Clinical Evaluation of Ceramic Inlays Compared to Composite Restorations

Abstract

SUMMARYThis study compared the clinical performance of indirectly manufactured ceramic Evopress inlays with those of directly placed, fine particle hybrid Filtek Z250 composite restorations in posterior teeth.From January 2000 to October 2003, 109 patients received 264 Evopress (Wegold) ceramic inlays and 68 patients received 145 Filtek Z250 (3M ESPE) composite restorations in a dental office. Two-hundred and fifty ceramic inlays (95%) and 135 composite restorations (93%) were re-examined up to 57 months after placement. Modified USPHS criteria were used for the study. The worst finding of all the assessments was the overall assessment of individual restorations. On the basis of these criteria, 220 (88%) Evopress ceramic inlays were assessed as Alpha at the time of clinical re-examination, 26 (10%) were judged Beta and four ceramic inlays (2%) were rated Delta in the re-examination interval and thus categorized as failures. At the time of re-examination, 91 of the 135 composite restorations (67%) were judged Alpha, 36 restorations (26%) were rated Beta and three restorations (2%) were judged Charlie. Five restorations (4%) were categorized as failures (Delta). In two cases, there were marginal gap formations; there were also two cases of secondary caries after 28 and 35 months, as well as a fracture after 13 months. According to Kaplan and Meier, the survival rate after 57 months was 94% for ceramic inlays and 93% for composite restorations. The log rank test showed no significant differences in the survival curves.The current study showed that indirectly manufactured Evopress ceramic inlays performed better than direct Filtek Z250 composite restorations in marginal adaptation, color match and Ralf-Thomas Lange, Dr med, Dr med dent, dentist, private office, Mönchengladbach, Germany *Peter Pfeiffer, Prof Dr med dent, professor, Department of Prosthetic Dentistry, School of Oral Medicine, University of Cologne, Germany Clinical RelevanceEvopress ceramic inlays and Filtek Z250 composite restorations showed no significant difference regarding survival probability at 57 months when used as Class I and II restoratives in premolars and molars. Both materials demonstrated acceptable clinical performance, with a preference for the ceramic inlays. 264Operative Dentistry anatomic form. However, with regard to survival probability, there was no significant difference.

Fracture Rates and Lifetime Estimations of CAD/CAM All-ceramic Restorations

“…Within the same time frame (12 y), we estimated a 10.5% failure probability for Empress CAD onlays and 9.5% for Empress CAD inlays. For a similar glass-ceramic (Evopress; Wegold, Wendelstein, Germany), 3 fractures were recorded from a total of 250 inlays after a mean period of 2.7 y (~0.5% annual failure rate) (Lange and Pfeiffer 2009). Conversely, the time that e.max CAD onlays are expected to show 10% of failure may take 30.3 y and inlays significantly longer, a difference revealed only when assuming an underlying failure distribution (Weibull).…”

Characterization of a polymer-infiltrated ceramic-network material

“…On the other hand, the dimensional changes resulting from the polymerization are determined by the monomers of the polymer matrix, and the most common monomers are BisGMA, UDMA, UTMA, and Bis-EMA [13]. Nevertheless, the clinical performance of direct composites is still inferior to the performance of indirect ceramic restorations considering marginal adaptation, color match, and anatomic form [14]. A 3-year clinical study showed that indirect resin-based composite restorations have inferior esthetic and wear resistance compared to all-ceramic restorations [15].…”

Quality and Survival of Direct Light‐Activated Composite Resin Restorations in Posterior Teeth: A 5‐ to 20‐Year Retrospective Longitudinal Study

“…Furthermore, some studies showed statistically similar clinical outcomes to replacements for amalgams, bonded resin inlays, and bonded ceramic inlays in systematic reviews . One clinical study showed similar mean survival times between ceramic inlays and PCRS after 57 months.…”