CASE REPORT

Inlay-retained Zirconia Fixed Dental

Prosthesis: Clinical and Laboratory
Procedures
Carlo Monaco, DDS, MSc, PhD
Division of Prosthodontics, Department of Oral Sciences, Alma Mater Studiorum,
University of Bologna, Bologna, Italy

Paolo Cardelli, DDS

Division of Prosthodontics, Department of Oral Sciences, Alma Mater Studiorum,
University of Bologna, Bologna, Italy

Michele Bolognesi, DT
Laboratorio Bonfiglioli-CCD, Bologna, Italy

Roberto Scotti, DMD, Prof

Division of Prosthodontics, Department of Oral Sciences, Alma Mater Studiorum,
University of Bologna, Bologna, Italy

Mutlu Özcan, Prof Dr med dent, PhD

University of Zürich, Dental Materials Unit, Center for Dental and Oral Medicine,
Clinic for Fixed and Removable Prosthodontics and Dental Materials Science,
Zürich, Switzerland

Correspondence to: Carlo Monaco

Division of Prosthodontics, Department of Oral Sciences, Alma Mater Studiorum, University of Bologna, Via San Vitale 59,

40125 Bologna, Italy; Tel: +39-51-208-8186, Fax: +39-51-225-208; E-mail: carlo.monaco2@unibo.it

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Abstract
Many treatment options are currently
available for single tooth replacement,
such as metal-ceramic, all-ceramic,
direct or indirect fiber-reinforced com-
posite fixed dental prostheses (FDPs)
or implants. Inlay-retained FDPs could
be indicated especially when adjacent
teeth have preexisting restorations and
where implant placement is not possible
or not indicated. In such cases, indica-
tion of both metal-ceramic and fiber-re-
MONACO ET AL
inforced composite FDPs has certain dis-
advantages. This paper describes the
use of all-ceramic inlay-retained FDPs
with zirconia frameworks, veneered with
a press-on technique. The retainer mar-
gins were made of pressed ceramic to
make adhesive luting possible. In deep
cavities, a full contour press-on ceramic
all around the retainers increased the
available surface area for the adhesive
approach.
(Eur J Esthet Dent 2012;7:48–60)
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 CASE REPORT
Introduction
Today, it is possible to replace a missing
tooth in the posterior area of the mouth
using different treatment modalities.
During the past decade, dental implants
have been the first choice, especially in
cases when the abutment teeth were
sound.1 In fact, when patients reject
implant therapy, with or without previ-
ous reconstructive surgery, or in cases
of already-restored teeth, the adhesive
treatment approach and other minimally
invasive procedures could also offer an
alternative solution, as opposed to con-
ventional full coverage fixed dental pros-
thesis (FDP).2 Moreover, the removal of
large parts of dental tissues to gain mac-
romechanical retention becomes prob-
lematic in young patients who have typi-
cally teeth with larger pulp chambers.
Pre-existing fillings can minimize tooth
structure removal and give retention to
the inlay-retained FDP, transforming it
into an ultraconservative option.3 These
retainers enable greater preservation of
healthy tooth structure4 and make peri-
odontal assessment easier.5,6
Although it is still accepted as the
golden standard, the application of full
coverage metal-ceramic FDPs has some
disadvantages. These include loss of re-
tention, soft tissue pigmentation or an
opaque-to-darkish cervical appearance
of the abutment teeth.7 Consequently,
alternative materials have achieved a
certain degree of popularity in prostho-
dontics, such as high-strength pressed
ceramics,8,9 fiber-reinforced composite
(FRC),10 and recently, alumina and yttria-
tetragonal zirconia polycrystal (Y-TZP)
with ceramic veneering.11-13 However,
these materials present some problems
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VOLUME 7 • NUMBER 1 • SPRING 2012
derived from their inherent properties
namely, high-strength pressed ceram-
ics have a potential for debonding12 with
also insufficient fracture resistance.13,14
FRCs on the other hand, has risks of fiber
exposure,15 delamination, and formation
of hairline micro-cracks in the composite
veneering material.15,16 A possible ex-
planation for these phenomena could be
the intrinsic flexibility of the fiber frame-
work that may also play an important
role in the marginal adaptation of the
FRC FDPs.16 The mechanical properties
of the zirconia, especially those related
to its stiffness, could help to avoid the
failures associated with FRC and high-
strength pressed ceramics. However,
zirconia still presents a challenge when
used with adhesive techniques due to
their single-phase tetragonal crystalline
structure that is not etchable by com-
monly-used agents such as hydrofluoric
acid.17,18
In fact, when cementation problems
can be overcome, inlay retained zirco-
nia FDPs could be good alternatives to
other materials and treatment options.
The purpose of this article is to illustrate
the technical and clinical procedures re-
lated to the placement of inlay-retained
FDPs made out of zirconia framework
that is veneered with a pressed ceramic
veneering and luted with a completely
adhesive approach.
Materials and methods
Indications and contraindications
Similar to other metal-free materials,
the properties of the materials used in
inlay-retained zirconia FDPs must be in-
 MONACO ET AL

