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PubMed1996

A 3-year clinical evaluation of a porcelain inlay system.

OBJECTIVES: The porcelain inlay technique was described over a century ago, and, although not yet used as a routine restorative procedure, may prove to provide restorations of unsurpassed functional and aesthetic qualities in certain situations. The aim of this study was to investigate the handling properties and clinical characteristics of a porcelain inlay system, to highlight any advantages and disadvantages of the restorations under investigation, and to indicate further studies as considered appropriate. METHODS: Fifty moderate to large-sized Class 1 and Class II restorations of a porcelain inlay system were investigated in premolar and permanent molar teeth of 27 adult patients over a 3-year period using modified United States Public Health codes and criteria. Selected restorations were evaluated indirectly by scanning electron microscopic analysis. RESULTS: There was a high early rate of bulk fracture. By 6 months post-placement there had been a limited deterioration in marginal integrity associated with 20% of the remaining restorations, but this trend was not seen to continue. Patient acceptance was very favourable. CONCLUSIONS: It was concluded that the system under investigation afforded a technique-sensitive method of producing tooth-coloured restorations. Proposals for further work include investigations of the fitting accuracy of indirect tooth-coloured restorations, cavity design modifications and the use of alternative bases and luting agents.

Adolescent↗
PubMed1995

Chemical versus dual curing of resin inlay cements.

Dual-cure inlay resin cements polymerize both chemically and through light activation; however, clinically some aspects of the cement are not readily accessible to the light source. This study investigated the degree of cement hardening achieved through chemical curing only versus dual curing and the effect of inlay thickness on cement hardness. Disks 6 x 2.5 mm were prepared from seven commercially available cements. Eight specimens were prepared from each material; half of the specimens were cured chemically only, and the remainder were dual-cured. Knoop hardness measurements were then recorded at 1-hour, 1-day, and 1-week intervals. In addition, 24 specimens of the same dimensions were prepared from each cement. Twelve specimens were dual-cured through resin composite spacers of varying thicknesses (1 to 6 mm), and the others were cured through similar ceramic spacers, and hardness measurements were recorded. Multivariate analysis of variance revealed significant differences in hardness of chemically cured versus dual-cured specimens at the 5% level of significance for all examined cements. Significant differences were also found in the hardness of specimens dual cured through ceramic or resin composite spacers 2 to 3 mm in thickness or more versus those that were dual cured without spacer regardless of the spacer material. It is concluded that chemical curing alone was not sufficient to achieve maximum hardening of the examined cements. Cement hardness was significantly reduced when inlay thickness was 2 to 3 mm or more.

Analysis of Variance↗
PubMed1998

The novel use of extracted teeth as a dental restorative material--the 'Natural Inlay'.

OBJECTIVE: This preliminary study aimed to find out whether it is possible to produce a well fitting Class II inlay from an extracted tooth using a copy-milling technique. METHODS: Two pairs of matching sound extracted permanent molar teeth were used. The molars were matched for mesio-distal size of the tooth crown and the convexity of the approximal surfaces. One tooth of each pair was assigned to be the 'donor' tooth, the other tooth being the 'host'. MO inlay preparations were made in the host teeth. These were restored with the milled 'Natural Inlays' produced from the donor teeth using the CELAY system. The restored host teeth were sliced and examined using light-microscopy. RESULTS: The specimens showed the desired location of enamel and dentine, and a clinically acceptable fit. CONCLUSION: This study has shown that by using the CELAY milling machine it is possible to 'recycle' extracted teeth for the production of dental restorations.

Cementation↗
PubMed1997

Marginal seal of composite inlays using different polymerization techniques.

The effect of indirect and semi-direct curing systems of Cl II composite inlays on microleakage was investigated in vitro and compared to conventional direct posterior composite restorations. Nearly identical Cl II cavities were restored with the same composite resin using different polymerization systems. Microleakage assessment was carried out after cyclic loading and thermal stressing by assessing the dye penetration. The data showed that all inlay techniques resulted in improved marginal sealing compared with conventional restorations. However, the indirect procedure resulted in significantly reduced microleakage compared to the semi-direct inlay techniques.

Acid Etching, Dental↗
PubMed2004

Influence of different light sources on microtensile bond strength and gap formation of resin cement under porcelain inlay restorations.

