Clinical Oral Investigations

, Volume 16, Issue 2, pp 451–461 | Cite as

Controlled, prospective, randomized, clinical evaluation of partial ceramic crowns inserted with RelyX Unicem with or without selective enamel etching. Results after 2 years

  • Frederike Schenke
  • Marianne Federlin
  • Karl-Anton Hiller
  • Daniel Moder
  • Gottfried Schmalz
Original Article
First Online:
Received:
Accepted:

Abstract

Among the materials used for luting indirect restorations, growing interest has been directed towards the use of self-adhesive resin cements. The aim of this prospective randomized controlled clinical trial was to evaluate the clinical performance of the self-adhesive resin cement RelyX Unicem (RXU) for luting partial ceramic crowns (PCCs). In addition, the influence of selective enamel etching prior to luting (RXU+E) was assessed. Two-year results are reported. Thirty-four patients (68 PCCs) had originally received the intended treatment at baseline (BL). Twenty-nine patients (14 male, 15 female) with a total of 58 PCCs participated in the 2-year recall. In each patient, one PCC had been placed with RXU, one PCC with RXU+E. Restorations were evaluated at BL and 24 months after placement using modified United States Public Health Service criteria for postoperative hypersensitivity, anatomic form, marginal adaptation, marginal discoloration, surface texture and recurrent caries. Additionally, the “percentage failure” within the 2-year recall period for all restorations (n = 68) was calculated according to ADA Program Guidelines. Target value for acceptability of each procedure was <5% failure within 24 m. For statistical analysis of the data, the chi-square test was applied (α = 0.05). The median patient age was 41 years (24–59 years). Median PBI was 8% (5–10%). Twenty-two RXU PCCs were placed in molars, seven in premolars. Twenty-one RXU+E PCCs were placed in molars, eight in premolars. Statistically significant changes were observed for marginal adaptation (MA) and marginal discoloration (MD) between BL and 2 years but not between the two groups (RXU, RXU+E). Percentage of alfa values at BL for MA (RXU, 97% and RXU+E, 100%) and for MD (RXU, 97% and RXU+E, 97%) decreased to RXU, 14% and RXU+E, 28% for MA and to RXU, 50% and RXU+E, 59% for MD after 24 months. Within the observation period, three failures were recorded with RXU (5.1% failure), one failure was recorded for RXU+E (1.7% failure), but a significant influence of selective enamel etching on failure could not be verified. Although the results of the present study reveal a slight tendency for more favourable results if selective enamel etching is applied prior to insertion of ceramic PCCs with a self-adhesive luting material, longer-term evaluation is needed to confirm this. Additional selective enamel etching with a self-adhesive luting material does not considerably improve clinical performance of the restorations within the observation period reported, neither does it impose a hazard with respect to postoperative hypersensitivity.

Keywords

Partial ceramic crowns Clinical evaluation RelyX Unicem USPHS criteria CEREC III 
This is a preview of subscription content, log in to check access.

