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Five Years Clinical Evaluation of Ceramic Inlays and Onlays Fabricated with Two Systems
Purpose: The aim of the study was to evaluate the 5-year clinical performance of ceramic inlays and onlays made with pressable lithium disilicate glass-ceramic (IPS e.max Press, Ivoclar Vivadent) and CAD/CAM technology (IPS e.max CAD, Ivoclar Vivadent).
Material and Merhods: Sixty-five restorations (35 IPS e.max Press and 30 IPS e.max CAD) were placed by two operators on 25 patients (mean age 33 years). All restorations cemented with dual-cured resin cement (Variolink DC, Ivoclar Vivadent) and Syntac Classic (Ivoclar Vivadent) adhesive system. The restorations were evaluated by two operators at baseline and every year thereafter annually for five years, using modified United States Public Health Service (USPHS) criteria.
Results: After the five-years clinical evaluations three CAD/CAM and one pressable restorations were fractured, secondary caries was observed on three restorations (three of them CAD/CAM), and two restorations showed debonding (one CAD/CAM, one heat pressed restorations). A general success rate of 86 % was recorded. The Fisher exact test revealed significant difference between heat-pressed and CAD CAM ceramic systems (p.0.05). The McNemar chi- square test showed significant differences in relation to marginal discoloration, marginal integrity, and surface texture between the baseline and three-year recall for both systems (p,0.001), with an increased percentage of Bravo scores.
Conclusion: These two types of ceramic materials demonstrated acceptable clinical performance after five years. İn cases of with the advancement of design algorithms and milling units of CAD/CAM accuracy, the expertise with the Cerec device and the clinical skills of the operator during preparation also impact the outcome of CAD/CAM fabricated restorations.