Clinical-statistical Study on the Biomimetic Adhesion of Whole Ceramic Inlays

Abstract

Currently, a new approach to restorative dentistry is possible, from biomimetic point of view, by using restorative materials with a natural tooth-like structure and very strong adhesion to the hard remaining tissues. The objective of the study was to compare in vitro the marginal adaptation of restorations with whole ceramic inlays, using the biomimetic method compared to the classical method. A batch of 60 extracted impacted molars was used for the study. Large cavities were prepared at occlusal proximal surfaces according to minimally invasive therapy principles. The teeth were divided into 4 study groups (A, B, C, D). Batches A and C contain teeth prepared and restored through classical method, with entirely ceramic inlays. Batches B and D contain teeth restored through biomimetic adhesive method. After preparation, fluid composite (Gradia Direct Flo - GC) was used as a basic filling material to seal dentine wounds and dental canaliculi according to biomimetic principles. Cementing was done with Variolink Esthetic DC-Ivoclar (lot A and B) and with Maxcem Elite - Kerr (lot C and D). Samples were cut and prepared for microscopic analysis. The analysis of the four batches revealed the existence of the microfissure in the dentine wounds and the presence of fragments detached from the cementing material layer. The hybrid layer is homogeneous with qualitative dental canaliculi sealing. The difference between the two methods is the size of these defects, in the case of the classical method being approximately 2 times larger. The difference between the two types of cementing material used is due to the fact that in case of Maxcem Elite - Kerr cement, discontinuities have been observed at the level of cementing material - inlay material interface. The biomimetic method is superior to the classical one, the integrity of the layers of materials used in the biomimetic treatment is clearly superior to the integrity of the layers of material used in the classical treatment.