journal of dentistry 38 (2010) 875–881

available at www.sciencedirect.com

journal homepage: www.intl.elsevierhealth.com/journals/jden

Eight-year outcome of posterior inlay-retained all-ceramic

fixed dental prostheses

S. Harder a, S. Wolfart b, S. Eschbach a, M. Kern a,*

a
Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University, Arnold-Heller Str. 16,
24105 Kiel, Germany
b
Department of Prosthodontics, RWTH University, Pauwelsstr. 30, 52074 Aachen, Germany

article info abstract

Article history: Aim: The main goal of this prospective clinical study was to evaluate the outcome of inlay-
Received 6 March 2010 retained fixed dental prostheses (FDPs) made from heat-pressed lithium-disilicate glass-
Received in revised form 28 July 2010 ceramic.
Accepted 29 July 2010 Methods: Forty-five FDPs were placed in 42 patients (21 women, mean age 36.1 years and 21
men, mean age 42.0 years). The FDPs replaced 4 premolars and 19 molars in the maxilla and
4 premolars and 18 molars in the mandible. Preparations were performed in accordance
Keywords: with general principles for ceramic inlay restorations. Five of the 45 FDPs were hybrid-
Clinical investigation retained restorations, i.e. one abutment tooth with an inlay retainer and one with a full
Survival crown retainer.
Inlay-retained fixed dental All FDPs were pressed in one piece using lithium-disilicate ceramic (IPS e.max Press,
prosthesis Ivoclar Vivadent). The minimum dimensions for the proximal connector were 4 mm in
All-ceramic height and 4 mm in width (16 mm2) with a minimum occlusal ceramic thickness of 1.5 mm.
Lithium-disilicate ceramic The surfaces of the inlay retainer were conditioned by etching with hydrofluoric acid 5% and
silane application. Standard adhesive luting techniques were performed using a dentin
adhesive (Syntac Classic, Ivoclar Vivadent) and a resin composite (Variolink II, Ivoclar
Vivadent). Clinical follow-up examinations were performed annually.
Results: The mean observation periods were 70 months (minimum 4, maximum 123
months). Twenty-seven FDPs (60%) failed during the observation period and had to be
replaced. The Kaplan–Meier survival rate for inlay-retained FDPs was 57% after 5 years and
38% after 8 years, while for hybrid-retained FDPs it was 100% after 5 and 60% after 8 years.
Conclusions: Inlay-retained FDPs made from lithium-disilicate ceramic present a high clini-
cal failure rate and therefore cannot be recommended.
# 2010 Elsevier Ltd. All rights reserved.

1. Introduction
Full crown preparation always presents a risk to pulp vitality
and may lead to pulp reactions in the long term.1 Approxi-
mately 63–73% of the coronal tooth structure is removed when
teeth are prepared for all-ceramic crowns.2 Therefore it
seemed desirable to adapt the type of abutment preparation
to avoid loss of sound tooth structure, not only for single tooth
restorations, but also for fixed dental prostheses (FDPs) in the
posterior teeth region.
The use of box-shaped preparation forms for the support of
inlay-retained FDPs might be the intended consequence if
caries activity is low and only a single tooth has to be replaced.
First promising attempts to use inlays as retainers for metal-
ceramic resin-bonded FDPs in the posterior teeth region were
made by Stokholm and Isidor3 in 1996 and Serdar Cotert and

* Corresponding author. Tel.: +49 431 597 2874; fax: +49 431 597 2860.
E-mail address: mkern@proth.uni-kiel.de (M. Kern).
0300-5712/$ – see front matter # 2010 Elsevier Ltd. All rights reserved.
doi:10.1016/j.jdent.2010.07.012
876 journal of dentistry 38 (2010) 875–881
[(Fig._1)TD$IG]

Fig. 1 – Preparation design for three-unit inlay-retained FDP in the left mandible and for hybrid-retained FDP in the right
mandible and related master cast. Three-unit inlay-retained FDP for the replacement of a second premolar in occlusal-
lingual view. FDPs in situ immediately after luting (left to right/top to bottom).

