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PubMed1995

Ceramic inlays and onlays: update 1995.

Tooth-colored inlays and onlays are increasingly sought by the public because of a growing interest in restorations that appear natural, and because of concerns about mercury in amalgam fillings. Following the introduction of bonded porcelain inlays in 1985, many of these restorations were placed. These inlays were a natural sequel to the porcelain laminate that reached North America in 1984, yet they did not enjoy the same rate of success. The advent of industrially fabricated porcelain blanks and the ability to copy-mill a positive as an inlay or onlay has resulted in a reliable and predictable dental restoration. Pressed ceramics, which are modelled by wax pattern, are also effective tooth-colored restorations.

Aluminum Oxide↗
PubMedDate not supplied

Radiopacity of resin-based inlay luting cements.

The radiopacity of a group of seven resin-based inlay luting cements in addition to two porcelain veneer cements was determined. Four inlay cements (Indirect Porcelain System Dentist Bonding Kit, Dicor MGC, Duo, and Twinlook) were found to have radiopacity values significantly greater than the radiopacity of enamel. Two other inlay cements (Dual and Porcelite Dual Cure) were found to have radiopacity values not significantly different from that of enamel, while All-Bond Crown and Bridge cement had a radiopacity value significantly lower than the radiopacity of dentin. For the two porcelain veneer cements examined, one material (Mirage Bond) had a radiopacity value significantly greater than that of enamel, while the other (G-Cera Porcelain Veneer Bonding System) had a radiopacity value significantly lower than that of dentin. It was concluded that only the materials that have radiopacity values greater than or equivalent to the radiopacity of enamel are suitable for use as inlay cements. For porcelain veneers, a relatively high radiopacity value of the cement is advantageous.

Analysis of Variance↗
PubMed1993

Inlays and onlays.

Dentists must meet the increased demands of patients for esthetic dentistry. Because the substitution of amalgam with direct composite restorations is somewhat problematic and restricted to special indications only, the most suitable method is the esthetic inlay. All available systems are reviewed and described. These restorations must be inserted with adhesive techniques. The performance and the problems associated with these techniques are described in detail. Improvements in luting techniques, eg, the use of ultrasonic energy, may further simplify the application technique for esthetic inlays. For clinical success, the margin quality of adhesively luted inlays is essential. In vitro and in vivo studies with esthetic inlays report good clinical behavior of such restorations. However, until the results of long-term clinical studies are available, these systems should not be used on a routine basis as a substitute for amalgam.

Composite Resins↗
PubMed1993

The dimensional accuracy and stability of composite inlays.

The dimensional accuracy and stability of two composite inlay materials was studied by assessing polymerisation shrinkage, thermal expansion and water sorption. Impression taking, die accuracy and stability and wear of the material were also considered. The mean coefficients of thermal expansion (20 to 65 degrees C) determined using a differential dilatometer were: Clearfil 21 X 10-6 and Isosit 31 X 10-6. A metal die similar to that used by Taylor in 1931 to assess casting shrinkage of gold inlays was used to assess polymerisation shrinkage. Isosit had a mean protrusion value of 0.321 mm providing a value for linear polymerisation shrinkage of 0.9%. In contrast Clearfil specimens had a mean protrusion of 0.108 mm providing a value for linear polymerisation shrinkage of 0.3%. The expansion due to water sorption at seven days was very small and did not offset the polymerisation shrinkage. However, these must be interpreted in light of the results of long term immersion studies. The total dimensional change of an Isosit specimen is -1.06%. For an inlay of 5 mm in diameter the linear dimensional change would be 54 micrometers, providing a cement space of 27 micrometers. The total dimensional change of a Clearfil specimen is -0.53%. For an inlay of 5 mm in diameter the linear dimensional change would be 27 micrometers, providing a cement space of 13.5 micrometers.

Absorption↗
PubMed1997

Effect of gap size and cement type on gingival microleakage in Class V resin composite inlays.

Microleakage along the gingival interface was measured in 52 teeth that had received standardized preparations at a fixed depth of 2.0 mm and were restored with Class V composite inlays. Two fabrication techniques and two types of luting cement were compared. Twenty-six teeth were cemented with a resin-modified glass-ionomer cement, and 26 were cemented with a conventional resin cement. Half of the inlay patterns in each cementation group were fabricated directly on the tooth, and half were fabricated indirectly on stone dies. The resin cement was more significantly effective in preventing leakage than the resin-modified glass-ionomer cement. There was no statistically significant difference between inlay fabrication techniques. For those inlays cemented with the resin cement, the mean leakage was substantially lower for the indirect patterns than for the direct group. Although this difference was not statistically significant, it suggests that the slightly larger interfacial gap resulting from the fabrication of indirect patterns is effective in creating a better seal.

