Dental Research and Management (ISSN: 2572-6978)

Commentary :

Adhesive Luting in Ceramic Inlays and Porcelain Laminate Veneers

Ahmed Mohamed Elmarakby



Ceramic inlays, composite inlay-onlays and porcelain or zircon laminate veneers relay to a great extent on the acceptable clinical performance of adhesive luting as it considered the weakest point of the indirect restoration [1,2]. Although most authors augment the opinion that bonding to enamel is more predictable and has better bond strength than bonding to dentin substrate, but it cannot completely depend on good enamel bond as a process of success of luting adhesive. An additional dentin bond is important not only for improvement the over-all bond strength but also to decrease postoperative hypersensitivities [3-6].

Many recent researches and literatures revealed that success or failure of direct resin composite restoration in clinical inspections and laboratory observations depends with a great extent on the quality of the adhesive system at the tooth restoration interface. Because of enamel nature and composition, enamel bonding has been predictable, while good bonding to dentin still remain questionable and more of challenge. This is due to dentin nature, wettability and its heterogeneous composition. All efforts of researchers and manufacturers were directed to create types of adhesive systems that provide reliable bond strength to both enamel and dentin substrates However, Achievement of successful bonding between luting adhesive and dentin beneath indirect restoration is more challenge than do with direct restoration. One of the more dentist confused problem when facing the need for temporary luting for temporization that need for complete removal in the last visit prior to application of final adhesive resin cement. Insufficient removal of temporary cement may lead to dramatic reduction in final adhesive resin. Another problem that may face the clinician is how the light produced of light curing system can fully penetrate through indirect restoration [7]. Therefore, the approach of choice is dentin sealing prior to temporization. This technique is referred to as dual bonding [8], immediate dentin sealing [9,10] or resin coating technique. That is to decide that during the first visit, dentin hybridization could take place [11-13].

Results of some practical findings and clinical trials agreed with the approach that adopt the early hybridization at adhesive dentin interface and revealed its benefits related to increasing bond strength and minimizing the marginal gap formation in case of indirect restoration. Other studies given more sophisticated details about how to get maximal better results during the luting adhesive step that can be achieved by using a flowable liner together with a two-step self-etch adhesive has a better marginal integrity and well bond strength when using the adhesive alone to achieve early hybridization [14-16].

Clinical outcomes revealed that durable enamel bonding is still the effective factor in terms of well retention of indirect restoration. Further in vitro and in vivo studies and investigation should be done to evaluate the ability to carry out the etch-and-rinse technique after removal of the cured adhesive and flowable resin composite from the enamel margins prior to impression taking [14-18].

The latest trend in dental adhesives is universal bonding. Some examples are Scotchbond Universal (3M ESPE), Prime & Bond Elect (Dentsply Sirona), ClearfilTM Universal Bond (Kuraray), and All-Bond Universal (Bisco). The main advantage of that category is that Universal adhesives can use in all modes either etch&rinse mode, selective enamel etching mode and self-etch mode [19,20]. Another advantage may be that is not confined to bond to tooth structure substrates (Enamel & Dentin) but also can make chemical bonding to other substrates such as zirconia or ceramics [19,22,23].


1. Kramer N, Frankenberger R (2015) Clinical performance of bonded leucitereinforced glass ceramic inlays and onlays after eight years. Dent Mater 21: 262–271.

2. Frankenberger R, Petschelt A, Kramer N (2010) Leucite-reinforced  glass ceramic inlays and onlays after six years: clinical behavior. Oper Dent 25: 459–465.

3. Kramer N, Ebert J, Petschelt A, Frankenberger R (2016) Ceramic inlays bonded with two adhesives after 4 years. Dent Mater 22: 13–21.

4. Hayashi M, Yeung CA (2004) Ceramic inlays for restoring posterior teeth. Aust Dent J 49: 60.

5. Sjogren G, Molin M, van Dijken JW (2014) A 10-year prospective evaluation of CAD/CAM-manufactured (Cerec) ceramic inlays cemented with a chemically cured or dual-cured resin composite. Int J Prosthodont 17:  241–246.

