Computer-designed inlays after 5 years in situ: clinical performance and scanning electron microscopic evaluation

Area of Science:

• Restorative Dentistry
• Dental Materials Science
• Biomaterials Engineering

Background:

• Computer-aided design/machining (CAD/CAM) has advanced ceramic dental restorations.
• Long-term clinical performance data for CAD/CAM ceramic inlays is crucial for evaluating their efficacy.
• Assessing marginal integrity and tooth-inlay interfaces is key to understanding restoration longevity.

Purpose of the Study:

• To evaluate the 5-year clinical performance of mesio-occlusodistal adhesive ceramic inlays.
• To assess wear, recurrent caries, color match, marginal discoloration, and marginal integrity.
• To examine tooth-cement and cement-inlay interfaces using scanning electron microscopy.

Main Methods:

• Eight ceramic inlays fabricated via CAD/CAM were clinically examined after 5 years.
• Evaluation used modified US Public Health Service criteria.
• Scanning electron microscopy assessed tooth-cement and cement-inlay interfaces at occlusal and axial margins.

Main Results:

• All inlays received excellent 'Alfa' ratings for wear, recurrent caries, and color match.
• Five inlays received 'Alfa' and three received 'Bravo' ratings for marginal discoloration and integrity.
• High percentages of continuous interfaces were observed: 81.0% (tooth-cement, occlusal), 84.1% (cement-inlay, occlusal), 73.6% (tooth-cement, axial), and 87.0% (cement-inlay, axial).

Conclusions:

• CAD/CAM ceramic inlays exhibit good long-term clinical performance over 5 years.
• The study highlights the potential of these restorations, with minor areas for improvement noted.
• Ongoing advancements in ceramic materials, design, and luting agents aim to further enhance restoration quality.