Notes

Acknowledgements

The authors would like to express their thanks and appreciation to Prof. Dr. L. J. Nunez, Memphis, Tennessee, for reviewing the manuscript and for his advice as a native English speaker in terms of grammar and style.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Abo Hamar SE, Hiller KA, Jung H, Federlin M, Friedl KH, Schmalz G (2005) Bond strength of a new universal self-adhesive resin luting cement to dentin and enamel. Clin Oral Investig 9:161–167PubMedCrossRefGoogle Scholar
  2. 2.
    Frankenberger R, Krämer N, Petschelt A (2000) Technique sensitivity of dentin bonding: effect of application mistakes on bond strength and marginal adaptation. Oper Dent 25:324–330PubMedGoogle Scholar
  3. 3.
    Van Meerbeek B, De Munck J, Yoshida A, Inoue S, Vargas M, Vijay P, Van Landuyt K, Lambrechts P, Vanherle G (2003) Buonocore memorial lecture. Adhesion to enamel and dentin: current status and future challenges. Oper Dent 28:215–235PubMedGoogle Scholar
  4. 4.
    Gerth H, Dammaschke T, Zücher H, Schäfer E (2006) Chemical analysis and bonding reaction of RelyX Unicem and Bifix composites. A comparative study. Dent Mater 22:934–941PubMedCrossRefGoogle Scholar
  5. 5.
    Van Meerbeek B, Van Landuyt K, De Munck J, Hashimoto M, Peumans M, Lambrechts P, Yoshida A, Inoue S, Suzuki K (2005) Technique-sensitivity of contemporary adhesives. Dent Mater 24:1–13CrossRefGoogle Scholar
  6. 6.
    Wilson AD, Prosser HJ, Powis DM (1983) Mechanism of adhesion of polyelectrolyte cements to hydroxyapatite. J Dent Res 62:590–592PubMedCrossRefGoogle Scholar
  7. 7.
    Schenke F, Hiller KA, Schmalz G, Federlin M (2008) Marginal integrity of partial ceramic crowns within dentin with different luting techniques and materials. Oper Dent 33:516–525PubMedCrossRefGoogle Scholar
  8. 8.
    Behr M, Rosentritt M, Regnet T, Lang R, Handel G (2004) Marginal adaptation in dentin of a self-adhesive universal resin cement compared with well-tried systems. Dent Mater 20:191–197PubMedCrossRefGoogle Scholar
  9. 9.
    DeMunck J, Vargas M, Van Landuyt K, Hikita K, Lambrechts P, Van Meerbeek B (2004) Bonding of an auto-adhesive luting material to enamel and dentin. Dent Mater 20:963–971CrossRefGoogle Scholar
  10. 10.
    Frankenberger R, Lohbauer U, Schaible RB, Nikolaenko SA, Naumann M (2008) Luting of ceramic inlays in vitro: marginal quality of self-etch and etch-and-rinse adhesives versus self-etch cements. Dent Mater 24:185–191PubMedCrossRefGoogle Scholar
  11. 11.
    Hikita K, Van MB, De MJ, Ikeda T, Van LK, Maida T, Lambrechts P, Peumans M (2007) Bonding effectiveness of adhesive luting agents to enamel and dentin. Dent Mater 23:71–80PubMedCrossRefGoogle Scholar
  12. 12.
    Peumans M, De Munck J, Van Landuyt K, Poitevin A, Lambrechts P, Van Meerbeek B (2009) Two-year clinical evaluation of a self-adhesive luting agent for ceramic inlays. J Adhes Dent. doi: 10.3290/j.jad.a17547 PubMedGoogle Scholar
  13. 13.
    Taschner M, Frankenberger R, Petschelt A, Krämer N (2007) IPS-Empress inlays luted with a self-adhesive resin-cement after two years. J Dent Res 86:(Spec Iss B: Abstr. No. 0013 (European Division/CED); (www.dentalresearch.org)
  14. 14.
    Taschner M, Frankenberger R, Garcia-Godoy F, Rosenbusch S, Petschelt A, Krämer N (2009) IPS Empress inlays luted with a self-adhesive resin cement after 1 year. Am J Dent 22:55–59PubMedGoogle Scholar
  15. 15.
    van Dijken JW, Hasselrot L, Ormin A, Olofsson AL (2001) Restorations with extensive dentin/enamel-bonded ceramic coverage. A 5-year follow-up. Eur J Oral Sci 109:222–229PubMedCrossRefGoogle Scholar
  16. 16.
    Bindl A, Mörmann WH (2003) Clinical and SEM evaluation of all-ceramic chair-side CAD/CAM generated partial crowns. Eur J Oral Sci 111:163–169PubMedCrossRefGoogle Scholar
  17. 17.
    Federlin M, Männer T, Hiller KA, Schmidt S, Schmalz G (2006) Two-year clinical performance of cast gold vs ceramic partial crowns. Clin Oral Investig 10:126–133PubMedCrossRefGoogle Scholar
  18. 18.
    Felden A, Schmalz G, Federlin M, Hiller KA (1998) Retrospective clinical investigation and survival analysis on ceramic inlays and partial ceramic crowns: results up to 7 years. Clin Oral Investig 2:161–167PubMedCrossRefGoogle Scholar
  19. 19.
    American Dental Association (1996). ADA Acceptance Program Guidelines: Restorative Materials. ADA Council on Scientific Affairs: ChicagoGoogle Scholar
  20. 20.