Ozturk4 in 1997. Today the demand for metal-free restorations conditions and were in need of one or two three-unit FDPs but
with the desirable qualities such as aesthetics close to the had an otherwise sufficiently restored dentition.
natural teeth and additional superior biocompatibility, leads Informed consent for the study was obtained from all
to the consideration whether all-ceramic inlay-retained FDPs subjects on a written form approved by the Ethical Committee
are a viable treatment option for the posterior region. of the Medical Faculty of the Christian-Albrechts University at
The outcome of all-ceramic inlay-retained FDPs has been Kiel. The edentulous space had to be equal or smaller than the
investigated in vivo5–7 and in vitro8–12. In vitro investigations width of a molar. The bone level of the vital abutment teeth
regarding the fracture strength of three-unit inlay-retained
FDPs made from heat-pressed lithium-disilicate ceramic and
[(Fig._2)TD$IG]
yttrium-oxide partially stabilized zirconia were promising. But
for the clinical use of all-ceramic material for inlay-retained
restorations only short-term data are available to the present
time.5–7 The aim of the present study therefore was to assess
the intermediate clinical outcome of an heat-pressed lithium-
disilicate glass-ceramic for the use in inlay-retained 3-unit
FDPs when adopted with a standardized protocol concerning
preparation technique, restoration design and luting proce-
dure (Figs. 1 and 2).

2. Materials and methods

2.1. Study design

Patients referred to the Department of Prosthodontics,

Propaedeutics and Dental Materials of the Christian-Albrechts
University, Kiel, Germany with the need for a 3-unit FDP were Fig. 2 – Same FDPs as shown in Fig. 1, after 96 months
selected for the study. All patients were in good health observation time.
 journal of dentistry 38 (2010) 875–881
had to correspond to at least two-thirds of the root length with
no signs of active bone resorption or periapical pathology.
Oral hygiene had to be good and caries activity low.
Maximum tooth mobility of grade 1 was accepted. Patients
with probing depths greater than 4 mm, vertical bone loss
around abutment tooth, extreme bruxism, limited vertical
space for the required connector height of 4 mm or a
conspicuous medical or psychological history were excluded
from the study.
2.2. Clinicians
All clinical treatment of the patients included in this study
was performed by fifteen clinicians. The mean vocational
experience of the clinicians was 2.9  1.0 years. The clinical
treatment procedures were supervised and inspected by 2
dentists with a specialization in prosthodontics (approved by
the German Society for Prosthodontics and Dental Materials
[DGZPW]). To ensure homogeneity in treatment procedures
during the study, all clinicians were calibrated considering the
following treatment modalities.
2.3. Prosthodontic procedures
Inlay preparation procedures were performed in accordance
with the general principles for ceramic inlay restorations.
Abutment teeth were prepared with a mesial-occlusal, occlusal-
distal or mesio-occlusal-distal inlay cavity, respectively. Box-
shaped inlay cavities were prepared with fine (30–40 mm grain)
diamond instruments under avoidance of any sharp angles. The
finishing line was a shoulder, no bevels were used. In five cases,
there was a need for full crown preparation of one of the two
abutment teeth respectively. In these five cases, hybrid-
retained restorations (one abutment tooth with an inlay
retainer and one with a full crown retainer) were fabricated.
After abutment preparation, impressions were taken with
a simultaneous, dual-mix technique using polyether material
(Permadyne, 3M/ESPE, Seefeld, Germany). The impressions
were cast with Type IV gypsum (GC-Fuji Rock EP, Tokyo, Japan)
and a die spacer was applied to each master die (Vita In-Ceram
Distanzlack, Vita, Bad Säckingen, Germany). All FDPs were
made from a heat-pressed lithium-disilicate glass-ceramic
