A prospective clinical study of indirect and direct composite and ceramic inlays: Ten-year results

Objective: The aim of this investigation was to evaluate the clinical performance of 4 types of tooth-colored inlays. Method and materials: Fifteen direct ceramic inlays (Cerec Cos 2.0), 15 direct composite inlays (Brilliant DI, Coltène), 14 indirect ceramic inlays (Vita Dur N), and 14 indirect composite inlays (Estilux, Kulzer) were placed in 37 patients, according to manufacturer instructions. The inlays were evaluated 1 week (baseline), 6 months, and 1, 3, 4, 5, and 10 years after cementation (modified California Dental Association Quality Evaluation System). The ratings were compared using the chi-square test. For comparing the survival rates among the 4 types of inlays, a life-table analysis was done, followed by a log-rank test. Results: Three Vita Dur N inlays were replaced after 1, 4, and 8.5 years; 3 Cerec inlays were replaced after 4.5, 8.5, and 9.5 years; and 3 Brilliant DI inlays needed replacement after 1, 5, and 6.5 years, all because of secondary caries or fractures. Three inlays (Estilux) were replaced because of persisting hypersensitivity or pulpal damage. Six inlays (3 Vita Dur N, 1 Estilux, and 2 Brilliant DI) were repaired for minor fractures. During the observation period, the surface texture of Vita Dur N inlays became significantly rougher. About 80% of the inlays, including repaired inlays, were in function after 10 years. Conclusion: After 10 years of observation, survival of the 4 types of tooth-colored inlays was similar and considered clinically acceptable. The survival rates were within the range of survival for direct composite restorations. Keywords: ceramic, inlay, marginal adaptation, morphology, resin composite, surface texture, survival rate