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PubMed1995

Direct composite inlays versus conventional composite restorations: three-year clinical results.

A clinical trial of direct composite inlays versus conventionally (incrementally) placed restorations made from the same material was started in January 1989. Restorations were randomly allocated to matched pairs of cavities. This study reports the 3-year performance of 71 of the 100 pairs of restorations placed over a 2-year period and followed-up every 6 months. Clinical assessments were made using USPHS criteria (indirect measurements of occlusal wear were made using Ivoclar standard dies) and annual bite wing radiographs. Direct inlays showed significantly less occlusal wear than conventional restorations, but the difference was small. The clinical performance of both types of restoration was similar and compared favourably with studies of other materials. No secondary decay was diagnosed. The direct inlays, however, took longer to place and did not reduce postoperative sensitivity or failure rate (8% failure of inlays and 4% of conventional composites over 3 years). Contouring of proximal and occlusal aspects was not facilitated with direct inlays but may be easier with indirect inlays on removable dies.

Adult↗

PubMed1997

Marginal adaptation of a sintered ceramic inlay system before and after cementation.

The long term clinical performance of porcelain inlays depends on a number of factors and the marginal adaptation is one of significant interest. The purpose of this in vitro study was to evaluate the marginal integrity of a sintered inlay technique (Ducera), before and after cementation. MOD cavities without bevels were prepared on 10 human mandibular molar teeth and porcelain inlays were fabricated according to the manufacturer's instructions. Inlays were evaluated microscopically for their adaptation to the occlusal and approximal margins of the tooth by means of a replica technique. Inlays were cemented with a dual-cured hybrid composite luting material (Enforce). After polishing, each tooth was sectioned in buccal/lingual and mesial/distal directions following the same procedure in the sectioning of replicas. The marginal gap and the thickness of exposed cement were measured at each section. The mean marginal gap of 71.83 +/- 8.93 microm recorded for the occlusal margin before cementation was significantly smaller than that of 105.6 +/- 39.33 microm calculated at the approximal margin. Following the cementation, the adaptation of the inlays at the occlusal margin was also found to be superior to that of the approximal margin. Comparison of mean gap values before and after cementation revealed that the marginal gap increased by 6.94 microm and 23.25 microm at the occlusal and approximal margins, respectively. Although polishing was performed after cementation, excess luting material was still observed, that caused an increase in the width of the exposed luting cement.

Analysis of Variance↗

PubMed1998

Cerana--a new method for the restoration of teeth with prefabricated ceramic inlays.

Cerana are all-ceramic, prefabricated inlays which replace enamel and are produced in a lucite-reinforced glass ceramic. To evaluate the clinical quality of Cerana inlay therapy, 38 patients with a total of 60 inlays were examined in a retrospective cross-sectional study. The inlays were primarily of Class I type, but even Class II tunnel preparations and Class V were examined. The median age of the inlays was 1.5 years. A modified form of the California Dental Association criteria was used in the evaluation. The results show that all inlays were of excellent or acceptable character in terms of marginal fit, colour and surface roughness. None of the patients reported any post-operative symptoms of pain. One restoration had secondary caries and a fractured marginal ridge. One restoration with poor anatomical form caused by a fractured filling and one restoration with deep marginal discolouration were discovered. Although the follow-up time was short, the results show that Cerana can be considered an interesting alternative to other tooth-coloured materials on the market.

Adolescent↗

PubMed2000

Effect of different luting procedures on the seating of ceramic inlays.

This in vitro study evaluated the effect of different luting procedures on the proper seating of ceramic inlays and on the marginal seal through microleakage testing. Sixty mesial-, occlusal-, distal- (MOD) cavities were prepared in third molars, and distributed among four groups. In the control group 1, the cavity surface was treated with dentin and enamel bonding agents; ceramic inlays were placed into the cavity and light cured. In group 2, the dentin and enamel bonding agents were cured prior to the placing of the inlays, and following the insertion. In group 3, the inlays were luted without enamel bonding. In group 4, the inlays were cemented using a one-bottle bonding and two times light curing. The groups with only one time light curing at the end of the luting process exhibited the smallest luting space following cementation. The smallest dye penetration values were obtained for the two groups with separate light curing of the dentin bonding agent. Reducing the film thickness of polymerized dentin bonding agents, i.e. by changing the composition of the bonding agents, could facilitate proper seating of ceramic inlays together with a better marginal seal.