Cementation↗
PubMedDate not supplied

6-year clinical evaluation of fired ceramic inlays.

The purpose of the present study was to evaluate the quality of fired ceramic inlay restorations consisting of a feldspathic porcelain system (G-Cera Cosmotech II) after 6 years in vivo. A total of 49 fired ceramic inlays (for 27 premolars and 22 molars: class 1 in 11 teeth, class 2 in 36 teeth, and onlays in two teeth) were placed in 29 patients, and all restorations were evaluated at the time of placement, at 6 months, and 1, 2, 4, and 6 years after placement using modified USPHS criteria. Replicas made of the restorations were observed using a scanning electron microscope (SEM) to assess the state of the marginal area and wear of the restoration. Favorable color match was noted, and no bulk fracture, tooth fracture, or missing restorations were detected. Longevity was observed in 92% of the fired ceramic inlay restorations at 6 years (Kaplan-Meier method); however, marginal fracture was detected in six restorations (13%) and marginal discoloration in 11 (23%). SEM evaluation disclosed marginal microfracture in 49% of the restorations, wear in 19%, and wear of resin cement along margins in 36% at 6 years. No significant difference was observed in the incidence of each of these three characteristics between molars and premolars. This longitudinal 6-year clinical observation suggested that fired ceramic inlay restorations made by the G-Cera Cosmotech II system are aesthetic, durable, and clinically acceptable. Further follow-up is needed for the restorations showing marginal degradation and fracture from a microscopic and macroscopic perspective.

Dental Marginal Adaptation↗
PubMed2001

Amniotic membrane inlay and overlay grafting for corneal epithelial defects and stromal ulcers.

OBJECTIVES: To determine the effect of amniotic membrane transplantation (AMT) on persistent corneal epithelial defects (PEDs) and to compare the efficacy between inlay and overlay techniques. METHODS: Thirty patients (30 eyes) underwent AMT for PED. The use of AMT was restricted to patients in whom all previous measures, including bandage contact lens and tarsorrhaphy, had failed. The amniotic membrane was placed on the surface of the cornea in overlay (group A) or inlay (group B) fashion. RESULTS: The PED healed after the first AMT in 21 eyes (70%) within an average of 25.5 days after surgery and recurred in 6 eyes (29%). Among the 22 eyes treated with an overlay AMT (group A), the PED healed after the first AMT in 14 eyes (64%) within an average of 24.5 days and recurred in 4 eyes (29%). Among the 8 eyes treated with an inlay AMT (group B), the PED healed within an average of 27.4 days after AMT, which did not statistically significantly differ from group A (P = .72). The PED healed after the first AMT in 7 eyes (88%) and recurred in 2 (29%) of 7 eyes. CONCLUSIONS: The AMT can be helpful in the treatment of PED in which all other conventional management has failed. However, the success rate in our study was not as high as that previously reported, and our results showed a high incidence of recurrences of epithelial defects. We did not find any difference between overlay and inlay techniques in terms of healing time and recurrence rate.

Adult↗
PubMed2006

Full arthroscopic inlay reconstruction of posterior cruciate ligament.

We report a full arthroscopic inlay reconstruction technique to avoid the morbidity of traditional open inlay procedure. With the transeptal approach a trough is created arthroscopically at the anatomical tibial insertion of the PCL, which must fit with the patellar bone block of a quadriceps tendon autograft. The bone plug is harvested with two nonabsorbable sutures, each end of which is passed through two holes from the cortical to the cancellous side. The graft is introduced into the knee joint from the posteromedial portal using two traction sutures passed previously through two transtibial tunnels exiting at the middle of the trough. Tibial graft fixation is achieved using the sutures knotted at the anterior aspect of the tibial cortex. Arthroscopic inlay procedure may be a rational surgical alternative because it reduces the crucial steps of an open inlay procedure, such as extensive exposure of the posterior capsule, the need of position change with risk of contamination, longer surgical time, and the risk of bone block fracture if an autograft is harvested. The arthroscopic procedure may also be performed also when hardware presence of previous surgery limits use of the open technique. We initially limited use of this technique to patients: (1) undergoing PCL revision surgery, (2) having hardware from previous tibial surgery, and (3) presenting a PCL lesion following posterior dislocation with previous vascular surgery. The results have been good, and we are now also using this technique for primary PCL reconstruction with favorable results.

