3 Year Clinical Behavior of an Aesthetic Composite Luting Cement

Objectives: To evaluate clinical behavior of aesthetic luting cement (Variolink Esthetic, Ivoclar Vivadent, Schaan, FL) in combination with CAD/CAM glass ceramic restorations and different adhesives after 3years.
Methods: 60 all-ceramic restorations (30inlays/30partial crowns, IPS e.max CAD, Ivoclar Vivadent) were adhesively luted with a composite luting cement in dual-curing mode. 3operators treated 20patients each. 3different adhesive protocols were combined with adhesive luting cement: Adhese Universal selfetch vs. Adhese Universal etch&rinse vs. Syntac etch&rinse (all Ivoclar Vivadent) (table1). After 3years of clinical function 58 restorations (2drop-outs) were examined using FDI-criteria for evaluation of indirect restorations in regard to aesthetic, functional and biological properties.
Results: 100% of restorations presented an “excellent”/”good” clinical behavior after 3years regarding aesthetic, functional and biological properties (table2). Due to occlusal adjustments and 3years of function 8restorations (13.8%) showed occlusal areas with silk-mat luster. None of restorations showed surface staining, a chipping or a loss of retention. 11restorations (19.0%) were scored“good” regarding their color match. Small deviation in translucency were found for these restorations in localized areas of restored tooth. Only for 3restorations (5.2%) anatomic form was rated as good. None of patients reported hypersensitivity. In 5cases (8.6%) localized plaque led to gingiva irritation. Patients were reinstructed regarding optimal oral care. SQUACE analysis of luting composite margin revealed that 82.7% of total margin length were rated as “excellent” regarding marginal staining. Only 17.3% of total margin length showed minor marginal staining after 3years of function (scored”good”). Regarding marginal irregularities 56.9% of total margin length were evaluated as “excellent”. Minor irregularities were detected for 43.1% of total margin length (scored”good”). SQUACE analysis of total margin length regarding marginal staining and marginal irregularities revealed no significant difference for 3 used adhesives (table3).
Conclusions: In summary, the aesthetic composite luting cement “Variolink Esthetic DC” combined with the 3 tested adhesive protocols is perfectly indicated to be used as luting material of all-ceramic restorations.