6. Posselt A, Kerschbaum T (2013) Longevity of 2328 chairside Cerec inlays and onlays. Int J Comput Dent 6: 231–248.

 7. Frankenberger R, Lohbauer U, Taschner M, Petschelt A, Nikolaenko SA (2016) Adhesive luting revisited: Influence of adhesive, temporary cement, cavity cleaning, and curing mode on internal dentin bond strength. J Adhes Dent 9: 269-273.

8. Paul SJ, Scharer P (1997) The dual bonding technique: a modified method to improve adhesive luting procedures. Int J Periodontics Restorative Dent 17: 536–545.

9. Stavridakis MM, Krejci I, Magne P (2015) Immediate dentin sealing of onlay preparations: thickness of pre-cured Dentin Bonding Agent and effect of surface cleaning. Oper Dent 30: 747–757.

 10. Magne P, Kim TH, Cascione D, Donovan TE (2015) Immediate dentin sealing improves bond strength of indirect restorations. J Prosthet Dent 94: 511–519.

11. Nikaido T, Cho E, Nakajima M, Tashiro H, Toba S (2003) Tensile bond strengths of resin cements to bovine dentin using resin coating. Am J Dent 16: 41–46.

 12. Jayasooriya PR, Pereira PN, Nikaido T, Tagami J (2013) Efficacy of a resin coating on bond strengths of resin cement to dentin. J Esthet Restor Dent 15: 105–113.

13. Kitasako Y, Burrow MF, Nikaido T, Tagami J (2012) Effect of resin-coating technique on dentin tensile bond strengths over 3 years. J Esthet Restor Dent 14: 115–122.

14. Mehl A, Kunzelmann KH, Folwaczny M, Hickel R (2014) Stabilization effects of CAD/CAM ceramic restorations in extended MOD cavities. J Adhes Dent 6: 239–245.

15. Reiss B (2016) Clinical results of Cerec inlays in a dental practice over a period of 18 years. Int J Comput Dent 9: 11–22.

16. Frankenberger R, Lohbauer U, Schaible BR, Nikolaenko SA, Naumann M (2016) Luting of ceramic inlays invitro:marginal quality of self-etch and etchand-rinse adhesives vs. self-etch cements. Dent Mater 24: 185-191.

17. Manhart J, Chen H, Hamm G, Hickel R (2014) Buonocore Memorial Lecture. Review of the clinical survival of direct and indirect restora- tions in posterior teeth of the permanent dentition. Oper Dent 29: 481–508.

18. Schulz P, Johansson A, Arvidson K (2013) A retrospective study of Mirage ceramic inlays over up to 9 years. Int J Prosthodont 16: 510–514.

19. Cardoso MV, de Almeida Neves A, Mine A, Coutinho E, Van Landuyt K (2011) Current aspects on bonding effectiveness and stability in adhesive dentistry. Aust Dent J 56 :     31-44.

 20. Mena-Serrano A, Kose C, De Paula EA, Tay YL, Reis A, et al. (2014) A new universal simplified adhesive: 18-month clinical evaluation. Oper Dent 39: 113-127.

 21. Chen C, Niu LN, Xie H, Zhang ZY, Zhou LQ et al. (2015) Bonding of universal adhesives to dentine—old wine in new bottles? J Dent 43: 525-536.

 22. Delbons FB, Perdigao J, Araujo E, Melo Freire CA, Caldas DD, et al. (2015) Randomized clinical trial of four adhesion strategies in posterior restorations-18-month results.   J Esthet Restor Dent 27: 107-117.

23. Watanebe LG, Marshall GW, Marshall SJ (1999) Variables influence on shear bond strength testing to dentin. In Tagami J, Toledano M, Prati C, eds. Advanced Adhesive Dentistry 3rd International Kuraray Symposium.


Adhesive Luting, Ceramic Inlays, dentin, resin cement, enamel


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