    Needleman I, Worthington H, Moher D, Schulz K, Altmann DG (2008) Improving the completeness and transparency of reports of randomized trials in oral health. Am J Dent 21:7–12PubMedGoogle Scholar
  21. 21.
    Federlin M, Wagner J, Männer T, Hiller KA, Schmalz G (2007) Three-year clinical performance of cast gold vs ceramic partial crowns. Clin Oral Investig 11:345–352PubMedCrossRefGoogle Scholar
  22. 22.
    Anderegg CR, Metzler DG (2001) Tooth mobility revisited. J Periodontol 72:963–967PubMedCrossRefGoogle Scholar
  23. 23.
    Federlin M, Sipos C, Hiller KA, Thonemann B, Schmalz G (2005) Partial ceramic crowns. Influence of preparation design and luting material on margin integrity - a scanning electron microscopic study. Clin Oral Investig 9:8–17PubMedCrossRefGoogle Scholar
  24. 24.
    Ryge G (1980) Clinical criteria. Int Dent J 30:347–358PubMedGoogle Scholar
  25. 25.
    Krejci I, Krejci D, Lutz F (1992) Clinical evaluation of a new pressed glass ceramic inlay material over 1.5 years. Quintessence Int 23:181–186PubMedGoogle Scholar
  26. 26.
    Mörmann WH, Götsch T, Krejci I, Lutz F, Barbakow F (1991) Clinical status of 94 Cerec ceramic inlays after 3 years in situ. In: Mörmann WH (ed) International Symposium on computer restorations. The state of the art of the Cerec method (Proceedings), Quintessenz, Berlin, pp 355–363Google Scholar
  27. 27.
    Saxer UP, Muhlemann HR (1975) Motivation and education. SSO Schweiz Monatsschr Zahnheilkd 85:905–919PubMedGoogle Scholar
  28. 28.
    American Dental Association (2003). ADA Acceptance Program Guidelines: Tooth-colored restorative materials for posterior teeth. ADA Council on Scientific Affairs: ChicagoGoogle Scholar
  29. 29.
    Hickel R, Roulet JF, Bayne SC, Heintze SD, Mjör IA, Peters M (2007) Recommendations for conducting controlled clinical studies of dental restorative materials. Clin Oral Investig 11:5–33PubMedCrossRefGoogle Scholar
  30. 30.
    Krämer N, Frankenberger R, Pelka M, Petschelt A (1999) IPS Empress inlays and onlays after four years—a clinical study. J Dent 27:325–331PubMedCrossRefGoogle Scholar
  31. 31.
    Studer SP, Lehner C, Brodbeck U, Schärer P (1996) Short-term results of IPS Empress inlays and onlays. J Prosthodont 5:277–287PubMedCrossRefGoogle Scholar
  32. 32.
    Wagner J, Hiller KA, Schmalz G (2003) Long-term clinical performance and longevity of gold alloy vs ceramic partial crowns. Clin Oral Investig 7:92–97CrossRefGoogle Scholar
  33. 33.
    Frankenberger R, Reinelt C, Petschelt A, Krämer N (2009) Operator vs. material influence on clinical outcome of bonded ceramic inlays. Dent Mater 25:960–968PubMedCrossRefGoogle Scholar
  34. 34.
    Tobi H, Kreulen CM, Gruythuysen RJ, van Amerongen WE (1998) The analysis of restoration survival data in split-mouth designs. J Dent 26:293–298PubMedCrossRefGoogle Scholar
  35. 35.
    Heymann HO, Bayne SC, Sturdevant JR, Wilder AD Jr, Roberson TM (1996) The clinical performance of CAD-CAM-generated ceramic inlays: a four-year study. J Am Dent Assoc 127:1171–1181PubMedGoogle Scholar
  36. 36.
    Hickel R, Manhart J (2001) Longevity of restorations in posterior teeth and reasons for failure. J Adhes Dent 3:45–64PubMedGoogle Scholar
  37. 37.
    Krämer N, Frankenberger R (2005) Clinical performance of bonded leucit-reinforced glass ceramic inlays and onlays after eight years. Dent Mater 21:262–271PubMedCrossRefGoogle Scholar
  38. 38.
    Frankenberger R, Taschner M, Garcia-Godoy F, Petschelt A, Krämer N (2008) Leucite-reinforced glass ceramic inlays and onlays after 12 years. J Adhes Dent 10:393–398PubMedGoogle Scholar
  39. 39.
    Kashiwada T, Morita M, Kato S (2006) Abrasion Behavior of an Experimental Resin Modified Glass Ionomer Cement. J Dent Res 84:(Spec Iss A: Abstr. No. 0533 (IADR General Session); (www.dentalresearch.org)
  40. 40.
    Goracci C, Cury AH, Cantoro A, Papacchini F, Tay FR, Ferrari M (2006) Microtensile bond strength and interfacial properties of self-etching and self-adhesive resin cements used to lute composite onlays under different seating forces. J Adhes Dent 8:327–335PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Frederike Schenke
    • 1
  • Marianne Federlin
    • 1
  • Karl-Anton Hiller
    • 1
  • Daniel Moder
    • 1
  • Gottfried Schmalz
    • 1
  1. 1.Department of Operative Dentistry and PeriodontologyUniversity Medical Center Regensburg—Dental SchoolRegensburgGermany

Personalised recommendations