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Long-term performance of posterior InCeram Alumina crowns cemented with different luting agents: a prospective, randomized clinical split-mouth study over 5 years

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Abstract

Objectives

This prospective, randomized clinical split-mouth study investigated the 5-year performance of InCeram Alumina posterior crowns cemented with three different luting cements. 4-META- and MDP-based cements were used for adhesive luting. Glass ionomer cement served as control.

Materials and Methods

Sixty patients were treated with 149 (n = 62 Panavia F/MDP; n = 59 SuperBond-C&B/4-META; n = 28 Ketac Cem/glass ionomer) InCeram Alumina crowns on vital molars and premolars in a comparable position. Follow-up examinations were performed annually up to 5 years after crown placement using the modified United States Public Health Service (USPHS) criteria. Kaplan–Meier survival analysis comprised secondary caries, clinically unacceptable fractures, root canal treatment and debonding. Kaplan–Meier success rate included restorations with minimal crevices, tolerable color deviations (<1 Vitashade), and clinically acceptable fractures. Logistic regression models with a random intercept were fitted.

Results

The 5-year Kaplan–Meier survival probabilities were: SuperBond-C&B 88.7 %, Panavia F 82.8 %, Ketac Cem 80.1 % with no significant difference (p = .813). Endodontical treatment was carried out on 7.4 % of all abutment teeth, and 5.4 % revealed secondary caries. Unacceptable ceramic fractures were observed in 7.4 %. Debonding was a rare complication (1.3 %). The 5 year Kaplan–Meier success rate was 91.6 % for SuperBond-C&B-, 87.4 % for Ketac Cem- and 86.3 % for Panavia F-bonded restorations with no significant difference (p = .624). All cement types showed significant marginal deterioration over time (p < .0001).

Conclusions

Posterior InCeram Alumina crowns showed acceptable long-term survival and success rates independent of luting agent used. Ceramic fractures, endodontical treatments and secondary caries were the most frequent failures.

Clinical relevance

Glass-infiltrated Alumina crowns in combination with adhesive as well as conventional cementation can be considered as a reliable treatment option in posterior teeth.

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Conflict of Interest

This study was financially supported by Sun Medical, Shiga, Japan.

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Authors and Affiliations

  1. Department of Prosthodontics, School of Dentistry, Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany

    Christian F. Selz, Joerg R. Strub, Kirstin Vach & Petra C. Guess

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  1. Christian F. Selz
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  2. Joerg R. Strub
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  3. Kirstin Vach
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  4. Petra C. Guess
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Correspondence to Petra C. Guess.

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Selz, C.F., Strub, J.R., Vach, K. et al. Long-term performance of posterior InCeram Alumina crowns cemented with different luting agents: a prospective, randomized clinical split-mouth study over 5 years. Clin Oral Invest 18, 1695–1703 (2014). https://doi.org/10.1007/s00784-013-1137-6

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