Acid Etching, Dental↗

PubMed1992

Microleakage of indirect inlays placed on different kinds of glass ionomer cement linings.

The objective of this study is to compare the marginal seal of Class II cavities restored with indirect inlays constructed on glass ionomer cement linings having different curing properties. Also the effect of acid-etching of these liners on microleakage was investigated. Mesio-occlusal and disto-occlusal cavities in 80 extracted human molars having the cervical floor below the cementoenamel junction were prepared (n:160). Half of the preparations were restored with Ceramco II porcelain and the rest with SR-Isosit resin inlay material. Liners as light curing Ionoseal light+chemically curing LCL 8 and Zionomer and chemically curing Ketac-Bond glass ionomer cements (GICs) were used. On mesial preparations GICs were acid-etched but were not on distal preparations. All inlays were cemented with Ultrabond composite material. After thermocycling the teeth were placed in a basic fuchsin dye solution for 24 h, then each tooth was sectioned. By using a stereomicroscope the extent of marginal leakage was scored and statistically evaluated. Microleakage was observed beneath all GIC linings and was more extensive between light curing GIC/dentine interface. By acid-etching of GICs the microleakage between GIC/dentine interface was increased significantly. Whether acid-etching was applied or not a significantly increased microleakage was recorded between chemically curing GIC/composite interfaces. Although the marginal microleakage was witnessed in both inlays, it appeared that porcelain inlays provided a better marginal seal, in comparison to SR-Isosit inlays.

Acid Etching, Dental↗

PubMed1992

Effects of cement-curing modes on dentin bonding of inlays.

The aim of this in vitro study was to evaluate dentin adhesion after cementation of immediate direct "All Purpose" Hybrid (AP.H) composite inlays (Dentsply) and Cerec Dicor-MGC (Dentsply) inlays with the dentin adhesive Prisma Universal Bond 2 (Dentsply) and the dual-curing Dicor-MGC luting composite (Dentsply). In 24 extracted human molars, standard MOD cavities were prepared with one approximal margin located in enamel and the other one located in dentin. They were divided into four groups: (I) AP.H inlays, luting composite only, chemically cured; (II) AP.H inlays, luting composite, immediately-light-cured; (III) AP.H inlays, luting composite, initially chemically and delayed-light-cured (15 min); and (IV) MGC inlays, luting composite, initially chemically and delayed-light-cured (15 min). In vitro load cycles corresponding to five years of clinical stress followed. Initially and after specimens were loaded, the margins were analyzed quantitatively by SEM. The tooth/cement and cement/inlay interfaces were scored separately. The initial percentages of "continuous margin"--at both the tooth/luting composite and luting composite/inlay interfaces--were higher than 94% for all groups. At the end of the load cycles, the quality of the margins at the tooth/luting composite interface significantly decreased for all groups. The highest decrease was found for the cervical margins located in dentin, where only 37%-61% were scored as "continuous margin". The AP.H inlay/luting composite interface showed almost no change. At the MGC inlay/luting composite interface, the percentage of "continuous margin" decreased to 74%. After specimens were loaded, the percentage of "continuous margin" in dentin was lower than in enamel, despite the use of a dentin bonding agent (PUB 2).(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗

PubMed1995

Marginal and internal fit of four different types of ceramic inlays after luting. An in vitro study.

The marginal and internal fit of four different types of ceramic inlays--Cerec, Celay, Empress, and Vita In-Ceram Spinell--was determined after they had been luted on extracted premolars. For the Cerec inlays sharp and U-shaped proximal box shapings were also compared. There was no statistically significant difference either in the proximal fit or in the gingivoproximal fit between the four inlay systems studied, with the exception of the Cerec inlays made for preparations with sharp proximal boxes, which had wider marginal gaps. At the occlusal margins a significant-principle order of the gap width was established. The best internal fit was recorded for the Celay inlays, whereas there was no significant difference in the internal fit between the other systems. For the Cerec inlays the U-shaped proximal box shaping improved the marginal accuracy all around the restoration.

Aluminum Oxide↗

PubMed1995

Ceramic inlays (Cerec) cemented with either a dual-cured or a chemically cured composite resin luting agent. A 2-year clinical study.