dicated.3 Careful clinical evaluation and

treatment planning should be performed
prior to the rehabilitation procedure. In-
lay-retained FDPs could be indicated
in patients with good oral hygiene, less
caries susceptibility, presenting coronal
tooth height of a minimum 5 mm or high-
er, parallel abutments and maximum
mesio-distal edentulous gap of 12 mm
(Fig 1). Contraindications include severe
parafunctions, the absence of enamel
Fig 1 Occlusal view of a representative clinical
on the preparation margins, extensive
situation suitable for inlay-retained zirconia FDP.
crown defects and various degrees of
abutment tooth mobility. Endodontically
treated teeth should have their cusps
included in the preparation for their cov-
erage and protection.3 Otherwise, the
clinician should consider a complete
crown preparation.19 Unsolved perio-
dontal pathologies or gingival bleeding
should also be considered as an abso-
lute contraindication, because gingival
bleeding compromises the adhesive
bonding between the prepared tooth
and the resin.20
Moreover, periapical radiographs of
the selected abutment teeth should be
Fig 2 Tooth preparation.
made and model analysis conducted,
starting with irreversible hydrocolloid
impressions. Attention should be paid
to generalized wear facets, antagonist
contact positions, premature contacts,
clinical crown height, horizontal exten-
sion of the edentulous ridge, and align-
ment of the abutment teeth. Canine guid-
ance must be ensured to avoid torsional
stress on the FDP.21 When canine guid-
ance no longer exists, its reconstruc-
tion should be considered prior to tooth
preparation for the inlay-retained FDP.

Fig 3 Polyether impression of the prepared teeth.

