Marginal adaptation of ceramic and composite inlays in minimally invasive mod cavities

Abstract

OBJECTIVES: This study aims to evaluate the effect of a minimally invasive mesial-occlusaldistal (mod) preparation on the marginal adaptation of ceramic and composite inlays with the aim of saving sound dental substance. MATERIALS AND METHODS: Class II mod cavities were prepared in 50 extracted human molars and randomly allocated to five groups (n = 10). In all groups, the mesialproximal box margins were located in the dentin, 1 mm below the cementoenamel junction (CEJ), while the distal box margins were 1 mm above the CEJ. In groups A and B, conventional standard preparations with a divergent angle of = 6°were prepared. In groups C, D, and E, minimally invasive standard preparations with a convergent angle of = 10°were prepared. In groups A and D, composite inlays and, in groups B and C, ceramic inlays were fabricated (chairside economical restoration of esthetic ceramics (CEREC)) and adhesively inserted. In group E, a direct composite filling using the incremental technique was placed. Replicas were taken before and after thermomechanical loading (1,200,000 cycles, 50/5°C, max. load 49 N). Marginal integrity (tooth-luting composite, luting composite-inlay) was evaluated by scanning electron microscopy (×200). The percentage of continuous margins in the different locations was compared between and within groups before and after cycling, using ANOVA and Scheffé post hoc test. RESULTS: After the thermomechanical loading, no significant differences were observed between the different groups with respect to the interface of luting composite-inlay. At the interface of toothluting composite for preparations involving the dentin, groups A and B behaved significantly better compared to the control group E, which in turn were not different to groups C and D. CONCLUSION: Composite and ceramic inlays inserted in minimally invasive prepared mod cavities result in margins not different from those of inlays placed in conventional mod preparations. Direct composite filling margins, however, were inferior to those attained by conventional indirect restorations. CLINICAL RELEVANCE: Minimally invasive preparations for mod inlays with undercuts show marginal adaptation equal to that of conventional inlay preparation design. Keywords: Composite inlay, ceramic inlay; minimally-invasive; marginal adaption Declaration of interests:The authors declare they have no conflicts of interest. AbstractObjectives To evaluate the effect of a minimally-invasive mod-preparation on the marginal adaptation of ceramic and composite inlays with the aim of saving sound dental substance. Materials and MethodsClass II mod-cavities were prepared in 50 extracted human molars and randomly allocated to five groups (n=10). In all groups, the mesial-proximal-box-margins were located in dentin, 1 mm below the cementoenamel junction (CEJ), while the distal-boxmargins were 1 mm above the CEJ. In group A and B, conventional standard preparations with a divergent angle of α = 6° were prepared. In Group C, D and E minimally invasive standard preparation...

Influence of different composite materials and cavity preparation designs on the fracture resistance of mesio-occluso-distal inlay restoration

“…In addition, deeper proximal boxes with limited or no enamel provided at the margins are more challenging clinically 29) . Therefore, maximum preservation of dental hard tissues and minimal invasive cavity designs should be selected to increase the longevity of the tooth 30) . Resin-composite restorative materials in the oral cavity are subject to different environments and cyclic fatigue 31) .…”

Indirect Resin Composite Restorations Fabricated With Chairside CAD/CAM Systems

“…Non-proximal cavities IPS Empress CAD (Ivoclar Vivadent, Schaan, Liechtenstein) Zaruba et al 28 Evaluation the effect of the minimally invasive MOD cavities prepared on marginal adaptation of direct composite restorations, CAD/CAM composite inlays and CAD/CAM ceramic inlays with the aim of protecting sound dental substance.…”

Efficacy of direct restorative materials in proximal box elevation on the margin quality and fracture resistance of molars restored with CAD/CAM onlays

“…(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)15) Lastly, PBE is reported in some publications to perform similar, in terms of margin quality and strength, to restorations placed without PBE. (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13) In addition to the benefits of PBE, utilization of Computer Aided Design-Computer Aided Machined (CAD-CAM) ceramic infiltrated resin composite restorations and resin, nano-ceramic materials in conjunction with the PBE technique offers the following advantages over ceramic restorations: conservation of tooth structure, esthetics, cost, ease of adjustment, reparability and lower enamel wear rates. (7,8,12) Typically, PBE is completed with resin-based composite (RBC) and an adhesively bonded occlusal indirect restoration.…”

“…(2) PBE has been revisited and refined by several authors. (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13) Placing indirect prosthesis margins on direct base materials has even been suggested for use in deep anterior class III and V restorations. (14) In certain clinical cases, when surgical or orthodontic intervention is not an option, the PBE procedure has the potential to save time, money, and biologic tissue.…”

“…Additional benefits of placing indirect restoration margins on an elevated margin using direct materials are noted in the literature. (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13) Indirect restoration preparation and delivery have inherent complexities, especially for onlays and inlays, which can be complicated by deep proximal defects. (7,8) When utilizing PBE, a simplified preparation design gives rise to more manageable internal tooth and restoration intaglio surfaces.…”