On the basis of the criteria of the California Dental Association (CDA), 66 CAD/CAM-manufactured ceramic class-II inlays (Cerec) were compared intraindividually after they had been cemented with either a chemically cured or a dual-cured composite resin luting agent in 27 patients. Plaque and gingival conditions, the overall time consumption for producing each inlay, and the frequency of postoperative sensitivity were also evaluated. There was no statistically significant difference between the two luting agents with regard to the properties evaluated. One inlay was replaced owing to fracture of the restored tooth just before the 24-month re-examination. After 2 years excellent CDA ratings were obtained for color in 92% of the remaining 65 inlays. The corresponding figures for surface and for anatomic form were 100% and 85%, respectively. For margin integrity 85% of the 33 inlays cemented with the dual-cured luting agent and 88% of the 33 inlays cemented with the chemically cured luting agent were rated excellent after 2 years.

Adolescent↗

PubMed1997

Esthetic posterior restorations utilizing the double-inlay technique: a novel approach in esthetic dentistry.

The employment of adhesively bonded porcelain or resin composite inlays is considered problematic in Class II cavities extending into the dentin and cannot be recommended as a routine procedure for current clinical practice. A two-part restoration in the form of a double inlay provides an alternative to the clinically established gold inlay restoration. The double inlay is composed of a conventionally cemented metal base and an adhesively bonded porcelain inlay. After the metal substructure is coated with silica or a microretentive opaque glaze is fired, the porcelain inlay can be luted to the metallic base with a bonding resin composite. This procedure incorporates the advantages of cast restorations at the critical cervicoproximal cavity margin and the esthetic and stabilizing properties of the adhesively bonded restoration technique in visible areas.

Bicuspid↗

PubMed1999

Wear of composite resin inlays and antagonistic enamel.

PURPOSE: To evaluate the wear of composite resin inlays and antagonistic enamel wear when they opposed each other. MATERIALS AND METHODS: Cylindrical-shaped composite disk specimens were fabricated with three composite resin inlay materials and a heat-treated direct composite resin (control). The lingual cusps of extracted human maxillary premolars were placed perpendicular to flatten composite resin inlay specimens. Two body localized wear test was carried out using six specimens per material. The surface area of worn enamel and composite specimens was measured by a computerized analysis system. RESULTS: There were statistical differences between inlay materials and the control with respect to enamel wear, although no differences existed between the inlay materials tested. Worn enamel analysis by SEM indicated that large size quartz filler particles created the coarsest surface. The results suggest that the composite resin inlay materials tested are better than the quartz-containing composite resin in terms of antagonistic enamel wear.

Analysis of Variance↗

PubMedDate not supplied

Factors affecting the shear bond strength of bonded composite inlays.

PURPOSE: This article analyzes the influence of different pretreatments on the bond strength between inlays and the resin cement of three different composite inlay systems: Z-100, Targis, and Art Glass. MATERIALS AND METHODS: Four separate treatments of the composite-bonding agent interface were investigated: (1) untreated surface, (2) grinding, (3) sandblasting, and (4) sandblasting followed by silane treatment. Surface topography, roughness, and shear bond strength were evaluated using digital scanning electron microscopy, confocal laser scanning profilometry, and a Lloyd LRX equipped for shear bond testing, respectively. RESULTS: The bond strength is presented both with respect to composite surface pretreatment and with respect to different composite inlay systems. Independent of the composite inlay system, the sandblasted and silane-treated surface was found to give the highest bond strength values, followed by the sandblasted and ground surfaces. The untreated surface showed the lowest bond strength. For pretreated surfaces, Targis showed the highest (P < 0.05) bond strength values, followed by Art Glass and Z-100. This distribution, however, was reversed for the untreated interface, where Z-100 showed the highest bonding strength (P < 0.05). CONCLUSION: Surface pretreatment and roughness as well as the inlay material have an impact on the bond strength and the retention of composite inlays.

Adhesiveness↗

PubMedDate not supplied

Effect of cavity form and setting expansion of refractory dies on adaptability of fired ceramic inlays.

