title: Eight year results with direct ceramic restorations (Cerana).
abstract: BACKGROUND
  Single-visit system ceramic restorations are now in use to provide an alternative to resin-based materials. Inserts have been shown to improve characteristics of composite restorations.
  
  
  OBJECTIVE
  To investigate the longevity of Cerana (Nordiska Dental, Sweden) in a prospective clinical trial.
  
  
  METHODS
  Cerana restorations use matched drills with pre-etched and silanated leucite inserts cemented using a conventional restorative composite resin material. The results of 33 Cerana restorations up to eight years (25 Class I, eight class II) are presented. Restorations were reviewed and assessed by two examiners using modified USPHS criteria for anatomical form (AF) A-C, marginal adaptation (MA) A-D, surface roughness (SR) A-D, marginal discoloration (MD) A-C, colour match (CM) A-C and discomfort (DT) A-D as well as retention.
  
  
  RESULTS
  The percentage of A scores for AF, MA, SR, MD, CM and DT at baseline (n = 33) were: 100, 100, 79, 100, 21, 100; after two years (n = 27) 100, 85, 33, 100, 19, 100 and after four years (n = 24) 96, 75, 17, 96, 25, 100. At six years (n = 20) 95, 70, 10, 95, 15, 100 and finally at the eight year recall (n = 18) 94, 61, 0, 94, 6, 100. AF was maintained in all except for one fractured marginal ridge. MA of the insert was good but composite was lost where exposed. SR increased to a B score for all inserts. MD at B grade was observed in 6% between composite and tooth but none between insert and composite. CM was stable in all cases. DT nil in all. There were no scores less than B. All reviewed restorations were retained, clinically acceptable and in function except for two lost for reasons not directly related to the Cerana insert. One class II restoration had a fractured marginal ridge but otherwise remains satisfactory.
  
  
  CONCLUSIONS
  The results suggest that these restorations can be expected to perform well. Cerana is acceptable in terms of aesthetics, patient acceptance, occlusal wear and ease of use and is a good alternative for a single-visit, tooth coloured restoration in suitable cavity shapes.
authors.affiliation: King's College London Dental Institute at Guy's, King's College & St Thomas' Hospitals, Denmark Hill Campus, London SE5 9RW.
authors.forename: B J
authors.initials: BJ
authors.lastname: Millar
authors.affiliation: King's College London Dental Institute at Guy's, King's College & St Thomas' Hospitals, Denmark Hill Campus, London SE5 9RW.
authors.forename: P B
authors.initials: PB
authors.lastname: Robinson
mesh_terms: D000538:Aluminum Silicates; D002516:Ceramics; D003188:Composite Resins; D003776:Dental Porcelain; D019554:Dental Restoration Wear; D006801:Humans; D007284:Inlays; D011446:Prospective Studies
chemical_list: D000538:Aluminum Silicates; C113675:Cerana; D003188:Composite Resins; D003776:Dental Porcelain; C078519:leucite