Clinical evaluation of two types of ceramic inlays and onlays after 6 months

Abstract

he aim of the present study was to evaluate the clinical performance of two types of ceramics: a slurry-powder ceramic (Duceram Plus, Degussa) -D and a hot-pressed leucite-based glass-ceramic (IPS Empress, Ivoclar Vivadent) -IPS. Eighty-six restorations, 44 IPS and 42 D, were made by one operator. A total of 33 onlays and 53 inlays on twenty-seven premolars and 59 molars were cemented in 35 patients of both sexes, mean age 35 years. All restorations were cemented with the dual-resin cement (Variolink, Ivoclar-Vivadent) under rubber dam and were evaluated at the baseline and after six months, using the modified U.S.P.H.S. criteria for postoperative sensitivity, secondary caries, fracture, color match, marginal discoloration, marginal integrity and surface texture. Additionally radiographs and intraoral photographs were carried out. At baseline 86 restorations were analyzed and all of them received Alfa rating, except for the following that received Bravo rating for postoperative sensitivity -IPS (2.27%); D (7.14%); for color match -IPS (2.27%); D (2.38%) and for surface texture -IPS (2.27%); D (11.90%). After 6 months 100% of the restorations were analyzed and the following received Bravo rating: color match -IPS (4.55%) and D (9.52%); surface texture -IPS (2.27%) and D (11.9%); marginal discoloration -IPS (6.82%) and D (4.76%) and marginal integrity -IPS (4.55%) and D (7.14%). The results were submitted to the Fisher and McNemar Statistical Tests. No significant differences were noticed between the two ceramics. Both ceramics demonstrated satisfactory clinical performance after six months. Uniterms: Ceramic; Inlay; Onlay; Esthetic restoration; Clinical study. ste trabalho se propôs a avaliar a performance clínica de dois tipos de cerâmica: IPS Empress, Ivoclar-Vivadent -IPS e Duceram Plus, Degussa -D. Foram realizadas 86 restaurações por apenas um operador, sendo 44 IPS e 42 D. Vinte e sete pré-molares e 59 molares, num total de 33 onlays e 53 inlays, foram cimentadas em 35 pacientes de ambos os sexos, com idade média de 35 anos. A cimentação das restaurações foi realizada com cimento resinoso dual (Variolink, Ivoclar-Vivadent) sob isolamento absoluto e avaliadas no baseline e após 06 meses, mediante o critério U.S.P.H.S. modificado, quanto à sensibilidade pulpar, reincidência de cárie, fratura, reprodução de cor, descoloração marginal, integridade marginal e textura superficial. Adicionalmente foram realizadas radiografias e fotografias. No baseline foi obtida a classificação Bravo nos itens sensibilidade pulpar -IPS (2,27%); D (7,14%); reprodução de cor -IPS (2,27%); D (2,38%) e textura superficial -IPS (2,27%); D (11,90%). Após 06 meses foram analisadas as 86 restaurações, nas quais foi constatada a classificação Bravo para os itens reprodução de cor -IPS (6,82%); D (2,38%); textura superficial -IPS (2,27%); D (9,52%); descoloração marginal -IPS (6,82%); D (4,76%) e integridade de superfície-IPS (4,55%); D (7,14%). Os resultados obtidos foram submetidos ao Teste Estatístico de Fisher e McNemar. Não houve dife...

Considerations for Altering Preparation Designs of Porcelain Inlay/Onlay Restorations for Nonvital Teeth

“…Fradeani et al reported that marginal discoloration and marginal integrity were interrelated, and both would deteriorate with time . This fact can be attributed to the wear of resin luting cement, which was considered to be one critical aspect of adhesively luted ceramic restorations . This was found in some prospective studies, in which the marginal adaptation was the criterion with the lowest Alpha ratings and may also have affected the results of this study, provided the timeframe for follow‐up was longer.…”

“…In the present study, GIC was used as a base to block out undercuts, helping to standardize the depth of the pulpal floor and reducing the loss of tooth substance during cavity preparation. 31 GIC bases may reduce the risk of cusp fracture during the time between cavity preparation and the insertion of adhesive inlays. 23 It seems that depth of the preparation and the remaining inter-axial thickness were among the most critical factors that reduced the fracture resistance of teeth.…”

“…Another failure of ceramic restorations has been reported to occur as bulk fractures . Factors associated with clinical success of ceramic inlay/onlay restorations appear to be related to cavity preparation, cementing agents, insufficient thickness, and internal defects in ceramics . Ceramic materials with more favorable mechanical properties have the potential to function effectively as inlays/onlays .…”

“…24 Factors associated with clinical success of ceramic inlay/onlay restorations appear to be related to cavity preparation, [25][26][27][28] cementing agents, 29 insufficient thickness, 30 and internal defects in ceramics. 31 Ceramic materials with more favorable mechanical properties have the potential to function effectively as inlays/onlays. 19,32 IPS e.max Press (Ivoclar Vivadent AG, Schaan, Liechtenstein), which is a multiphase glass-ceramic with a high degree of crystallinity and favorable mechanical properties (flexural strength 400 MPa) 18,19 demonstrated strength against fracture and tensile forces.…”

Biaxial flexural strength of Turkom-Cera core compared to two other all-ceramic systems

“…Several developments have taken place in these areas resulting in the production of ceramic materials for clinical use. These include the aluminous porcelain crown (Vitadur, Vita Zahnfabrik, Bad Säckingen, Baden-Württemberg, Germany), the non shrink ceramic crown (Cerestore, Johnson and Johnson, East Windsor, NJ, USA), the castable mica glass-ceramic crown (Dicor, Caulk/Dentsply, Milford, DE, USA) and the leucite-reinforced glass ceramics (IPS Empress, Ivoclar Vivadent, Schaan, Liechtenstein) 8,20,22,26,32 . All these all-ceramic systems exhibit low flexural strengths (100-150 MPa), which make them at risk of failure when used for the construction of either posterior crowns or fixed partial dentures 12,21,23 .…”