The purpose of this study was to investigate the effect of cavity form and setting expansion of refractory die materials on the adaptability of fired ceramic inlays. Standardized Class I cavities with three kinds of lateral wall divergences (10 degrees, 20 degrees, and 30 degrees) and three kinds of surface roughness were prepared in epoxy resin blocks. A refractory die was prepared from an impression of the epoxy resin cavity, whose setting expansion ranged from 0.01 to 1.13%. A ceramic inlay was fired on each die. The fabricated inlay was inserted into the epoxy resin cavity, and the interfacial distance between the ceramic inlay and the cavity wall at the margin was measured using a reflecting microscope at X100 magnification. The internal fit was measured after sectioning the specimen longitudinally. The results were analyzed by ANOVA and Sheffé's F test. Good adaptation was achieved with the smooth-surface cavity. The adaptability depended on the angle of the cavity divergence, and small gaps were observed in 20 degrees and 30 degrees cavities (P < 0.05). The inlays fabricated on the refractory dies with a small setting expansion demonstrated small internal gaps. Significantly good adaptation was achieved when the setting expansion was less than 0.2% (P < 0.05). The results indicated that the cavity form and the setting expansion of the refractory die material had significant effects on the adaptability of fired ceramic inlays.

Analysis of Variance↗

PubMedDate not supplied

A prospective clinical study of ceromer inlays: results up to 53 months.

PURPOSE: The aim of this study was to evaluate the clinical performance of a ceromer (Targis) in indirect inlay restorations. MATERIALS AND METHODS: Ninty-nine Targis inlays (37 premolars, 62 molars) were placed in 51 patients (mean age 27 years). Twenty-nine percent of the restorations were placed in patients with parafunctional habits such as bruxism or clenching. All restorations were in occlusion and were placed using Variolink (43 Variolink Ultra, 56 Variolink II high viscosity) in combination with the Syntac Classic adhesive system under rubber dam isolation. The restorations were evaluated according to modified USPHS criteria at baseline and for a recall period of 6 to 53 months after insertion. RESULTS: There were two clinically unacceptable failures in total. Fracture was registered in one molar at 38 months, and one molar needed endodontic treatment 7 months after insertion. Based on Kaplan-Meier statistical analysis, the estimated survival rate of the inlays was 97.9% (97.7% for Variolink Ultra, 98.2% for Variolink II high viscosity). It was apparent that deterioration occurred in the surface texture of the inlays, since a slightly pitted surface was observed in 29% of the inlays at recall examinations. CONCLUSION: In this in vivo study, Targis inlays luted with both resin luting agents functioned satisfactorily, with a relatively low fracture rate over a mean evaluation period of 28 months.

Adult↗

PubMed2004

[Marginal adaptation after cementing of gold inlays cast by an experimental procedure. SEM analysis].

AIM: Marginal adaptation is one of the most important factors in dental reconstructions. The aim of the present work was to evaluate with in vivo and in vitro studies the marginal precision and the microstructure of the gold cast inlays. METHODS: For the in vivo analysis 10 patients were selected, while for the in vitro study 10 extracted teeth were used. The impressions were made by polyvinylsiloxane while the master cast was made by gypsum type IV. The inlays were cast in gold (JRVT Jensen) using an experimental procedure. After cementing, the margins of each inlay was burnished. To evaluate the marginal discrepancy of in vivo inlays, the replica technique was used, while for the in vitro analysis the serial slice cut technique was performed. All samples were processed for metallographic analysis using SEM. RESULTS: The measured in vivo inlay marginal gap was 9,06+/-3,37 microns (mean+/-SD), while for in vitro inlay the marginal gap was of 10,47+/-2,09 microns (mean+/-SD). Metallographic analysis showed equiaxial grain of small dimension. CONCLUSIONS: The results suggest that using the proposed casting technique it is possible to increase marginal adaptation and microstructural properties.

Calcium Sulfate↗

PubMedDate not supplied

A preliminary prospective evaluation of all-ceramic crown-retained and inlay-retained fixed partial dentures.

