Objectives: To evaluate marginal quality and resin-resin transition of lab made resin composite inlays in deep proximal cavities with and without 3 mm proximal box elevation (PBE) using resin composites before and after thermo-mechanical loading (TML).
Methods: MOD cavities with one proximal box beneath the cementoenamel junction were prepared in 40 extracted human third molars. Proximal boxes ending in dentine were elevated 3 mm with different resin composites (G-Cem, Maxcem Elite as self-adhesive resin cements and Clearfil Majesty Posterior as restorative resin composite in one or three layers bonded with AdheSE), or left untreated. Clearfil Majesty Posterior inlays were luted with Syntac and Variolink II (n = 8). Marginal quality as well as the PBE-composite inlay interface was analyzed under an SEM using epoxy resin replicas before and after thermomechanical loading (100,000 × 50 N and 2500 thermocylces between +5 °C and +55 °C).
Results: Bonding resin composite inlays directly to dentine showed similar amounts of gap-free margins in dentine compared to PBE applied in three consecutive layers (p > 0.05). The groups with self-adhesive resin cements for PBE exhibited significantly more gaps in dentine (p < 0.05).
Significances: With layered resin composite, PBE is effective in indirect resin composite bonding to deep proximal boxes. Self-adhesive resin cements are not suitable for this indication.
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