Clinical success with ceramic inlays/onlays has been assisted by the ability to develop a reliable bond of composite resin to dental tissues. The purpose of this study was to test the efficiency of two different light sources on microtensile bond strength and the gap formation of resin cement under class II porcelain inlay restorations. Standardized mesio-occlusal cavities were prepared in 30 freshly extracted, intact human premolar teeth. Then impressions were made and ceramic inlays were fabricated. In the cementation process, the resin cement/inlay combinations were exposed to two different photopolymerization units. The polymerizations through 15 specimens were performed with a conventional halogen light source for 60 s, and the other specimens were cured by a plasma arc light for 9 s. After the cementation process, two 1.2 x 1.2 mm wide 'I' shape sections per tooth were produced with a sectioning machine and sections were subjected to microtensile testing after 24 h or 1 week. Gap formation of specimens cured by different photopolymerization units were evaluated with scanning electron microscopy (SEM). Statistically significant differences were found between the microtensile bond strength of inlays exposed to conventional light and plasma arc curing unit (P < 0.001). Plasma arc curing units make it possible to polymerize composite in much shorter times than conventional curing unit. However, the samples polymerized with conventional halogen light produced better microtensile bond strength than the plasma arc unit.

Bicuspid↗
PubMed2004

Microleakage of different cementation techniques in Class V ceramic inlays.

Microleakage between the restorative materials and the cavity walls of teeth remains a problem. The purpose of this study was to evaluate the microleakage around Class V ceramic inlay restoration using three different cementation techniques. Class V preparations were made on the buccal surfaces of 45 freshly extracted premolar teeth. The teeth were randomly divided into three groups of 15. In the first group, dentine bonding agent (DBA) (Clearfil Liner Bond 2V) was applied immediately after the tooth preparation (D-DBA). In the second group, DBA was applied to the prepared cavities while luting ceramic inlays (I-DBA). In the third group, DBA was not applied at either stage (No-DBA). Impressions were made and ceramic inlays (Ceramco II) fabricated and cemented in the Class V cavities. The restorations were stored in water at room temperature for 24 h. All restorations were thermocycled and then subjected to a dye penetration test. After sectioning, leakage at cavity/restoration interface was scored. Statistical analysis was performed using Kruskal-Wallis, Mann-Whitney U and Wilcoxon's signed tests. Results showed no significant difference among three different cementation techniques (P > 0.05). Microleakage at the dentine margins was greater than that at the enamel margins (P < 0.05).

Bicuspid↗
PubMed1993

Distributed crack analysis of ceramic inlays.

In all-ceramic restorations, crack formation and propagation phenomena are of major concern, since they may result in intra-oral fracture. The objective of this study was calculation of damage in porcelain MOD inlays by utilization of a finite-element (FE) implementation of the distributed crack theory. "Damage" is defined as the parameter that describes the local decrease of stiffness caused by microdefects. In the simulated MOD ceramic inlay, the crack initiation starts at the internal occlusal surface near the pulpo-axial line angle. This initiation is invisible from the external surface and cannot be detected by the clinician. The crack initiation at the internal surface started as soon as 55-60% of the loading needed for complete fracture was reached. The use of FE techniques for calculation of the fracture in loaded ceramic inlays offers prospects for further detailed study of the crack behavior, including three-dimensional modeling and cyclic loading situations.

Ceramics↗
PubMedDate not supplied

Seating of composite inlays with ultrasonic vibration.

The use of vibration enables the clinician to use high-viscosity luting agents when seating composite inlays and allows quick and efficient placement of the inlay. The film of composite luting agent is achieved in a much shorter time and with lower loads by ultrasonic vibration than using manual methods. In order to achieve a thin lute, the vibrations of the ultrasonic scaler must be directed perpendicular to the surface of the inlay.

Composite Resins↗
PubMed1977

Pulpal reaction to polycarboxylate and zinc phosphate cements used with inlays in deep cavity preparations.

The purpose of the present investigation was to compare histologically pulpal reactions beneath inlays cemented with either a zinc phosphate or a polycarboxylate cement. No inflammatory reaction was seen beneath any of the 39 deep cavity preparations in teeth without pulpal lesions and with an inlay cemented with polycarboxylate cement. In the contralateral teeth, under 39 inlays cemented with zinc phosphate cement, an inflammatory reaction was seen beneath two cavity preparations. In one, bacteria were found on the floor of the preparation. On the basis of this result and the findings of our earlier investigations, it may be warranted to conclude that neither the polycarboxylate cement nor the zinc phosphate cement has any notable irritating effect on the pulp. If the irritation occurs after cementation of the restoration, it may be caused by debris containing bacteria and left behind on the prepared surfaces by bacterial growth from the surface of the tooth. The findings underline the importance of removing grinding debris and bacteria before cementation of the restoration.