Adolescent↗
PubMed2001

Dislocation of the polyethylene inlay due to anterior tibial slope in revision total knee arthroplasty.

We report a case of dislocation of the polyethylene inlay in revision total knee arthroplasty. Eight days after revision arthroplasty due to a previous infection, the polyethylene inlay of a PCL- retaining cemented total knee arthroplasty dislocated at about 80 degrees of flexion on the CPM machine. Lateral X-ray examination revealed an anterior slope of the tibial cut of 5 degrees. Correction of the tibial slope to a posterior tibial slope of 7 degrees reduced the forces on the posterior aspect of the inlay and no redislocation occurred. The mechanisms causing tibial inlays to dislocate in TKA are analyzed and discussed.

Arthroplasty, Replacement, Knee↗
PubMed2006

Reconstruction of isolated posterior cruciate ligament injuries: a clinical comparison of the transtibial and tibial inlay techniques.

PURPOSE: To compare the clinical and stress radiologic results of posterior cruciate ligament (PCL) reconstruction using the transtibial tunnel technique and tibial inlay technique. TYPE OF STUDY: Retrospective case series. METHODS: Patients who had received isolated PCL reconstruction without combined ligamentous reconstruction and who also had a minimum 2-year follow-up were included in the study. The transtibial tunnel technique with quadrupled hamstring autograft group (group A) was composed of 21 knees and the tibial inlay technique with bone-patellar tendon-bone autograft group (group B) of 22 knees. We compared the 2 groups with regard to Lysholm knee scores, Tegner activity scores, posterior draw tests at 90 degrees flexion, and radiologic stability of the knees by using a Telos device (Austin & Associates, Fallston, MD). RESULTS: The Lysholm knee scores showed a significant improvement from 55.3 points preoperatively to 91.5 at the final follow-up in group A and from 51.7 preoperatively to 93.5 at the final follow-up in group B. However, intergroup differences were not significantly different (P = .259). Activity levels, as determined using the Tegner scoring system, also showed significant improvements at the final follow-up in both groups, but again, this was not significantly different (P = .264). On the posterior drawer test at the final follow-up, normal or grade I laxity was observed in 19 patients in group A and in 20 patients in group B. By instrumented posterior laxity testing, mean side-to-side differences were significantly improved from 12.3 mm preoperatively to 3.7 mm at the final follow-up in group A and from 11.0 mm to 3.3 mm in group B, but without significance (P = .607). CONCLUSIONS: The transtibial tunnel and tibial inlay techniques produced relatively good clinical and stress radiologic results, and no significant differences were identified between the 2 techniques. Therefore, we suggest that the transtibial tunnel and tibial inlay techniques are both satisfactory PCL reconstruction procedures. LEVEL OF EVIDENCE: Level III.

Arthroscopy↗
PubMed2005

Photoablative inlay laser in situ keratomileusis (PAI-LASIK) in the rabbit model.

PURPOSE: To evaluate the suitability, biocompatibility, and efficacy of a proprietary hydrogel photoablative inlay (PAI) for use during laser in situ keratomileusis (LASIK). SETTING: Laboratory study, Tulane University Health Sciences Center, New Orleans, Louisiana, USA. METHODS: Eight rabbits (1 eye each) underwent the PAI-LASIK procedure; 4 eyes had a disk-shaped inlay and 4, a donut-shaped inlay. Preoperatively, the hydrogel material was ablated with a programmed correction of 5.0 diopters of hyperopia or myopia. RESULTS: The eyes were followed for 1 to 16 months. No eye showed signs of rejection or extrusion of the PAI. There was no significant difference in corneal clarity or the healing rate between eyes with donut-shaped PAIs and those with disk-shaped PAIs. One eye with a donut-shaped PAI had minimal corneal haze. The remaining inlays did not opacify or fracture during ablation. CONCLUSION: The hydrogel material can be used for the proposed PAI-LASIK procedure.

Animals↗
PubMedDate not supplied

[Complete dislocation of the polyethylene inlay after internal hemipelvectomy and individually fitted tumor endoprosthesis].

