Leucite-reinforced glass ceramic inlays luted with self-adhesive resin cement: a 2-year in vivo study.

Abstract OBJECTIVES: Aim of the present prospective controlled clinical study was to compare the clinical performances of two different cementation procedures to lute IPS Empress inlays and onlays. METHODS: Eighty-three IPS Empress restorations (70 class-II inlays, 13 onlays/47 premolars, 36 molars) were placed in 30 patients (19 females/11 males, mean age=39 years). Two cementation procedures were tested: group 1: forty-three restorations were luted with a self-adhesive resin cement (RelyX Unicem, RX, 3M ESPE); group 2: forty restorations were luted with an etch-and-rinse multistep adhesive (Syntac Classic, Ivoclar-Vivadent) and Variolink II low (SV, Ivoclar-Vivadent). All restorations were evaluated after 2 weeks (baseline=1st recall=R1, n=83), 6 months (R2, n=83), 1 year (R3, n=82), and 2 years (R4, n=82) by two independent blinded calibrated examiners using modified USPHS criteria. RESULTS: From R1 to R4, one failure occurred in the SV group (at R2) due to marginal enamel chipping. After 2 years of clinical service (R4), better marginal and tooth integrity (p<0.05) was found in group 2 (SV) compared to the use of the self-adhesive cement (RX, group 1), while no differences were found for all remaining investigated criteria (p>0.05). The absence of enamel in proximal boxes (10% with no enamel and 51% of the restorations with less than 0.5mm enamel width at the bottom of the proximal box) did not affect marginal performance (p>0.05). SIGNIFICANCE: The self-adhesive resin cement RelyX Unicem showed clinical outcomes similar to a conventional multi-step cementation procedure after 2 years of clinical service for most of the tested criteria.