All-ceramic Restorations Luted with a Self-Etching Adhesive: Two-Year Report

Objectives: To evaluate tooth sensitivity and clinical performance from all-ceramic restorations (CR) cemented with a self-etching adhesive using USPHS modified criteria. Methods: Patients were recruited from the University of Michigan School of Dentistry dental clinics and IRB approval was obtained. Thirty-one restorations were included in the study. Preparation and placement of all CRs was performed by 1 operator. A dual-cure cement with a self-etching adhesive was used for final cementation following manufacturer's instructions. Sensitivity was measured using water at 40⁰F and recorded on visual analog scale (0-100 mm) at baseline and each recall (1 week, 3, 6, 12 and 24 months). The following categories were evaluated using modified USPHS criteria: gingival index, color match, margin discoloration, margin integrity, recurrent caries and proximal contact. Clinical evaluations were performed by 2 evaluators and consensus determined for categories of disagreement. Intraoral photographs were taken of each restoration. PVS impressions were used to create replicas of the restorations to analyze marginal integrity with an optical microscope and imaging software. Results: There was no significant difference between mean sensitivity ratings at each recall or differences from baseline values (p>0.05). Margin integrity of the inlays/onlays showed the most change over time, both clinically and under the microscope. The majority of changes occurred between 1 week and 3 months. There were no significant changes in other characteristics and no restorations were lost over the 2 year recall due to retention failure. Imaging analysis of occlusal margins under function will be presented. Conclusions: There was no significant tooth sensitivity or loss in CR retention using the new adhesive. CR type did not affect sensitivity ratings. Minor signs of breakdown were seen on images of occlusal margins at 2 years. All CRs were clinically acceptable after 2 years. Supported by Dentsply Caulk.