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 CASE REPORT
Pretreatment
Existing restorations adjacent to the
pontic area were removed, and if car-
ies was present, carefully excavated.
The prepared dentin was then immedi-
ately sealed with an adhesive system
to prevent contamination by bacteria,
and components coming from the im-
pression and provisional cementation
materials.22,23 Moreover, this procedure
reduces the hydrodynamic effect de-
rived from the inadequate seal of tem-
porary materials.24-26 Therefore, dentin
bonding reduces the postoperative sen-
sitivity.27,28 The build-up was fabricated
with composite materials to eliminate the
undercuts and to compensate for the
gap between the residual tooth structure
and ideal preparation design.
Preparation
The cavity preparation for inlay-retained
zirconia FDPs was performed according
to the following guidelines:
„2.5 mm occlusal depth (floor of isth-
mus to central groove)
„3 mm vestibular-palatal/lingual width
of the intercuspal isthmus
„2 mm depth of proximal box (shoul-
der with rounded internal angle)
„4.5 mm buccal vestibular width (3 mm
of zirconia framework and 0.5–0.6 mm
of ceramic veneering for each side)
„minimum dimensions of connectors:
3 x 3 mm
„inclusions of cusps in the prepar-
ation when the abutment tooth has
a wide bucco-oral defect (>50%) or
has been devitalized
„divergence angle of the cavity of ap-
proximately 6 degrees (Fig 2).
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The recommended impression tech-
nique was based on silicone materials
with a one-step technique (polyether or
VPS) (Fig 3).
Laboratory procedures
and options
The master impressions were developed
with polyurethane resin (Exakto-Form®,
Bredent, Senden, Germany) (Figs 4a,
b). Zeiser model mounting was per-
formed, and the fixed dental prosthe-
sis waxed up (Sculpturing Wax Chip®
(beige), Yeti Dental, Engen, Germany)
(Fig 5). Laboratory putty VPS (Platinum
95, Zhermack SpA, Badia Polesine, Italy)
could be used to create three templates
of the fixed dental prosthesis area: buc-
cal, occlusal, and palatal/lingual. The
waxed-up fixed dental prosthesis was
then removed from the preparations,
and the model was powdered with a
thin layer of TiO2 and scanned for CAD
procedures (inEOS®, Sirona, Bensheim,
Germany) (Fig 6). The master model
was scanned again after repositioning
and powdering the waxed fixed dental
prosthesis. The two scans of the master
model were superimposed, and prep-
aration margins defined with the fixed
dental prosthesis semi-transparent on
the screen (Cerec® inLab 3D software,
Sirona). The FDP framework is always
designed with a connector surface of
at least 3 x 3 mm, and a palatal/lingual
bar on the medium third of the pontic, to
hold the framework in the right position
during press-on.
At this stage, based on the depth of
the cavity preparations, two framework-
design options were available that led
to different surface conditionings of the
 MONACO ET AL

a b

Fig 4 Details of the retainer preparation on the a) premolar, and b) molar on the master model.

Fig 5 Wax-up of the inlay-retained FDP. Fig 6 Master model powdered for scanning be-
fore computer aided design (CAD).

Fig 7 Sintered zirconia framework for deep re- Fig 8 Ceramic liner application.
tainers.

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 CASE REPORT
Fig 9 Framework stabilization with wax and VPS
positioning template.
inlay-retained FDP during the adhesive
luting procedures:
„Less deep cavity preparations
(2.5 mm): the zirconia framework lies
on the cavity floor and has a reduced
circumferential dimension, leaving
space for etchable glass ceramic at
the margins (Figs 4a, b).
„Deep cavity preparations (>3.3 mm):
the zirconia framework is enclosed
inside the over-pressed ceramic. In
this way, all inner surfaces of the re-
tainers are covered by the etchable
glass ceramic (Fig 7).
Following the CAD stage, zirconia frame-
works were milled from a pre-sintered
block (IPS e.max® ZirCAD for inLab
Blocks B 40 L; Ivoclar Vivadent, Schaan,
Liechtenstein) with a dedicated machine
(Cerec inLab® MC XL, inLab, Sirona, Aus-
tria). Refinishing with a tungsten carbide
bur was necessary to remove the last
zirconia excesses before sintering. The
milled framework is color-infiltrated (IPS
e.max® ZirCAD Colouring Liquid, Ivoclar
Vivadent) and the residual connection to
the base of the block was removed.
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Fig 10 Framework junction to VPS positioning
template.
After placement in a refractory box
containing zirconia-isolating spheres
(Sintramat® ZrO2 beads, Ivoclar Viva-
dent), the framework was sintered for
7.5 hours in the relevant sintering fur-
nace (Sintramat®, Ivoclar Vivadent),
until it reached 1,500°C, followed by ap-
proximately 30 minutes of cooling.
After sintering, different technical
procedures were used for the more
shallow and the deep cavity prepara-
tions:
„For the more shallow preparations,
a ceramic uncolored liner (IPS
e.max® Ceram ZirLiner clear, Ivoclar
Vivadent) was placed in a creamy
consistency all over the framework
and fired. After this heat treatment,
the liner thickness should be at least
0.1 mm. The ceramic veneering was
then waxed up.
„For deep preparations, full ceramic
contour of the FDP was obtained by
performing the following procedures:
- The occlusal portion of the liner
(IPS e.max® Ceram ZirLiner clear,
Ivoclar Vivadent) was layered and
fired (Fig 8);