(IPS e.max Press, Ivoclar Vivadent, Schaan, Liechtenstein)
according to the manufacturers’ instructions.
For the fabrication of the FDPs, the wax patterns were
fabricated and invested with a special investment material (IPS-
Press Vest Speed, Ivoclar Vivadent). All FDPs were pressed in
one piece and no additional veneering was conducted. After the
pressing process, minor adjustments to fit the castings to their
dies were performed under a light microscope (magnification
20) if necessary. The use of additional veneering ceramic was
only performed in cases where small corrections were neces-
sary (i.e. pontic area, aesthetic form correction of the FDP). The
individualization of colour was achieved by using universal
intensive stains (Universal Stains Kit, Ivoclar Vivadent).
The minimum occlusal ceramic thickness for inlays and
crowns was 1.5 mm. For the proximal connector the minimum
dimensions were 4 mm in height and 4 mm in width (16 mm2).
The marginal fit of the abutments was checked intraorally
with a silicon based indicator paste (Fit Checker, GC). If
877
necessary, adjustments were performed. The marginal fit of
the restorations was accepted, if the silicon indicator paste
showed a thin and homogeneous layer. No temporary
cementation of the FDPs was performed to avoid microcracks
in the ceramic material.
All restorations were cemented adhesively. The surfaces of
the inlay retainers were etched with 5% hydrofluoric acid
(Ceramic etchant, Ivoclar Vivadent) for 20s and minimum 60s
silane coating (Monobond S, Ivoclar Vivadent). Then the FDPs
were bonded to the abutment teeth with standard luting
techniques using a dentin adhesive (Syntac Classic, Ivoclar
Vivadent) and a bonding resin (Variolink II, Ivoclar Vivadent).
Rubber dam protection was used during adhesive cementation
procedures. After cementation, a radiograph of the restoration
and its abutment teeth was obtained.
2.4. Follow-up clinical examinations
One to three weeks after cementation patients were scheduled
for a final evaluation. Follow-up examinations were per-
formed after 6 months, 12 months and then annually.
All patients who did not attend the follow-up examination
were contacted via telephone. They were asked two standard-
ized questions: (1) ‘‘Is the FDP still in situ?’’ and (2) ‘‘Do you
have any problems with your teeth in general and especially
with the FDP?’’
2.5. Outcome
According to Walton13, treatment outcomes were allocated to
1 of 6 fields:
Successful: Review of the documentation and patient
examination revealed no evidence of or no need for retreat-
ment other than maintenance procedures, which include
prophylaxis and minor occlusal or contour adjustments.
Surviving: The patient could not be examined directly, but the
patient and the examination of the patients’ records confirmed
via telephone interview that there had been no retreatment
other than that described for a successful outcome.
Unknown: The patient could not be traced or reached by
telephone.
Dead: The patient had passed away during the observation
period. In these cases the FDPs were rated successful until
death.
Repaired: The original marginal integrity of all the retainers
and abutment teeth was maintained irrespective of other
retreatments/modifications. Occlusal perforation of a retainer
for access to perform endodontic therapy was not considered a
repair.
Failed: Any retainer or its marginal interface with its
respective abutment tooth had been lost.
All types of failures that occurred during the observation
time could be assigned to the following subcategories: (1) a
restoration had to be replaced because of the loss of retention
of one inlay retainer (Debonding I) or both inlay retainers
(Debonding II); a restoration had to be replaced because of
fracture of one inlay retainer (Fracture I) or both inlay retainers
(Fracture II) or because of fracture of the pontic (Fracture III) or
the combination of both, debonding and fracture of the inlay
(Combined).
878 journal of dentistry 38 (2010) 875–881

