Long-term outcomes of all-ceramic inlays and onlays after a mean observation time of 11 years

Objectives: Long-term retrospective evaluation of the survival rate and the technical and biologic outcomes of all-ceramic inlays and onlays in premolars and molars. Method and materials: Fifty-four patients treated as part of a prospective clinical trial and having received 157 inlays and 27 onlays made out of a leucite-reinforced glass-ceramic (IPS Empress) in premolars and molars, were invited to the present follow-up examination. The survival of the restorations was evaluated. The biologic outcomes were assessed by measuring the pocket probing depth (PPD), the Plaque Index (PI), and the Sulcus Bleeding Index (SBI). The technical behavior was evaluated using modified US Public Health Service criteria (modUSPHS). Finally, patient satisfaction was recorded with a questionnaire. Data of patients and restored teeth were analyzed descriptively, and continuous variables were given in mean values and standard deviations. For the analysis of the restoration survival over time, the Kaplan-Meier survival estimate was calculated. The level of statistical significance was set at P .05. Results: Thirty-six patients (20 women, 16 men; mean age 50.9 years) with 132 restorations, 107 inlays and 25 onlays, were examined after a mean observation time of 11.2 ± 4.3 years. The overall 11-year survival rate of the 132 restorations was 80.3%. Inlays exhibited an 11-year survival rate of 80.4% and onlays of 80.0%. Twenty-two technical complications occurred. Ceramic fractures (10.6%) and chipping (2.3%) were the most frequent complications. Six biologic complications occurred (4.5%). Conclusion: Glass-ceramic inlays and onlays presented favorable long-term clinical survival and success rates. Technical complications were predominant, and biologic problems remained rare. More clinical long-term data are needed. Keywords: adhesive cementation, all-ceramic restoration, glass-ceramic, long-term, minimally invasive