Fig 11 Wax-up of the retainer obtained by frame-
work repositioning on the model by means of the
template.
- A soft wax was placed between
the pontic and the edentulous
area of the master model, and the
framework was moved until the oc-
clusal clearance from the template
is uniform. Then, the same wax is
placed under the retentions. A new
occlusal template that contacts the
framework was prepared (Fig 9);
- The wax under the pontic and the
retention was removed, and the
liner was layered and fired in this
portion;
- The FDP was locked to the new
template with an adhesive wax
(Fig 10) while the technician holds
it in the hand, putting fluid wax
under the inlays and the pontic,
and obtaining the right modeling
repositioning on the master model,
starting from the inlays (Fig 11);
- Occlusal waxing was performed
using the first template, generated
from the wax up analysis.
In both cases, the wax cylinders that will
drive the pressed ceramic to the frame-
work are placed on every cusp of the
MONACO ET AL
Fig 12 Inlay-retained FDP with full contour wax-
up ready for the ceramic press-on.
pontic (Fig 12). The press-on technique
follows a lost-wax technique. After this
stage, the ceramic (ZirPress, Ivoclar
Vivadent) was heated at 900°C for 15
minutes after an increase of 60°C/min.
It was then injected by the same device
(Programat EP 5000, Ivoclar Vivadent).
When ceramic cooling was complete,
the ceramic channels were removed
with a tungsten carbide bur and the FDP
adapted to the master model (Fig 13). For
the correct color matching, shade and
stain can be used (1 or 2 firings). Other-
wise, the FDP can be ceramic stratified
(IPS e.max Ceram, Ivoclar Vivadent).
Try-in
The fit of the structure in the oral cav-
ity was controlled using a low-viscosity
silicone material (Fit Checker Black 1-1
PKG, GC, Tokyo, Japan), which showed
no friction and demonstrated marginal
integrity of the retainers.
The occlusion was controlled with
35 μm occlusal paper, both in maxi-
mum intercuspidation position and dur-
ing the eccentric movements, correct-
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 CASE REPORT
ing the FDP with fine diamond burs and
reshaping opposing fillings, if existing.
The interproximal contact areas with the
adjacent teeth were also checked if they
were involved in the restoration.
The FDP was then glazed (e.max®
Ceram Glaze Fast, Ivoclar Vivadent)
and then ready for the luting procedures
(Figs 14a, b).
Placement
The temporary restoration was removed
from the preparations using a manual
instrument, such as a probe and exca-
vator. A rubber dam was then placed,
isolating the preparations from the oral
cavity. The dam margins were placed
inside the gingival sulcus using a spatu-
la and air pressure; otherwise, the dam
could cover some parts of the retentions.
In some cases, the rubber dam place-
ment should be integrated with the use
of a retraction cord and/or a liquid dam.
The preparations were cleaned using
a pumice paste over a rotating brush at
7,000 RPM. The luting procedure then
started as follows:
FDP conditioning
The cleaned and dried ceramic surfaces
that are to be in contact with the cement
were etched with 9.6% hydrofluoric acid
for 60 seconds. The surfaces were then
cleaned with suction and rinsed with a
water spray for 60 seconds. The ceramic
precipitates were removed from the sur-
face by ultrasonically cleaning the FDP
in 95% ethylic alcohol for 10 minutes.
The surface was carefully air dried, and
a silane coupling agent placed on the
etched surfaces and left to react with the
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surface for 5 minutes at 60°C. A single
layer of bonding agent from the 3-step
adhesive system chosen was applied
on the surfaces, and luted with a micro-
brush. The FDP was then placed under
a dark cover, preventing polymerization
of the adhesive.
Cavity conditioning
The cavities were treated with Al2O3
particles partly covered with SiO2 (Co-
Jet Sand, 3M ESPE) with an intraoral
sandblaster (CoJet Prep, 3M ESPE,
Seefeld, Germany) until the surface of
the preparation appeared completely
treated. The surfaces were then etched
for 30 seconds with 35% phosphoric
acid. Etching gel was rinsed for 20 sec-
onds with an air/water spray, and the
primer of the same adhesive system
used for the FPD applied for 20 sec-
onds with a microbrush and then gently
evaporated. The bonding agent already
used on the FDP was then applied with
a microbrush, but not polymerized.
Final placement
A 2 mm layer of restorative composite
material was heated to 60°C and placed
on the retentions with a spatula. The FDP
was then carefully placed. Finger pres-
sure was used first, and then more direct
pressure was applied, letting the patient
close the mouth with the dam in place.
The patient was let bite half of a wooden
bite stick that was placed between the
opposing arch and the pontic. Excess
composite was removed with thin instru-
ments (Carver/Occlusal Former DD1 /
DD2, Suter Dental Manufacturing, Chico,
CA, USA) and floss (Oral-B Superfloss,
 MONACO ET AL

