Restorations with extensive dentin/enamel-bonded ceramic coverage. A 5-year follow-up.

The durability of restorations with extensive dentin/enamel-bonded posterior partial and complete ceramic coverages were investigated. The effect of luting with a dual-cured and a self-cured luting agent was also studied. In 110 patients, 182 ceramic coverages (IPS Empress) were placed. In 58 restorations, Syntac was used in combination with the dual-cured resin composite Variolink. In the other restorations luted with the chemically cured resin composite Bisfil 2B, 25 were bonded with Gluma, 57 with Allbond 2, and 42 with Syntac. Of the 182 ceramics, 13 (7.1%) were assessed as non-acceptable after a mean observation period of 4.9 yr (range 4.3 7.5 yr). The reasons for failure were fracture (5), lost restorations (4), secondary caries (3) and endodontic treatment (1). No significant differences in failure rate were seen between the two luting agents or between the three dentin-bonding agents. Ceramic coverages placed on non-vital teeth failed in 9.7% of cases (3/31) and on vital teeth in 6.6% (10/151). The success rate of the dentin-enamel-bonded ceramic coverages reduces the need for a traditional full-coverage therapy and/or post or pin(s) and core placement. The technique investigated showed many clinical advantages such as less destruction of healthy tissue, and avoidance of endodontic treatment and/or deep cervical placement of restoration margins.