Table 1 – Distribution by location of 40 inlay-retained and Table 2 – Outcome of FDPs (n = 45) after a mean
5 hybrid-retained fixed dental prostheses (FDPs). observation time of 70 months.
Location Type of FDP Outcome Type of FDP

Inlay-retained Hybrid-retained Inlay-retained Hybrid-retained Total

Right maxilla Successful 9 2 11

Second premolar 3 – Surviving 5 1 6
First molar 5 1 Unknown 1 – 1
Dead – – –
Left maxilla
Repaired – – –
Second premolar 1 –
Failed 25 2 27
First molar 12 1
FDP, fixed dental prosthesis.
Left mandible
Second premolar 1 –
First molar 8 1

Right mandible
Second premolar 1 2
First molar 9 –
FDP, fixed dental prosthesis.
2.6. Statistical evaluation
Kaplan–Meier’s survival curves14 were used to demonstrate
cumulative survival rates and timing of FDPs. Survival time
was described by the distance between the date of cementa-
tion and the date of the last follow-up examination for the
categories: success, surviving and repaired. In case of failed
FDPs, survival time was described by the distance between the
date of cementation and the date of failure. For the dead and
unknown categories survival time was described between the
date of cementation and the latest date of known status.
3. Results
3.1. Patients
Forty-two patients were included in the study and gave their
written consent (21 women with a mean age of 36.1 years,
range 20–61 years; 21 men with a mean age of 42.0 years, range
24–67 years). Altogether, 45 inlay-retained FDPs were inserted.
The distribution of the replaced teeth is shown in Table 1.
3.2. Outcome of FDPs
Table 2 shows the distribution of all FDPs to the different
outcome categories. After a mean observation time of 70
months (minimum 4 months = first failure, maximum 123
months = last observation), 18 (40%) out of 45 FDPs were still in
situ, whereas the status of one inlay-retained FDP of one
patient remained unknown after an observation period of 61
months. Last known status after clinical investigation of this
FDP was successful.
In four FDPs incorporated in 3 patients, biological problems
occurred (Table 3). In one case endodontic treatment of one
abutment teeth was performed 17 months after cementation
and, in the same patient, caries occurred at one abutment
tooth of another restoration 72 month after cementation. In
two other cases, caries occurred at one abutment teeth
respectively after 55 and 93 months after cementation. After
restorative therapy of the caries, all of these restorations are
still in function.
The descriptive analysis of failures that occurred in 40 inlay-
retained and 5 hybrid-retained FDPs is shown in Table 4.
Twenty-seven (60%) out of 45 FDPs were lost during the
observation period. Eighteen out of 45 FDPs were lost because
of fractures (40%) and six because of debonding of one or two of
the inlay retainers (13%). In three cases (6%), the FDPs were lost
because of a combination of fracture and debonding of the inlay
retainers. The two failures that occurred in the hybrid-retained
FDP group were fractures of one inlay retainer (Table 4).
The descriptive analysis of failures occurred in 40 inlay-
retained and 5 hybrid-retained FDPs related to the replaced
tooth site is shown in Table 5. Eleven out of 18 fractures
occurred in the mandible while 4 out of 6 FDPs were lost due to
debonding in the maxilla. All combined failures occurred in
the maxilla.
The cumulative survival of the FDPs according to Kaplan–
Meier’s is demonstrated in Fig. 3. The five-year survival rate for
inlay-retained FDPs was 57% (95% CI 42–75%) and 100% for

Table 3 – Descriptive analysis of biological problems that occurred in 40 inlay-retained and 5 hybrid-retained FDPs.
Patient Gender Replaced tooth Time to failure Failure mode Restoration type

1 M 26 55.4 mo Caries at 27; still in situ at 76 mo IR

2 M 36 93.5 mo Caries at 37; still in situ at 106 mo HY

3 F 35 17.2 mo Endo of 34; still in situ at 122 mo IR

45 72.4 mo Caries at 46; still in situ at 122 mo HY

F, female; M, male; IR, inlay-retained FDP; H, hybrid-retained FDP; mo, months.

Tooth numbers shown are FDI.
 journal of dentistry 38 (2010) 875–881 879

Table 4 – Descriptive analysis of failures that occurred in 40 inlay-retained and 5 hybrid-retained FDPs.
Failure mode n

Fracture of one inlay retainer – (Fracture I) 13a

Fracture of both inlay retainers – (Fracture II) 3
Fracture of pontic area – (Fracture III) 2
Total fracture 18

Debonding of one inlay retainer – (Debonding I) 3

Debonding of both inlay retainers – (Debonding II) 3
Total debonding 6

Fracture and debonding of both inlay retainers – (Combined) 3b

Total 27

a
One out of 13 fixed dental prostheses (FDP) showing Fracture I failure mode was a hybrid-retained FDP.
b
One out of 3 fixed dental prostheses (FDP) showing Combined failure mode was a hybrid-retained FDP.

Table 5 – Descriptive analysis of failures that occurred in 40 inlay-retained and 5 hybrid-retained FDPs related to the
failure site.
Replaced teeth Failure mode Total

Fracture Debonding Combination: fracture No failure

and debonding

Maxilla 15 1 0 1 1 3
16 2 1 0 3 6
25 0 1 0 0 1
26 4 2 2 5 13

Mandible 35 0 0 0 1 1
36 5 0 0 4 9
45 1 0 0 2 3
46 5 2 0 2 9

Total 18 6 3 18 45

Tooth numbers shown are FDI.