Fig 13 Veneered FDP ready for clinical try-in.

a b

Fig 14 a) Cementation surface and b) occlusal surface of the final restoration ready for luting procedure.

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 CASE REPORT
Procter & Gamble, Cincinnati, USA). Fol-
lowing removal of excess composite, it
was polymerized from mesio-buccal,
mesio-lingual, disto-buccal, disto-lin-
gual, and occlusal directions. Addition-
al polymerization was performed for 20
seconds at each side with glycerine gel
that was placed to prevent oxygen from
inhibiting the polymerization. Excess lut-
ing material was removed with a scaler.
The tooth-restoration interface was
then finished using composite polish-
ing points (Astropol, Ivoclar Vivadent,
Schaan, Liechtenstein) at average RPMs
and then with an occlubrush (Occlu-
brush, Kerr, Orange, CA, USA) at 6,000
RPM. Proximal areas that are difficult to
reach can be finished with narrow finish-
ing strips (Soft-Lex 1954N, 3M ESPE, St.
Paul, MN, USA) (Fig 15).
Discussion
Inlay-retained FDPs could be consid-
ered when implants are not indicated or
cannot be afforded by the patients. Fur-
thermore, peri-implantitis issue or mar-
ginal bone loss around implants have
not been thoroughly solved in implant
dentistry.29 Such restorations could be
considered as conservative options,
compared to complete coverage FDPs.
Complete coverage FDPs may present
long-term survival rate due to macro-
mechanical retention, but biological
complications such as caries around the
restorations, loss of vitality or periodon-
tal problems are commonly reported.2
When abutment teeth contain restora-
tive fillings adjacent to the missing tooth,
inlay-retained FDPs are very minimally
invasive options because they require
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VOLUME 7 • NUMBER 1 • SPRING 2012
only minimum tooth structure removal
beyond the filling extension.
Complete coverage FDPs may present
long-term survival rate due to macro-
mechanical retention but biological
complications such as caries around the
restorations, loss of vitality or periodon-
tal problems are commonly reported.2
When abutment teeth contain restora-
tive fillings adjacent to the missing tooth,
inlay-retained FDPs are very minimally
invasive options because they require
only minimum tooth structure removal
beyond the filling extension. Wolfart et al
reported 89% survival rate after 4 years
for lithium disilicate, with failures due to
debonding or a combination of debond-
ing and fracture.11
The technique described here could
reduce these phenomena due to the ri-
gidity of the zirconia and the possibility
of adhesive cementation given by the
pressed ceramic.30 Ceramics materi-
als, moreover, have some basic advan-
tages in polishing and color matching,
as well as the possibility of intraoral re-
pair.31 On the other hand, zirconia has
the potential to age due to hydrotermal
degradation that could possibly occur
when it is exposed to oral fluids, which
is a phenomena that has not been clari-
fied yet in dentistry.32 With the use of
a full-contour veneering or at least the
use of a ceramic marginal closure at the
margins of the retainers, this problem
could be avoided.
Conclusions
Within the limits of a preliminary clinical
application, the technique described
here allows for single-tooth substitution

