Methods: In a controlled prospective clinical study, 57 Cergogold all-ceramic inlays (51 Class II inlays, 6 onlays; 35 premolars, 22 molars) were placed in 24 patients by four dentists. The restorations were luted with two different systems (MD = Definite Multibond + Definite; SV = Syntac + Variolink Ultra, Ivoclar Vivadent, Liechtenstein) without lining. At baseline, after 12, 24 and 48 months the ceramic restorations were examined according to modified USPHS codes and criteria.
Results: One patient including three restorations missed the four years recall (dropout). After 48 months of clinical service, two restorations had to be replaced due to chipping at the proximal ridge, and one due to tooth fracture at the occlusal margin, all other fillings were clinically acceptable (survival rate 93%; Kaplan-Meier algorithm). Except for the rate of hypersensitivity at baseline (MD: 27%; SV 0%; p<0.05), no differences were evident between the luting cements at all recalls (Mann-Whitney U-test; p>0.05). Between the four recalls (A baseline, B 1 year, C 2, and D 4 years) a statistically significant deterioration was detected for both groups [Alpha 1 / Alpha 2 / Bravo / Charlie] in %] regarding the criteria marginal adaptation (A 29/64/7/0; B 11/80/9/0; C 4/90/6/0; D 0/61/39/0), integrity filling A 96/4/0/0 B 87/9/4/0 C 77/8/15/0 D 37/31/30/2, and integrity tooth A 91/9/0/0 B 83/15/1/0 C 72/28/0/0 D 12/80/8/0 (Friedman test; p<0.001). After four years mainly, distinct deterioration with marginal fractures or chippings in proximal areas of the inlays were observed. No differences were found for the other criteria(p>0.05).
Conclusions: After four years of clinical service, both luting systems showed good clinical results and can be recommended to insert ceramic inlays. Supported by Degudent, Germany.