Objective: Aim of this study was to observe the efficacy of two different composite cements on the prevention of marginal deterioration around adhesive ceramic inlay restorations, under laboratory conditions, and to test the null hypothesis that different luting procedures cannot affect sealing ability of luted inlays.
Methods: Twenty-six standardized mesio-occlusal Class II cavities were prepared in extracted posterior teeth. Class II inlays were fabricated with IPS Empress II system following the manufacturer's instructions. The samples were divided into two groups of 13 teeth each at random. Group 1: The ceramic inlays of Group 1 were luted using Excite DSC and an experimental self-curing resin cement (Multilink, Vivadent); in this group, Excite DSC was self-activated and not light-cured. Group 2: Excite DSC in combination with a dual-curing resin cement (Variolink II, Vivadent) was used (as control). In this group Excite DSC was light-cured for 20s separately, before resin cement application. The 'wet' bonding technique was followed. Three samples of each group were selected at random for SEM observations, while the other 10 samples were processed for marginal leakage. The bonding mechanism to dentin and resin cement thickness was evaluated.
Results: Samples of both groups showed resin tag and adhesive lateral branch formation. In Group 1 the hybrid layer was mainly uniform along the interface between dental substrates and adhesive material, and resin cement thickness was between 20 and 85 microm. At the cervical margin no gap was detected. In Group 2 the cement thickness was between 30 and 110 microm and hybrid layer formation was observed along the interface but at the cervical margin it was not always uniform and continuous. Resin tag formation was uniform in both groups. At cervical margins, 80% of Group 1 samples showed a perfect seal at the dentin-cementum margins, and 90% at enamel margins. Group 2 samples showed only 50% of cervical margins free from leakage and 80% at the occlusal enamel margins. Statistically significant differences were found at cervical margins between the two groups, while no significant differences were found at enamel site.
Conclusions: It can be concluded that the self-curing adhesive-resin cement combination can properly seal Class II porcelain inlays.