Fig 15 Clinical result after 3 years of oral service.
when implant placement is not possible
or not indicated. Thus excessive dental
tissue removal for full-coverage FDPs
could be avoided. The use of a press-
on ceramic for a marginal or full contour-
ing of the retainer, allowing the adhesive
approach, could enhance the long-term
stability of such restorations.
Disclosure
The authors declare that they have no fi-
nancial interest in the companies whose
materials are used in this article.
MONACO ET AL
References
1. Misch CE, Misch-Dietsh F, Silc J, Barboza E,
Cianciola LJ, Kazor C. Posterior implant single-
tooth replacement and status of adjacent teeth
during a 10-year period: a retrospective report.
J Periodontol 2008;79:2378–2382.
2. Sailer I, Pjetursson BE, Zwahlen M, Hämmerle
CHF. A systematic review of the survival and
complication rates of all-ceramic and metal–
ceramic reconstructions after an observation
period of at least 3 years. Part II: fixed dental
prostheses. Clin Oral Impl Res 2007;18:86–96.
3. Edelhoff D, Spiekermann H, Yildirim M. Metal-
free inlay-retained fixed partial dentures. Quin-
tessence Int 2001;32:269–281.
4. Edelhoff D, Sorensen JA. Tooth structure
removal associated with various preparation
designs for posterior teeth. Int J Periodontics
Restorative Dent 2002;22:241–249.
59
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 7 • NUMBER 1 • SPRING 2012
 CASE REPORT
5. Freilich MA, Niekrash CE,
Katz RV, Simonsen RJ. Perio-
dontal effects of fixed partial
denture retainer margins:
configuration and location.
J Prosthet Dent 1992;67:
184–190.
6. Knoernschild KL, Camp-
bell SD. Periodontal tissue
responses after insertion of
artificial crowns and fixed
partial dentures. J Prosthet
Dent 2000;84:492–498.
7. Tan K, Pjetursson BE, Lang
NP, Chan ES. A systematic
review of the survival and
complication rates of fixed
partial dentures (FPDs) after
an observation period of at
least 5 years. III. Convention-
al FPDs. Clin Oral Impl Res
2004;15:654–666.
8. Kerschbaum T. Akzeptanz
der Adäsivprothetik. Ergeb-
nisse einer Umfrage. Phillip J
1992;9:451–455.
9. Sorensen JA, Cruz M, Mito
WT, Raffeiner O, Meredith
HR, Foser HP. A clinical
investigation on three-unit
fixed partial dentures fab-
ricated with lithium dis-
ilicate glass ceramic. Pract
Periodontics Aesthet Dent
1999:11;95–106.
10. Göhring TN, Roos M.
Inlay-fixed partial dentures
adhesively retained and
reinforced by glass fib-
ers: clinical and scanning
electron microscopy analysis
after five years. Eur J Oral
Sci 2005;113:60–69.
11. Wolfart S, Bohlsen F, Wegner
SM, Kern M. A preliminary
prospective evaluation of all-
ceramic crown-retained and
inlay-retained fixed partial
dentures. Int J Prosthodont
2005;18:497–505.
12. Ohlmann B, Rammelsberg
P, Schmitter M, Schwarz
S, Gabbert O. All-ceramic
inlay-retained fixed partial
dentures: preliminary results
from a clinical study. J Dent
2008;36:692–696.
13. Wolfart S, Ludwig K,
Uphaus A, Kern M. Frac-
ture strength of all-ceramic
posterior inlay-retained fixed
60
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 7 • NUMBER 1 • SPRING 2012
partial dentures. Dent Mater
2007;23:1513–1520.
14. Kiliçarslan MA, Kedici PS,
