In-vivo evaluation of a feldspathic ceramic system: 2-year results

Objectives: The aim of this clinical study was to evaluate feldspathic ceramic inlays by clinical criteria and quantitative margin analysis, and to compare clinical performance with the quantitative margin analysis results. Methods: Fifty fibre-reinforced feldspathic ceramic inlays were placed in box-shaped, Class II preparations with all margins located in enamel. A low-viscosity type dual-curing resin luting material was used for luting. The inlays were evaluated clinically according to modified US Public Health Service criteria after 2 days, 1 year, and 2 years. In addition, quantitative margin analysis was performed under a scanning electron microscope using an image analysing system. Results: Clinically the inlays performed very well after 2 years, showing no changes in colour, no recurrent caries and no marginal discolouration. Because of the wear of the composite resin luting material, margins were perceptible with an explorer in 54% of the cases after 2 years. Quantitative margin analysis showed significantly (P ≤ 0.05) more marginal gaps at the composite/ceramic interface compared with the enamel/composite interface at each evaluation. There was a significant increase in marginal gaps at both interfaces during the first year, whereas marginal gaps at the composite/ceramic interface did not increase significantly during the second year. Quantitative margin analysis showed that both time and interface had a significant influence on marginal gaps. Conclusion: Quantitative margin analysis should be included in clinical long-term trials on this type of restoration to recognize possible deficiencies in ceramic, composite resin luting material, and the luting interfaces.