Clinical evaluation of ceramic inlays and onlays fabricated with two systems: 12-year follow-up.

Abstract

The aim of this study was to evaluate the 12-year clinical performance of sintered (Duceram, Dentsply-Degussa, Dentsply International Inc., PA, USA)-D and pressable (IPS Empress, Ivoclar-Vivadent, Schaan, Leichtenstein)-IPS ceramic inlay and onlay restorations. Eighty-six restorations were placed in 35 patients with a median age of 33years by a single operator. The restorations were luted with dual-cured resin luting material (Variolink II, Ivoclar-Vivadent, Schaan, Leichtenstein) and Syntac Classic adhesive under rubber dam. The evaluations were conducted by two independent investigators at the baseline, 1, 2, 3, 5, and 12years using the modified USPHS criteria. At the 12-year recall, 22 patients were evaluated (62.86%), totalling 48 (55.81%) restorations. Seven restorations were fractured (one from Duceram and six from IPS), eight restorations presented secondary caries (three from Duceram and five from IPS), nine restorations showed unacceptable defects at the restoration margin and needed repair or replacement (two from Duceram and seven from IPS), and four IPS restorations presented pulp sensitivity. Chi-square and Mann-Whitney tests revealed that IPS Empress system showed the best results for color match and surface texture (p<0.05) but a significant worse result for fracture (p=0.05). Wilcoxon test showed significant differences in relation to color match, surface texture, marginal discoloration, and marginal integrity between the baseline and 12-year recall for both ceramic systems. This long-term clinical study observed that the main reasons for failure of ceramic restorations were related to fracture, recurrent caries, and decreased marginal integrity over time. Carefully monitoring of the ceramic-tooth interface may extend their clinical longevity.