Küçükeúmen HC, Uluda÷
BC. In vitro fracture resist-
ance of posterior metal-
ceramic and all-ceramic
inlay-retained resin-bonded
fixed partial denture. J Pros-
thet Dent 2004;92:365–370.
5. Monaco C, Ferrari M, Caldari
M, Baldissara P, Scotti R.
Comparison of 2 bonding
systems and survival of fiber-
reinforced composite inlay
fixed partial dentures. J Pros-
thodont 2006;19:577–585.
16. Monaco C, Krejci I, Bortol-
otto T, Perakis N, Ferrari M,
Scotti R. Marginal adapta-
tion of 1 fiber-reinforced
composite and 2 all-ceramic
inlay fixed partial denture
systems. Int J Prosthodont
2006;19:373–382.
17. Denry I, Kelly JR. State of
the art of zirconia for dental
applications. Dent Mater
2008;24:299–307.
18. Conrad HJ, Seong WJ,
Pesun IJ. Current ceramic
materials and systems with
clinical recommendations: a
systematic review. J Prosthet
Dent 2007;98:389–404.
19. Dietschi D, Duc O, Krejci
I, Sadan A. Biomechani-
cal considerations for the
restoration of endodontically
treated teeth; a systematic
review of the literature –
Part 1. Composition and
micro- and macrostructure
alterations. Quintessence Int
2007;38:733–743.
20. Cox CF, Tarim B, Kopel H,
Gürel G, Hafez A. Technique
sensitivity: biological fac-
tors contributing to clinical
success with various restora-
tive materials. Adv Dent Res
2001;15:85–90.
21. Bertschinger C, Paul SJ,
Lüthy H, Schärer P. Dual
application of dentin bond-
ing agents: effect on
bond strength. Am J Dent
1996;9:115–119.
22. Dietschi D, Spreafico R.
Current clinical concepts
for adhesive cementation of
tooth-colored posterior res-
torations. Pract Periodontics
Aesthet Dent 1998;10:47–54.
23. Türp JC, Greene CS, Strub
JR. Dental occlusion: a criti-
cal reflection on past, present
and future concepts. J Oral
Rehabil 2008;35:446–453.
24. Mash LK, Beninger CK,
Bullard JT, Staffanou RS.
Leakage of various types of
luting agents. Prosthet Dent
1991;66:763–766.
25. Millstein PL, Hazan E, Nath-
anson D. Effect of aging on
temporary cement retention
in vitro. J Prosthet Dent 1991;
65:768–771.
26. Woody TL, Davis RD. The
effect of eugenol-containing
and eugenol-free temporary
cements on microleakage in
resin bonded restorations.
Oper Dent 1992;17:175–180.
27. Brännström M, Lindén LÅ,
Ånström A. The hydrodynam-
ics of the dentinal tubule and
of pulp fluid: a discussion
on its significance in relation
to dental pain. Caries Res
1967;1:310–317.
28. Bergenholtz G. Effect of bac-
terial products on inflamma-
tory reactions in the dental
pulp. Scand J Dent Res
1977;85:122–129.
29. Meffert RM. Periodontitis and
periimplantitis: one and the
same? Pract Periodontics
Aesthet Dent 1993;5:79–80,
82.
30. Özcan M, Vallittu PK. Effect of
surface conditioning meth-
ods on the bond strength of
luting cement to ceramics.
Dent Mater 2003;19:725–731.
31. Özcan M, Niedermeier W.
Clinical study on the reasons
for and location of failures of
metal-ceramic restorations
and survival of repairs. Int J
Prosthodont 2002;15:299–
302.
32. Chevalier J, Deville S,
Münch E, Jullian R, Lair F.
Critical effect of cubic phase
on aging in 3mol% yttria-sta-
bilized zirconia ceramics for
hip replacement prosthesis.
Biomaterials. 2004;25:
5539–5545.