Clinical Evaluation of a Dual-cured Cement System

Simplified self-etching adhesives have been developed for use with dual-cured resin cements for indirect ceramic restorations. Objectives:   The purpose of this study was to evaluate the clinical performance of a self-etching adhesive (Xeno IV) with a self-curing activator (SCA) and a dual-cured resin cement (Calibra).  Methods: After obtaining informed consent, 42 Ceramic restorations in 25 patients were placed by a single trained operator in a private practice setting. Teeth without obvious pulpal pathology were selected for restoration. 9 pairs of matched full crowns were placed where one restoration was placed with Xeno IV and the contralateral placed with an etch and rinse system, Prime & Bond NT. An additional 17 posterior crowns and 7 onlays were placed with the experimental system. All anterior crowns and onlays were fabricated from a leucite ceramic and posterior crowns from a lithium disilicate ceramic. Restorations were evaluated at baseline and at 12 months (n=36) and 24 months (n=34) using modified Ryge criteria: Marginal Integrity (MI), Marginal Discoloration (MD), Restoration Integrity (RI), Caries (C) Tooth Sensitivity (S) and Gingival Index (GI). Data was analyzed with Chi Square.  Results: No significant changes were observed in the GI score. After 2 years, 5 restorations were lost to recall and 3 restorations failed. 2 onlays fractured (etiology undetermined) and 1 crown debonded. Data: (A=alfa, B=Bravo, C=Charlie, D=Delta)

            Baseline                     12 months                  24 months                     

MI       100% A                       100%A                        100%              

MD     96.6% A 3.7% B         !00% A                        100%  

RI        100%                           96.4A 3.6% D             89.3% A 10.7% D

C         100%A                        100%A                       100%A

S          78.6% A 21.4% B       100% A                       100%                                                                                              

No differences were observed between restorations in the paired groups (p>0.05). Conclusions:  The experimental material exhibited good clinical performance after 2 years, especially with respect to post-operative sensitivity. Supported by Dentsply/Caulk.