We report about an exceptional complication after internal hemipelvectomy and replacement of the defect with a custom-made endoprosthesis. A complete luxation of the PE-inlay out of the metal cup occurred. Radiologically we assumed a luxation of the femoral head in dorsal direction. Revision after a failed attempt of closed reposition showed a complete luxation of the inlay, which was caused by deficient fixation in the acetabular component. The absence of a contrast wire in the PE-inlay delayed the right diagnosis and made it difficult to find the dislocated inlay in the large wound.

Bone Neoplasms↗
PubMed1982

[Sports show support inlays. A biomechanical comparison of three different types of arch support (author's transl)].

The effect of three different types of support inlays for sports shoes was investigated in the basis of measurements made on 37 athletes who use such shoes in their daily training. The date were obtained from force measurements (repulsion force on the ground) and with the aid of films. The investigation showed that there was no difference in the average values of the three types of support (loose inlay, glued-in inlay and support permanently attached to the shoe). All the supports reduced medial bending at the ankle joint. None of them caused a reduction medial bending at the ankle joint. None of them caused a reduction of repulsion forces when the foot came into contact with the support. In propulsion, all the supports caused an increase in the lateral outturn of the foot. The scatter range in the measurements obtained with the loose inlay was greater; a connection was found between this and the possibility of the foot slipping in the shoe.

Biomechanical Phenomena↗
PubMed1997

[Clinical evaluation of ceramic inlay made by CAD/CAM for 3 year]

In this study,ceramic inlays made by CAD/CAM system were used to restore posterior tooth defects.After three years of clinical observation on 21 prostheses no secondary caries was found and patients satisfied with their restoration on aspects of color match and resistance to wear etc.Five cases of inlay fracture and of obvious space between inlay margin and Cavowall were found.The main reason was the insufficient thickness of the inlays meanwhile the selection of bonding agent was not appropriate.The clinical successful rate is 76.20%.As CAD/CAM is a sophisticated technique induced into prosthodontic area just in 1980's,it has still some deficiency to be improved and perfected.

Journal Article↗
PubMed1997

Preliminary report: a ceramic containing crosslinked collagen as a new cranial onlay and inlay material.

Simple ceramic bone graft materials have demonstrated significant limitations for use in craniomaxillary reconstruction. We investigated a new, alloplastic composite bone grafting material containing particulate hydroxyapatite and crosslinked collagen in a time-sequence study. Five rabbits underwent surgical placement of high-loading and low-loading composite onlay and inlay grafts in the parietal region of the skull. Animals were sacrificed at either 1, 2, 4, or 6 months postoperatively. All rabbits demonstrated tissue continuity and healing of both onlay and inlay grafts to the outer table of the skull. Bony ingrowth was shown in both onlays and inlays with bone proliferation and vascularization. Bony ingrowth was seen as early as 1 month postoperatively. Inlay grafts healed flush to the outer table, while onlay grafts maintained at least 80% of graft volume at 6 months postoperatively. We conclude that a composite bone grafting material containing a ceramic and collagenous matrix may offer significant advantages to the reconstructive surgeon. The material appears to be easy to handle and carve, is biologically tolerated, and is able to maintain graft volume. Further studies of this new composite material are warranted.

Animals↗
PubMedDate not supplied

[Modelling of dental tissues for inlays with profile wax].

A method has been developed for modelling, with profile wax, of absent dental tissues for inlays with the application of one-stage model casting. Close contact is guaranteed by the application of the method--point, free interdental space, exact construction of the "tail" of the inlay in the aproximal sides of the tooth and a possibility of great economization of metal while working out the inlays on highly destructed teeth.

Humans↗
PubMed1991

Microleakage around direct composite inlays.

The purpose of this study was to compare the microleakage around direct composite inlays bonded with a dual cure luting composite into Class V type inlay cavities in extracted molar teeth. Bonding methods which included two cavity cleansing regimes and three bonding treatments were used. Either pumice and rinse or rinse only cavity cleansing was used to remove the separator agent (agar/alcohol) from the cavity surface prior to inlay bonding. Restorations were thermocycled between 5 degrees C and 55 degrees C (with intermediate baths at 36 degrees C) before (240 cycles) and during (12 cycles) silver staining. Microleakage around the sectioned restorations was quantified using digital imaging microscopy at x 40 magnification. Data analysis indicated that failure to include pumice slurry application as part of the cavity cleansing regime prior to bonding lead to a marked increase in microleakage at the enamel/restoration interface following one of the three bonding treatments.

Air↗