PURPOSE: The purpose of this preliminary prospective study was to evaluate the clinical outcome of crown-retained and inlay-retained fixed partial dentures (FPDs) made from a new lithium-disilicate glass-ceramic (IPS e.max Press, Ivoclar Vivadent). MATERIALS AND METHODS: Eighty-one 3-unit FPDs were placed in 68 patients. The FPDs replaced teeth in the anterior (8%) and posterior region (92%). All teeth were prepared according to a standardized protocol. The size of the proximal connector of the FPDs was 12 mm2 (anterior) or 16 mm2 (posterior), respectively. Crown-retained FPDs were cemented either with glass ionomer (n = 20) or resin composite (n = 16), while all inlay-retained FPDs (n = 45) were cemented with resin composite. Initial follow-up was performed at 6 and 12 months and annually thereafter. RESULTS: The mean observation periods were 48 months (for crown-retained FPDs) and 37 months (for inlay-retained FPDs). None of the crown-retained FPDs failed during the observation period, while 6 inlay-retained FPDs (13%) had to be replaced. Six cases failed because of debonding (n = 3) or a combination of debonding and fracture (n = 3). During the observation period, 2 patients died and the status of another 5 patients is unknown. The 4-year survival rate according to Kaplan-Meier was 100% for crown-retained FPDs and 89% for inlay-retained FPDs. The differences between the groups were statistically significant. CONCLUSION: Crown-retained 3-unit FPDs made from a new glass-ceramic have a significantly better outcome up to 5 years than inlay-retained 3-unit FPDs over the observation period.

Adult↗

PubMed2006

A new design for all-ceramic inlay-retained fixed partial dentures: a report of 2 cases.

In a previous clinical study, all-ceramic resin-bonded 3-unit inlay-retained fixed partial dentures (IRFPDs) had a significantly worse outcome in the posterior region than did crown-retained 3-unit FPDs made from the same material. Debonding or fractures were causes of failure. To improve the clinical outcome of IRFPDs, a new framework design was developed: (1) The inlay retainers were made out of CAD/CAM-manufactured zirconia ceramic to improve fracture resistance, and additional veneering of the inlays was omitted. (2) The inlay retainers were completed with a shallow occlusal inlay (1-mm minimum thickness) and an oral retainer wing (0.6-mm minimum thickness). The wings were designed to reduce stress on the inlay retainer caused by torsion forces when the FPD is loaded nonaxially and to increase the enamel adhesive surface area. The pontic was circumferentially veneered with feldspathic porcelain. The clinical and laboratory procedures of this new treatment modality are described, and 2 exemplary clinical cases are presented. This new preparation and framework design might improve the clinical outcome of all-ceramic resin-bonded IRFPDs. However, adequate evidence of long-term safety and efficacy is required before this new design can be recommended for general clinical practice.

Adult↗

PubMed1990

Composite resin inlays: a single appointment technique.

This article presents a time efficient technique for the fabrication and subsequent placement of a composite resin inlay. An inlay preparation is cut into a tooth and a polyvinylsiloxane impression is made. A polyether impression of the polyvinylsiloxane impression forms a die, then a composite resin inlay is fabricated on the die. The inlay is contoured and polished on the die and occlusion is evaluated clinically. The inlay has a final polymerization under intense light and vacuum pressure, then is cemented with a mixture of unfilled resin and hybrid composite. The technique allows an esthetic restoration to be placed in one appointment. The die provides easy access and rapid inlay fabrication. There is no need to place a separator on the prepared tooth, no chance of premature tooth bonding, and interproximal contact is easily achieved.

Adult↗

PubMed1989

[Some properties of various composite resin inlay products].

Several problems associated with materials and clinical techniques are pointed out for posterior composite resin restoration. One of the solutions to these problems is the application of the indirect composite resin inlays. Three kinds of products for composite resin inlay are being marketed at present. We examined the mechanical properties, surface roughness and radiopacity for each product. Inlay/Onlay (Ivoclar), Brilliant D.I. (Colténe) and CR Inlay (Kuraray) were used in this study, and composite resin inlays were fabricated in accordance with the manufacturers' instructions. The highest values of mechanical properties after immersion in water for 24 hours are shown below: table; see text The mechanical properties of the composite resin inlay, subjected to thermal cycling at 4 degrees C and 60 degrees C for 3 minutes each for 5,000 cycles, tended to decrease in comparison with those immersed in water for 24 hours. Inlay/Onlay showed the smallest surface roughness (Ra), i.e. the best smoothness value below: table; see text The radiopacity was highest for Inlay/Onlay with Brilliant D.I. and CR Inlay being successively lower.

Composite Resins↗