6-year clinical evaluation of fired ceramic inlays

The purpose of the present study was to evaluate the quality of fired ceramic inlay restorations consisting of a feldspathic porcelain system (G-Cera Cosmotech II) after 6 years in vivo. A total of 49 fired ceramic inlays (for 27 premolars and 22 molars: class 1 in 11 teeth, class 2 in 36 teeth, and onlays in two teeth) were placed in 29 patients, and all restorations were evaluated at the time of placement, at 6 months, and 1, 2, 4, and 6 years after placement using modified USPHS criteria. Replicas made of the restorations were observed using a scanning electron microscope (SEM) to assess the state of the marginal area and wear of the restoration. Favorable color match was noted, and no bulk fracture, tooth fracture, or missing restorations were detected. Longevity was observed in 92% of the fired ceramic inlay restorations at 6 years (Kaplan-Meier method); however, marginal fracture was detected in six restorations (13%) and marginal discoloration in 11 (23%). SEM evaluation disclosed marginal microfracture in 49% of the restorations, wear in 19%, and wear of resin cement along margins in 36% at 6 years. No significant difference was observed in the incidence of each of these three characteristics between molars and premolars. This longitudinal 6-year clinical observation suggested that fired ceramic inlay restorations made by the G-Cera Cosmotech II system are aesthetic, durable, and clinically acceptable. Further follow-up is needed for the restorations showing marginal degradation and fracture from a microscopic and macroscopic perspective.