Acrylic Resins↗
PubMed1990

The clinical evaluation of heat-treated composite resin inlays.

Laboratory research indicates the physical properties of composite resin used for posterior restorations can be significantly increased if a secondary dry heat treatment of the material was accomplished. This study investigated the clinical performance of a heat-treated composite resin inlay, using both the direct and indirect methods of clinical evaluation. Contrary to laboratory results, no significant differences in wear could be measured between conventional light-cured inlays and those with secondary dry heat treatment. Other clinical advantages of the heat-treated inlays were observed.

Analysis of Variance↗
PubMed1992

A clinical examination of ceramic (Cerec) inlays.

Two hundred and five Cerec ceramic inlays placed by 8 dentists in 72 patients were examined independently by 3 calibrated evaluators 12-24 months after insertion, using the criteria of the California Dental Association (CDA) and also certain periodontal variables. Proximal dental plaque and bleeding on probing were not seen more often on Cerec surfaces than on control homologous surfaces. Ten patients reported postoperative sensitivity after treatment with Cerec inlays. Excellent CDA ratings for Color and Surface were obtained in 57% and 26%, respectively, and for Anatomic Form and Margin Integrity in 55% and 83%, respectively. Obvious differences were seen among the participating dentists with regard to the clinical quality of Cerec inlays. At present, the long-term performance of the Cerec technique cannot be predicted.

Adolescent↗
PubMed1997

Filler content and gap width after luting of ceramic inlays, using the ultrasonic insertion technique and composite resin cements. An in vitro study.

The effect of ultrasonic insertion on the filler content and the gap width for two brands of composite resin luting agents, intended for luting with the ultrasonic insertion technique, were studied after MOD ceramic inlays (Cerec) had been placed. In addition, the internal and marginal gap widths were determined after MOD ceramic inlays (Celay) bad been luted on extracted premolars with this technique. No statistically significant differences (P > 0.05) were observed for either brand between the filler content obtained from the internal surfaces, from the excess luting agent, or from the luting agent as delivered. There were no statistically significant differences (P > 0.05) between the final internal and marginal gap widths when the two brands of luting agent were compared with each other. Except for the final occlusal and internal gap widths obtained for the inlays luted with the Sono-Cem luting agent, no statistically significant differences (P > 0.05) were observed between the gap widths at the different locations determined. Thus, the ultrasonic insertion technique used did not significantly influence the filler ratio of the hybrid luting agents studied. Judged by the findings in this study, the properties of luting agents seem to greatly influence the final marginal and internal gap widths.

Bicuspid↗
PubMed1993

The extent of polymerization of Class II light-cured composite resin restorations; effects of incremental placement technique, exposure time and heating for resin inlays.

The extent of polymerization of light-cured composite resins cured in relatively large class II cavities was estimated by measuring Knoop hardness on sectioned surfaces of resin restorations. The influences of the incremental placement technique, exposure time, and post-curing of resin inlay on the extent of polymerization of two different resin materials were examined. For both MFR type (HE) and hybrid type (P50) materials, the 3-step incremental placement technique was superior when the cavity was restored by the direct filling method. For resin inlays, the post-heating improved the conversion of resin restorations. However, because the final degree of conversion of resin attained by heating was influenced by the initial conversion of the resin at the stage of light-curing, the 2-step incremental placement technique was recommended at the light-curing stage for even resin inlays. As the exposure time is influenced by the transmittance of material and the intensity of activator light, it should be optimized in accordance with manufacturers' directions.

Acrylic Resins↗
PubMed1999

Influence of filler content and gap dimension on wear resistance of resin composite luting cements around a CAD/CAM ceramic inlay restoration.

We investigated the influence of filler content and gap dimension on the wear resistance of composite luting cement around CAD/CAM ceramic inlay restorations. Experimental hybrid dual-cured composite luting cements containing 60, 70, 72, 74 and 80 wt% of silanated barium-silica fillers were used for cementing CAD/CAM ceramic inlay into the cavity. The specimens involving inlay-cement-tooth interfaces were subjected to a three-body wear test. The relation between the interfacial gap dimension and wear loss was also investigated using 60, 70 and 80 wt% filled cements. The cements containing more than 70 wt% filler presented significantly higher wear resistance than 60 wt% filled cement. There was a positive linear relationship between gap dimension and wear loss, and the inclination of the regression line decreased with increasing filler content. These results indicated that the higher filler content of the cement increased the wear resistance and this desirable influence appeared more remarkably in the wider horizontal gap dimension.

