title: Influence of proximal box elevation technique on marginal integrity of adhesively luted Cerec inlays.
abstract: OBJECTIVE
  This in vitro study evaluated the marginal quality of Lava Ultimate inlays in deep proximal cavities with and without proximal box elevation (PBE) before and after thermomechanical loading (TML).
  
  
  METHODS
  Mesio-occluso-distal cavities with proximal boxes beneath the cementoenamel junction (CEJ) were prepared in 24 human molars. Then, one of the proximal boxes was elevated with Filtek Supreme above the CEJ. The specimens were divided into three groups (n = 8). The inlays of group A were adhesively luted to the cavities with Scotchbond Universal and Rely X Ultimate, the inlays of group B with Monobond Plus, Syntac, and Variolink II, and the inlays of group C with Clearfil Ceramic Primer and Panavia SA Cement. Epoxy resin replicas were taken before and after thermomechanical loading (1,200,000 cycles, 55 °C/5 °C, max. load 50 N). Marginal integrity at the different interfaces tooth/PBE, tooth/dentine, inlay/PBE, inlay/dentine was evaluated with scanning electron microscopy (×200). The percentage of continuous margin (% of total proximal margin length) was compared between the groups before and after TML.
  
  
  METHODS
  Mann-Whitney U test (p = 0.05).
  
  
  RESULTS
  No significant differences (p > 0.05) before and after TML were found between the three groups for bonding the inlay to dentine or to PBE composite.
  
  
  CONCLUSIONS
  The marginal integrities of bonding inlays directly to dentine are not different from bonding inlays to a proximal box, which has been elevated by a composite filling material. For deep proximal cavities, the PBE technique could be an alternative technique to conventional methods. Clinical research is needed to confirm.
authors: Department of Prosthetic Dentistry, University Medical Center Regensburg, 93042, Regensburg, Germany. veronika.mueller@ukr.de.
authors: Veronika
authors: V
authors: Müller
authors: Department of Prosthetic Dentistry, University Medical Center Regensburg, 93042, Regensburg, Germany.
authors: Karl-Heinz
authors: KH
authors: Friedl
authors: Department of Prosthetic Dentistry, University Medical Center Regensburg, 93042, Regensburg, Germany.
authors: Katrin
authors: K
authors: Friedl
authors: Department of Prosthetic Dentistry, University Medical Center Regensburg, 93042, Regensburg, Germany.
authors: Sebastian
authors: S
authors: Hahnel
authors: Department of Prosthetic Dentistry, University Medical Center Regensburg, 93042, Regensburg, Germany.
authors: Gerhard
authors: G
authors: Handel
authors: Department of Prosthetic Dentistry, University Medical Center Regensburg, 93042, Regensburg, Germany.
authors: Reinhold
authors: R
authors: Lang
mesh_terms: D002516:Ceramics; D003188:Composite Resins / Q000737:chemistry*; D003738:Dental Cements; D018772:Dental Marginal Adaptation; D003793:Dental Restoration, Permanent / Q000379:methods*; D003799:Dental Stress Analysis; D006801:Humans; D066298:In Vitro Techniques; D007284:Inlays; D008422:Materials Testing; D008689:Methacrylates; D008855:Microscopy, Electron, Scanning; D008963:Molar; D010710:Phosphates; D019279:Resin Cements / Q000737:chemistry*
chemical_list: C000621301:Clearfil Ceramic Primer; D003188:Composite Resins; D003738:Dental Cements; C474035:Filtek Supreme; D008689:Methacrylates; C076808:Monobond S; D010710:Phosphates; C528569:Rely-X; D019279:Resin Cements; C074543:Cerec; C103502:Variolink; C041330:Scotchbond; C052304:Panavia EX
keywords: Marginal quality; Proximal box elevation; Resin nanoceramics; Subgingival margins