were used in combination with one hybrid composite. After 21 days of storage, 10 specimens for each adhesive system were subjected to thermocycling (1150 cycles) for 24 h and were afterwards debonded in a push-out test. Another 20 specimens were tested with cyclic fatigue according to the staircase method with 5000 cycles for each specimen. Static and cyclic push-out bond strengths, respectively, for each group were (MPa): SY 16.9 +/- 0.9 and 14.2 +/- 1.7, SE 17.5 +/- 1.8 and 14.8 +/- 3.4, SB 18.5 +/- 1.7 and 13.9 +/- 2.1, PB 14.6 +/- 2.2 and 7.2 +/- 2.4, PE 13.4 +/- 2.2 and 6.8 +/- 1.8. Both quasistatic and dynamic bond strengths revealed better values for the multi-step systems (P < 0.05). All adhesive systems tested revealed a significant fatigue behaviour which was more pronounced for the one-bottle system with a decrease of about 50% independent of additional dentin etching.

Adhesiveness↗
PubMed1999

Internal adaptation and overhang formation of direct Class II resin composite restorations.

The aim of the present in vitro study was to evaluate different restorative concepts for posterior resin composite fillings in terms of internal adaptation and overhang formation. Eighty standard occluso-distal cavities with and without a 1.5-mm bevel were restored in a phantom head using Syntac Classic and Tetric Ceram with and without Tetric Flow as thin lining or Solid Bond and Solitaire with and without FlowLine. The restorations were finished intraorally and afterwards subjected to thermal loading (1150 x +5 degrees C/+55 degrees C) for 24 h. The proximal margins of the original specimens were analyzed for overhangs under a stereo light microscope (100-fold magnification) before and after intraoral control with loupes, including additional polish. Afterwards the teeth were cut longitudinally, replicated, and their internal integrity analyzed under a SEM (200-fold magnification). The combination of flowable and viscous composites resulted in enhanced internal adaptation for both adhesive systems. However, Syntac Classic exhibited superior adaptation characteristics compared with Solid Bond. In terms of overhang formation, the use of flowable materials always led to higher percentages of marginal overhangs in beveled cavities. Higher viscous materials alone resulted in higher percentages of underfilled margins of beveled than box-shaped cavities. It was clear that the use of magnifying glasses during finishing was beneficial for reducing marginal overhangs up to 40%.

Composite Resins↗
PubMed1999

Crack formation of all-ceramic crowns dependent on different core build-up and luting materials.

OBJECTIVES: The aim of this in vitro study was to evaluate various core build-up and luting materials regarding their effect on crack formation of all-ceramic crowns. METHODS: Fifty-six freshly extracted sound human third molars were prepared according to a standardized procedure obtaining a circular shoulder of 1.5 mm with all margins located in dentin. Sixty percent of the dentin volume were removed and restored with totally bonded build-up composite resins or resin-modified glass ionomer cements (RMGIC) or compomers. Cast IPS-Empress caps were manufactured and luted with the different materials. For each material group, the volumes of the core build-ups and of the luting cements were determined. The caps were examined for cracks after 1, 3, 6, 9 and 12 months storage in 0.9% saline solution at 37 degrees C. RESULTS: The tested groups revealed no major differences in the percentage of the core build-ups and in the volume of the luting cements. After 12 months only the group with composite resin build-up and luting showed no crack formation. RMGIC/compomer build-up or RMGIC/compomer luting always resulted in cracking of the caps. CONCLUSIONS: Within the limits of this study it can be concluded that the hygroscopic expansion of RMGIC/compomer materials led to failure of all-ceramic crowns, when the materials are used for both core build-up or adhesive bonding.

Acrylates↗
PubMed1999

IPS Empress inlays and onlays after four years--a clinical study.

OBJECTIVE: Ceramic inlays are used as esthetic alternatives to amalgam and other metallic materials for the restoration of badly damaged teeth. However, only limited clinical data are available regarding adhesive inlays and onlays with proximal margins located in dentine. In a prospective, controlled clinical study, the performance of IPS Empress inlays and onlays with cuspal replacements and margins below the amelocemental junction was examined. MATERIALS AND METHODS: Ninety-six IPS Empress fillings were placed in 34 patients by six clinicians. The restorations were luted with four different composite systems. The dentin bonding system Syntac Classic was used in addition to the acid-etch-technique. At baseline and after 6 months, one, two and four years after placement the restorations were assessed by two calibrated investigators using modified USPHS codes and criteria. A representative sample of the restorations was investigated by scanning electron microscopy to evaluate wear. RESULTS: Seven of the 96 restorations investigated had to be replaced (failure rate 7%; Kaplan-Meier). Four inlays had suffered cohesive bulk fractures and three teeth required endodontic treatment. After four years in clinical service, significant deterioration (Friedman 2-way Anova; p < 0.05) was found to have occurred in the marginal adaptation of the remaining restorations. Seventy-nine percent of the surviving restorations exhibited marginal deficiencies, independent of the luting composite. Neither the absence of enamel margins, nor cuspal replacement significantly affected the adhesion or marginal quality of the restorations. CONCLUSION: After four years, extensive IPS Empress inlays and onlays bonded with the dentin bonding system Syntac Classic were found to have a 7% failure rate with 79% of the remaining restorations having marginal deficiencies.

Adult↗