Four-year clinical evaluation of a self-adhesive luting agent for ceramic inlays.
OBJECTIVE
The aim of this randomized controlled clinical trial was to evaluate the 4-year clinical performance of a self-adhesive resin cement, RelyX Unicem (3M ESPE), used for cementation of ceramic inlays. In addition, the influence of selectively acid-etching enamel prior to luting on the clinical performance of the restorations was assessed.


METHODS
Sixty-two IPS Empress 2 inlays/onlays were placed in 31 patients by two experienced clinicians. The restorations were luted with RelyX Unicem with (=experimental group: E) or without (=control group: NE) prior enamel etching with phosphoric acid. At baseline, 6 months, and 1, 2, and 4 years after placement, the restorations were assessed by two calibrated investigators using modified USPHS criteria. Ten selected samples of each group were investigated under SEM regarding morphological changes at the cement-inlay interface.


RESULTS
The recall rate at 4 years was 97%. Two restorations (1 E, 1 NE) were lost, and one (E) had to be replaced due to inlay and tooth fracture resulting in a survival rate of 95%. No significant differences between the experimental and control group were noticed regarding all criteria (McNemar, p < 0.05). An obvious deterioration in marginal integrity was observed after 4 years as only 5% (E = 7%; NE = 3%) of the restorations exhibited an excellent marginal adaptation. In 90% of the restorations small, still clinically acceptable marginal deficiencies were observed. SEM of the luting gap showed an increased wear of the RelyX Unicem cement over the 4-year period.


CONCLUSIONS
The self-adhesive luting cement RelyX Unicem can be recommended for bonding of ceramic inlays/onlays. Additional selective enamel etching does not improve the clinical performance of the restorations within the 4-year period.


CONCLUSIONS
The self-adhesive resin composite RelyX Unicem showed acceptable clinical performance after 4 years of clinical service.
Leuven BIOMAT Research Cluster, Department of Conservative Dentistry, School of Dentistry, Oral Pathology and Maxillo-facial Surgery, Catholic University of Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium. marleen.peumans@med.kuleuven.be
Marleen
M
Peumans
M
M
Voet
J
J
De Munck
K
K
Van Landuyt
A
A
Van Ende
B
B
Van Meerbeek
D000134:Acid Etching, Dental; D000293:Adolescent; D000328:Adult; D002484:Cementation; D003738:Dental Cements; D018772:Dental Marginal Adaptation; D003776:Dental Porcelain; D017268:Dental Prosthesis Retention; D017220:Dentin-Bonding Agents; D005260:Female; D006801:Humans; D007284:Inlays; D053208:Kaplan-Meier Estimate; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D019279:Resin Cements; D018709:Statistics, Nonparametric; D055815:Young Adult
D003738:Dental Cements; D017220:Dentin-Bonding Agents; C483701:Rely X Unicem; D019279:Resin Cements; D003776:Dental Porcelain