The Influence of Deep Margin Elevation and Immediate Dentin Sealing on the Fracture Strength of Premolars Restored With Indirect Inlays: An In Vitro Study
ABSTRACT Objective To evaluate the effect of deep margin elevation (DME) and immediate dentin sealing (IDS) on the fracture strength of premolars restored with lithium disilicate inlay restorations. Materials and Methods Standard MOD inlays with proximal box preparations extending 3 mm apical to the...
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Wiley
2025-06-01
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| Series: | Clinical and Experimental Dental Research |
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| Online Access: | https://doi.org/10.1002/cre2.70161 |
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| author | Lulwa E. Al‐Turki Osamah A. Alsulimani Khadijah M. Baik Haytham Othmani Naif M. Alqarni Abdullah A. Alqarni Raghad A. Al‐Dabbagh |
| author_facet | Lulwa E. Al‐Turki Osamah A. Alsulimani Khadijah M. Baik Haytham Othmani Naif M. Alqarni Abdullah A. Alqarni Raghad A. Al‐Dabbagh |
| author_sort | Lulwa E. Al‐Turki |
| collection | DOAJ |
| description | ABSTRACT Objective To evaluate the effect of deep margin elevation (DME) and immediate dentin sealing (IDS) on the fracture strength of premolars restored with lithium disilicate inlay restorations. Materials and Methods Standard MOD inlays with proximal box preparations extending 3 mm apical to the cementoenamel junction were prepared on forty sound premolars (n = 10) randomly divided into four groups: inlays without DME and without IDS (G1); inlays without DME but with IDS (G2); inlays with DME but without IDS (G3); and inlays with both techniques applied (G4). Composite resin was applied incrementally to elevate the proximal cervical margin coronally to the cementoenamel junction. For immediate dentin sealing, bonding agent was applied immediately after tooth preparation. All teeth were restored with lithium disilicate inlays and, after adhesive resin cementation, specimens were thermomechanically aged for 500 cycles at 5°–55°C and then subjected to load failure testing. Failure loads and locations were recorded and analyzed using one‐ and two‐way ANOVA with Tukey's post‐hoc testing (α = 0.05). Failure modes were analyzed using descriptive statistics. Results The mean fracture loads were 565.76 ± 233.22 N, 978.47 ± 394.2 N, 974.31 ± 334.7 N, and 1108.21 ± 292.41 N for G1, G2, G3, and G4, respectively. Deep margin elevation (p = 0.011) and immediate dentin sealing (p = 0.010) were associated with significantly increased fracture loads. Fracture loads were significantly lower for G1 teeth than for G2‐G4 teeth, but there were no significant differences between G2, G3, and G4. G1 teeth showed 50% catastrophic and non‐catastrophic failures, which increased to 60% for G2 and decreased to 20% for G3 teeth. Samples with both seals and elevation (G4) had a 60% catastrophic failure rate. Conclusions When applied individually or together, deep margin elevation and immediate dentin sealing significantly increase the fracture strength of premolars restored with indirect lithium disilicate inlays. Clinical Implications In the challenging setting of margin elevation, studies on the effects of immediate dentin sealing have generally been limited to evaluating marginal integrity and bond strength. The findings of this In Vitro study suggest that both deep margin elevation and immediate dentin sealing protocols are likely to improve clinical outcomes of indirect lithium disilicate inlay restorations and may be considered viable options in clinical practice. |
| format | Article |
| id | doaj-art-37d0ade2e23c4af6af6f10d97c0e4992 |
| institution | Matheson Library |
| issn | 2057-4347 |
| language | English |
| publishDate | 2025-06-01 |
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| series | Clinical and Experimental Dental Research |
| spelling | doaj-art-37d0ade2e23c4af6af6f10d97c0e49922025-06-27T06:08:47ZengWileyClinical and Experimental Dental Research2057-43472025-06-01113n/an/a10.1002/cre2.70161The Influence of Deep Margin Elevation and Immediate Dentin Sealing on the Fracture Strength of Premolars Restored With Indirect Inlays: An In Vitro StudyLulwa E. Al‐Turki0Osamah A. Alsulimani1Khadijah M. Baik2Haytham Othmani3Naif M. Alqarni4Abdullah A. Alqarni5Raghad A. Al‐Dabbagh6Department of Oral Maxillofacial Prosthodontics, Faculty of Dentistry King Abdulaziz University Jeddah Makkah Province Saudi ArabiaDepartment of Oral Diagnostic Sciences, Faculty of Dentistry King Abdulaziz University Jeddah Makkah Province Saudi ArabiaDepartment of Oral Maxillofacial Prosthodontics, Faculty