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Ferrari et al tive sensitivity was found in around 19% of the restorations, with an average score of 1.9. Only in one case of ten was the postoperative sensitivity relatively high (score 6), while in other cases, the sensitivity was not spontaneous. However, at the 6-month recall, the score dropped from 6 (strong) to 3 (mild). This observation is in agreement with a study that reported hypersensitivity to be the most common postoperative complication. 17 The accurate fitting of the crown is another aspect that is worth mentioning, even though this property was not explicitly assessed in this paper. A good fitting of the ceramic restoration can prevent postoperative sensitivity and pulp complications. In several studies, it had been reported 12,19 that the marginal wear of a composite luting cement can undermine the mechanical support. To prevent excessive marginal wear, it is therefore mandatory to have the narrowest possible gap between the cavity preparation and ceramic restoration. Optimal fit (ranging from 50 to 100 μm) is preferred, 8 particularly if the margins extend below the cementoenamel junction. 7,9 A proper adhesive-cement material combination is essential for avoiding postoperative sensitivity. Other self-activated bonding systems are available on the market and have been clinically tested. 5,14 All of them are usually both self-activated and light cured in order to guarantee complete polymerization of the bonding layer at the surface (where the bonding agent can be reached by light) and in deeper areas where light cannot penetrate to the adhesive layer. The dual-curing resin cements are used in combination with the proprietary bonding systems. Accordingly, with the limits of this study, the mixture of XP BOND with SCA in combination with chemically curing Calibra showed clinically acceptable levels of postoperative sensitivity at the 2-week and 6-month recalls. These findings will be reevaluated during next recalls at 12 months, and 2 and 3 years. The utilization of a correct bonding technique is mandatory to achieve good clinical results in ceramic inlay luting. 9 In direct resin restorations, the bonding agent is routinely light cured prior to the insertion of the composite. In ceramic luting procedures, pre-curing of the adhesive resin may make restoration seating more difficult. Also in this regard, the use of a self-curing bonding agent is advantageous. In the present study, a self-curing cement was chosen for luting the restorations. The self-curing cements are able to achieve an adequate degree of conversion even at sites where light curing may be hindered by the thickness of the ceramic. The setting time of the resin cement can also be directly correlated to room temperature, glass plate, and mouth temperature. CONCLUSIONS XP BOND used in self-curing mode showed in only one case of 53 luted restorations a spontaneous postoperative sensitivity of medium intensity after 2 weeks, which dropped to a mild grade after 6 months, while all other 9 cases showed a very low degree of sensitivity. ACKNOWLEDGMENTS This research was sponsored by <strong>Dentsply</strong> DeTrey, Konstanz, Germany. REFERENCES 1. Alavi AA, Kianimanesh N. Microleakage of direct and indirect composite restorations with three dentin bonding agents. Oper Dent 2002;27:19-24. 2. Bergman MA. The clinical performance of ceramic inlays: a review. Aust Dent J 1999;44:157-168. 3. Dagostin A, Ferrari M. In vivo bonding mechanism of an experimental dual cure enamel-dentin bonding system. Am J Dent 2001;14:105-108. 4. Davidson CL. Luting cement, the stronghold or the weak link in ceramic restorations. Adv Engineer Mater 2001;3:763-767. 5. Fabianelli A, Goracci C, Bertelli E, Davidson CL, Ferrari M. A clinical trial of Empress II Porcelain inlays luted to vital teeth with a self-light-curing adesive system and a self-curing resin cement. J Adhes Dent 2006;8:427-431. 6. Ferrari M, Mason PN. Adaptability and microleakage of indirect resin inlays: an in vivo investigation. Quintessence Int 1993;24:861-865. 7. Ferrari M, Mason PN, Fabianelli A, Cagidiaco MC, Kugel G, Davidson CL. Influence of tissue characteristics at margins on leakage of class II indirect porcelain restorations. Am J Dent 1999;12:134-142. 8. Ferrari M, Dagostin A, Fabianelli A. Marginal integrity of ceramic inlays luted with a self curing resin system. Dent Mater 2003;19:270-276. 9. Frankenberger R, Krämer N, Petschelt A. Technique sensitivity of dentin bonding: effect of application mistakes on bond strength and marginal adaptation. Oper Dent 2000;25:324-330. 10. Hahn P, Schaller HG, Hafner P, Hellwig E. Effect of different luting procedures on the seating of ceramic inlays. J Oral Rehabil 2000;27:1-8. 11. Hickel R, Manhart J. Longevity of dental restorations in posterior teeth and reasons for failure. J Adhes Dent 2001;3:45-64. 12. Krämer N, Frankenberger R, Pelka M, Petschelt A. IPS Empress inlays and onlays after four years- a clinical study. J Dent 1999;28:325-331. 13. Krämer N, Lohbauer U, Frankenberger R. Adhesive luting of indirect restorations. Am J Dent 2000;13:60-76. 14. Krämer N, Frankenberger R. Clinical performance of bonded leucite –reinforced glass ceramic inlays and onlays after eight years. Dent Mater 2005;21:262-271. 15. Lee IB, Um CM. Thermal analysis on the cure speed of dual cured resin cements under porcelain inlays. J Oral Rehabil 2001;28:186-197. 16. Manhart J, Scheibenbogen-Fuchsbrunner A, Chen HY, Hickel R. A 2-year clinical study of composite and ceramic inlays. Clin Oral Invest 2000; 4:192-198. 17. Manhart J, Chen HY, Neuerer P, Scheibenbogen-Fuchsbrunner A, Hickel R. Three-year clinical evaluation of composite and ceramic inlays. Am J Dent 2001;14:95-99. 18. Millediing P, Örtengren U, Karlsson S. Ceramic inlay systems: some clinical aspect. J Oral Rehabil 1995;22:571-580. 19. Molin MK, Karlsson SL. A randomized 5-year clinical evaluation of 3 ceramic inlay systems. Int J Prosthodont 2000;13:194-200. 20. Raffaelli O, Cagidiaco MC, Goracci C, Ferrari M. XP BOND in self-curing mode used for luting porcelain restorations. Part A: microtensile test. J Adhes Dent 2007;9:275-278. Clinical relevance: The results of this 6-month study reveal good clinical performance of XP BOND in self-curing mode. 282 The Journal of Adhesive Dentistry
Sarrett Vol 9, Supplement 1, 2007 283
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THE JOURNAL OF ADHESIVE DENTISTRY V
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Guest Editorial Satellite Symposium
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THE JOURNAL OF ADHESIVE DENTISTRY C
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Dental Adhesives …. How it All St
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Söderholm resulted in a new genera
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