Finishing and polishing of indirect composite and ceramic inlays in-vivo: occlusal surfaces.

This study evaluated occlusal margins and surfaces of composite and ceramic inlays after finishing and polishing in vivo. Eighty Class II cavities surrounded by enamel were prepared by two experienced dentists. Forty cavities were restored with indirect microhybrid composite inlays (Tetric), the balance were treated with heat-pressed glass ceramic inlays (IPS Empress). Using a rubber dam, the inlays were inserted adhesively with a dual curing composite of high viscosity (Variolink Ultra). Finishing was performed with the sequence of a 30 microm and 20 microm diamond (finishing method FM 1) or a 30 microm diamond followed by a tungsten carbide finishing bur (FM 2). The composite inlays were divided into four groups of 10 that were finished and polished according to the following protocol: (A) FM 2/Diafix-oral, (B) FM 2/MPS gel, (C) FM 1/Diafix-oral, (D) FM 1/MPS gel. Ten ceramic inlays each were treated as follows: (E) FM 2/MPS gel, (F) FM 1/MPS gel, (G) FM 2/ Diamond polisher, (H) FM 1/Ceramiste silicon polishers. After polishing, replicas of the restorations were fabricated. The replicas were examined by SEM with respect to margin quality (portion of continuous margins, overhangs, submargination and marginal imperfections). Furthermore, surface properties were evaluated qualitatively, which included assessing roundness of the contours in three grades (smooth rounding, few edged contours or predominantly edged contours) and evaluation of the surface roughness (smooth and homogeneous surface, minor roughness or severe roughness). Quantitative analysis of the occlusal composite and ceramic inlay margins showed that 52.2%-84.6% were rated as continuous, 0%-14.0% were characterized by overhangs and 0.7%-10.8% by submargination. A portion of 4.9%-18.1% margins revealed imperfections. The amount of marginal gap formation was negligible. Composite and ceramic inlays showed a similar behavior with respect to marginal quality after finishing and polishing. Overall, there were no significant differences among the four methods applied to composite and the four methods used on ceramic inlays with respect to margin quality. The use of a 30 microm diamond followed by a tungsten carbide bur on composite and ceramic inlays resulted in a significantly larger portion of continuous margins compared to finishing with two diamonds (p=0.049). Qualitative evaluation of composite and ceramic inlays revealed that 50%-80% of the occlusal surfaces were characterized by few edged contours and 10%-50% by smooth rounding. With respect to roughness, smooth surfaces prevailed both on composite (67.5%-80.0%) and ceramic inlays (64.5%-77.3%). Overall, no significant differences were detectable between the methods for finishing and polishing composite inlays and the methods applied to ceramic restorations with respect to roundness of contours and surface roughness.