of Dentistry King Abdulaziz University Jeddah Makkah Province Saudi ArabiaChoueifat Medical Center Jeddah Makkah Province Saudi ArabiaAl‐Rahaily medical Center Jeddah Makkah Province Saudi ArabiaPeriodontics Resident King Fahad General hospital Jeddah Makkah Province Saudi ArabiaDepartment of Oral Maxillofacial Prosthodontics, Faculty of Dentistry King Abdulaziz University Jeddah Makkah Province Saudi ArabiaABSTRACT Objective To evaluate the effect of deep margin elevation (DME) and immediate dentin sealing (IDS) on the fracture strength of premolars restored with lithium disilicate inlay restorations. Materials and Methods Standard MOD inlays with proximal box preparations extending 3 mm apical to the cementoenamel junction were prepared on forty sound premolars (n = 10) randomly divided into four groups: inlays without DME and without IDS (G1); inlays without DME but with IDS (G2); inlays with DME but without IDS (G3); and inlays with both techniques applied (G4). Composite resin was applied incrementally to elevate the proximal cervical margin coronally to the cementoenamel junction. For immediate dentin sealing, bonding agent was applied immediately after tooth preparation. All teeth were restored with lithium disilicate inlays and, after adhesive resin cementation, specimens were thermomechanically aged for 500 cycles at 5°–55°C and then subjected to load failure testing. Failure loads and locations were recorded and analyzed using one‐ and two‐way ANOVA with Tukey's post‐hoc testing (α = 0.05). Failure modes were analyzed using descriptive statistics. Results The mean fracture loads were 565.76 ± 233.22 N, 978.47 ± 394.2 N, 974.31 ± 334.7 N, and 1108.21 ± 292.41 N for G1, G2, G3, and G4, respectively. Deep margin elevation (p = 0.011) and immediate dentin sealing (p = 0.010) were associated with significantly increased fracture loads. Fracture loads were significantly lower for G1 teeth than for G2‐G4 teeth, but there were no significant differences between G2, G3, and G4. G1 teeth showed 50% catastrophic and non‐catastrophic failures, which increased to 60% for G2 and decreased to 20% for G3 teeth. Samples with both seals and elevation (G4) had a 60% catastrophic failure rate. Conclusions When applied individually or together, deep margin elevation and immediate dentin sealing significantly increase the fracture strength of premolars restored with indirect lithium disilicate inlays. Clinical Implications In the challenging setting of margin elevation, studies on the effects of immediate dentin sealing have generally been limited to evaluating marginal integrity and bond strength. The findings of this In Vitro study suggest that both deep margin elevation and immediate dentin sealing protocols are likely to improve clinical outcomes of indirect lithium disilicate inlay restorations and may be considered viable options in clinical practice.https://doi.org/10.1002/cre2.70161deep margin elevationdentin sealingfracture strengthlithium disilicate inlay restorations |
| spellingShingle | Lulwa E. Al‐Turki Osamah A. Alsulimani Khadijah M. Baik Haytham Othmani Naif M. Alqarni Abdullah A. Alqarni Raghad A. Al‐Dabbagh The Influence of Deep Margin Elevation and Immediate Dentin Sealing on the Fracture Strength of Premolars Restored With Indirect Inlays: An In Vitro Study Clinical and Experimental Dental Research deep margin elevation dentin sealing fracture strength lithium disilicate inlay restorations |
| title | The Influence of Deep Margin Elevation and Immediate Dentin Sealing on the Fracture Strength of Premolars Restored With Indirect Inlays: An In Vitro Study |
| title_full | The Influence of Deep Margin Elevation and Immediate Dentin Sealing on the Fracture Strength of Premolars Restored With Indirect Inlays: An In Vitro Study |
| title_fullStr | The Influence of Deep Margin Elevation and Immediate Dentin Sealing on the Fracture Strength of Premolars Restored With Indirect Inlays: An In Vitro Study |
| title_full_unstemmed | The Influence of Deep Margin Elevation and Immediate Dentin Sealing on the Fracture Strength of Premolars Restored With Indirect Inlays: An In Vitro Study |
| title_short | The Influence of Deep Margin Elevation and Immediate Dentin Sealing on the Fracture Strength of Premolars Restored With Indirect Inlays: An In Vitro Study |
| title_sort | influence of deep margin elevation and immediate dentin sealing on the fracture strength of premolars restored with indirect inlays an in vitro study |
| topic | deep margin elevation dentin sealing fracture strength lithium disilicate inlay restorations |
| url | https://doi.org/10.1002/cre2.70161 |
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