title: Long-term performance of posterior InCeram Alumina crowns cemented with different luting agents: a prospective, randomized clinical split-mouth study over 5 years.
abstract: OBJECTIVE
  This prospective, randomized clinical split-mouth study investigated the 5-year performance of InCeram Alumina posterior crowns cemented with three different luting cements. 4-META- and MDP-based cements were used for adhesive luting. Glass ionomer cement served as control.
  
  
  METHODS
  Sixty patients were treated with 149 (n = 62 Panavia F/MDP; n = 59 SuperBond-C&B/4-META; n = 28 Ketac Cem/glass ionomer) InCeram Alumina crowns on vital molars and premolars in a comparable position. Follow-up examinations were performed annually up to 5 years after crown placement using the modified United States Public Health Service (USPHS) criteria. Kaplan-Meier survival analysis comprised secondary caries, clinically unacceptable fractures, root canal treatment and debonding. Kaplan-Meier success rate included restorations with minimal crevices, tolerable color deviations (<1 Vitashade), and clinically acceptable fractures. Logistic regression models with a random intercept were fitted.
  
  
  RESULTS
  The 5-year Kaplan-Meier survival probabilities were: SuperBond-C&B 88.7 %, Panavia F 82.8 %, Ketac Cem 80.1 % with no significant difference (p = .813). Endodontical treatment was carried out on 7.4 % of all abutment teeth, and 5.4 % revealed secondary caries. Unacceptable ceramic fractures were observed in 7.4 %. Debonding was a rare complication (1.3 %). The 5 year Kaplan-Meier success rate was 91.6 % for SuperBond-C&B-, 87.4 % for Ketac Cem- and 86.3 % for Panavia F-bonded restorations with no significant difference (p = .624). All cement types showed significant marginal deterioration over time (p < .0001).
  
  
  CONCLUSIONS
  Posterior InCeram Alumina crowns showed acceptable long-term survival and success rates independent of luting agent used. Ceramic fractures, endodontical treatments and secondary caries were the most frequent failures.
  
  
  CONCLUSIONS
  Glass-infiltrated Alumina crowns in combination with adhesive as well as conventional cementation can be considered as a reliable treatment option in posterior teeth.
authors.affiliation: Department of Prosthodontics, School of Dentistry, Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
authors.forename: Christian F
authors.initials: CF
authors.lastname: Selz
authors.forename: Joerg R
authors.initials: JR
authors.lastname: Strub
authors.forename: Kirstin
authors.initials: K
authors.lastname: Vach
authors.forename: Petra C
authors.initials: PC
authors.lastname: Guess
mesh_terms: D000328:Adult; D000368:Aged; D003442:Crowns; D003738:Dental Cements; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D003738:Dental Cements