Analysis of Variance↗
PubMed1976

[Filling therapy with special reference to experimental studies on model-cast inlays].

By way of introduction, the authors report the results from clinical and radiographic examination of teeth with inlays restorations. In view of further corroboration of the clinical results with modelcast inlays, the authors measured the marginal adaptation of inlays made of Goplat 203 and Sena 65, respectively. The difference in the average marginal adaptation between Goplat 203 and Sena 65 is insignificant, amounting to 3.6 mum in favour of the gold alloy, which permits to recommend Sena as a casting alloy for posterior teeth.

Dental Alloys↗
PubMedDate not supplied

Leucite-reinforced glass ceramic inlays and onlays after six years: clinical behavior.

Ceramic inlays are an esthetic substitute for large amalgam and other metallic restorations. This controlled clinical study evaluated the performance of IPS Empress inlays and onlays with cuspal replacements and proximal margins below the cementoenamel junction over six years of clinical service. Six dentists placed 96 ceramic restorations in 34 patients. Luting was accomplished using the enamel-etch-technique, a dentin bonding system (Syntac Classic) and four different composite systems. The restorations were assessed by two calibrated investigators using modified USPHS criteria at baseline (96 restorations), one (96), two (95), four (89) and six years (67). Seven of the 96 restorations investigated had to be replaced (failure rate 7%; Kaplan-Meier): Five inlays suffered cohesive bulk fractures and two teeth required endodontic treatment. After six years of clinical service, significant deterioration (Friedman 2-way ANOVA; p < 0.05) was found for marginal adaptation of the remaining restorations. Ninety-four 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 quality of the restorations.

Acid Etching, Dental↗
PubMed2001

Molar fracture resistance after adhesive restoration with ceramic inlays or resin-based composites.

PURPOSE: To determine the fracture resistance of teeth, following treatment with various types of adhesive restorations. MATERIALS AND METHODS: 5 0 caries-free, extracted human molars were randomly divided into five groups consisting of 10 molars each. MOD cavities were prepared in 40 molars with a width in the facio-lingual direction of 50% of the intercuspal distances. The cavities were filled with the following materials: Cerec or IPS Empress ceramic inlays, Arabesk or Charisma F resin-based composite (RBC) restorations. The control group consisted of 10 sound, non-restored molars. All 50 teeth were loaded occlusally until fracture using a tensile testing machine. The statistical analysis included ANOVA, Kolmogorov-Smimov-test, Scheffé test, and boxplots. RESULTS: There was no significant difference (P > 0.05) between the mean values of the sound teeth (2,102 N) and the teeth with the Cerec ceramic inlays (2,139 N). However, both groups demonstrated a significant difference (P < 0.05) when compared with the teeth with IPS Empress ceramic inlays (1,459 N) and Arabesk RBC restorations (1459 N). No significant differences were found between the last two groups. Molars restored with Charisma F composite restorations (1,562 N) revealed no significant difference when compared with all other groups including controls (P > 0.05). A stabilization of molars is possible by means of an adhesive restoration in the form of an "internal splinting" regardless of the restorative material used.

Acrylates↗
PubMed2000

Marginal integrity after fatigue loading of ceramic inlay restorations luted with three different cements.

PURPOSE: To evaluate the effect of fatigue loading on the quality of the cement around the margins of adhesive ceramic MOD inlays. MATERIALS AND METHODS: Non-metal IPS Corum porcelain inlays were made and cemented either with the resin-based composite Variolink, the compomer Dyract-Cem or the glass-ionomer cement Ketac-Cem. For each system, half of the specimens were subjected to thermal and mechanical load cycling to simulate fatigue loading. All teeth were then sectioned and evaluated by SEM on topography and by optical microscopy for dye penetration. RESULTS: Before loading, all systems showed good marginal integrity. After loading, inlays cemented with Variolink and Dyract-Cem showed no significant (P > 0.05) increase in marginal break down, however restorations cemented with Ketac-Cem, showed a significant (P < 0.05) deterioration at the margins.

Cementation↗