Comparison of 2 bonding systems and survival of fiber-reinforced composite inlay fixed partial dentures

Purpose: This randomized controlled study evaluated the clinical behavior of 3-unit inlay fixed partial dentures (IFPDs) made of the glass-fiber composite system SR Adoro/Vectris and luted with 2 different bonding systems over an observation period of 2 years. Materials and Methods: Thirty-nine glass-fiber–reinforced composite IFPDs were made to replace 1 missing maxillary or mandibular tooth. Nineteen IFPDs were randomly assigned to group A and luted with a 2-step bonding system (Excite DSC), while the other 20 IFPDs of group B were cemented with a 3-step adhesive (Syntac). Events like partial or total debonding of the IFPDs, fracture of the framework, or veneer and fiber exposures were considered failures. Color match, marginal discoloration, secondary caries, marginal adaptation, postoperative sensitivity, and surface texture were evaluated according to the United States Public Health Service modified criteria. Results: Two debondings and 2 fiber exposures occurred during the observation period. All failures occurred in group A. Some fatigue microcracks in the pontic area of the 2 detached IFPDs were observed under scanning electron microscopy. The postoperative sensitivity of group A was much higher than group B, and the abutments luted with Excite DCS showed postoperative sensitivity during the first month in 42.2% of cases. The sensitivity disappeared completely after 6 months. Statistical analysis (P < .05) indicated significant differences in postoperative sensitivity between the 2 groups. Conclusion: The IFPDs in combination with a 3-step adhesive demonstrated good clinical service in the short observation period. The microfractures of the layering material observed on the debonded IFPDs may suggest excessive flexibility of the fiber structures, which occurs if the framework is fabricated without observing the recommended dimensions.