hybrid-retained FDPs. After 8 years, the calculated survival
rate was 38% (95% CI 16–54%) for inlay-retained FDPs and 60%
(95% CI 17–100%) for hybrid-retained FDPs.
4. Discussion
The aim of the present prospective clinical study was to assess
the outcome of three-unit inlay-retained FDPs made from
lithium-disilicate ceramic. The results of the study showed a
poor outcome of the investigated FDPs for the replacement of
posterior premolars or molars after five and eight years, when
compared to the outcome of conventional crown-retained
FDPs made from the same ceramic,15 which was comparable
to conventional metal-ceramic FDPs.16
The failures of the inlay-retained FDPs were caused by
fracture, debonding or a combination of debonding and
fracture at the isthmus of one abutment, i.e. the connection
between the occlusal part and the proximal box of the inlay
(Fig. 4). High stresses at the adhesive interfaces when loading
the pontics during chewing eccentrically10 might have been
responsible for the high fracture and debonding rate. In
addition to high torsion forces at the inlay retainers, the
relatively small area bonded to enamel and the big area
bonded to dentin might be responsible for this intermediate
outcome, as bonding to dentin is considerably less durable
than bonding to enamel.17 After losing retention in the
proximal inlay box mostly located in dentin, the stability of
the inlay retainer was limited to its fracture strength in the
small isthmus area of the inlay, which could withstand the
chewing forces (see Fig. 4). Most failures due to fracture or
debonding were related to FDPs replacing first molars and
more fractures were observed in the mandible than in the
maxilla (Table 5). This might be explained by the higher
distortion of the mandible and the higher chewing stress
levels in the region of the first molar.
To improve the outcome of inlay-retained all-ceramic FDPs
various suggestions regarding material and framework design
have been published.5,12,18,19 In vitro investigations regarding
different framework materials for inlay-retained FDPs showed
a significant higher fracture strength of yttrium-oxide partially
stabilized zirconia ceramic compared to lithium-disilicate
heat-pressed ceramic as used in the present investigation.12,19
But first clinical attempts using zirconia frameworks for inlay-
retained FDPs with an conventional inlay-retainer design
similar to our investigation showed also high clinical failure
rates caused by debonding, fractures and chipping after a 12
months observation period.5
A new framework design for inlay-retained FDPs made
from zirconia ceramic with oral retainer wings and shallow
880 journal of dentistry 38 (2010) 875–881
[(Fig._3)TD$IG]

Fig. 3 – Kaplan–Meier’s curve demonstrating the cumulative survival for inlay-retained (continuous line) and hybrid-

[(Fig._4)TD$IG]
retained (dotted line) FDPs.

Fig. 4 – Example of an inlay-retained FDP that failed due to debonding and fracture of the distal inlay retainer (asterisks). The
fracture of the distal retainer occurred at the intersection between the occlusal part and the proximal box of the inlay.
Bonding of the mesial retainer (arrow) was sufficient and the inlay was left in situ.

occlusal inlays was described by Wolfart et al. in 2006.18 In this maximizing the bonding area and minimizing torsion forces
design the framework material provides higher fracture on the inlay retainers when the FPDs are loaded nonaxially.
strength than lithium-disilicate ceramic and the extended Preliminary results indicate no clinical failures within the first
bonding surface in enamel minimizes the risk of debonding by two years.20
 journal of dentistry 38 (2010) 875–881
The influence of the partial-retainer design on the failure
load of zirconia cantilever restorations was assessed in vitro
recently.21 A buccal retainer design that embraces the
proximal surface of the abutment tooth seems to be the most
promising to avoid loss of retention because of tilting stress
forces. But nevertheless, disadvantages reported for the buccal
retainer design for inlay-retained FDPs seem to be similar to
those for metal-ceramic inlay-retained FDPs: inadequate
colour matching of the additional retainer wing surface and
in addition oversized shape because of the minimal thickness
of the material. However, only small amounts of sound
coronal tooth structure have to be removed during the
preparation procedure. Furthermore, long-term data about
the clinical performance of this new design for inlay-retained
FDPs are still missing.
Regarding the tested lithium-disilicate ceramic material, it
is important to point out, that inlay-retained FDPs have never
been recommended by the manufacturer of the material.
Nevertheless, after an observation period of five years 57% of
the inlay-retained FDPs were still in situ, but survival rate
dropped to only 38% after eight years.
5. Conclusions
The clinical outcome of experimental inlay-retained FDPs
made from lithium-disilicate ceramic was not acceptable
when compared to conventional crown-retained FDPs. There-
fore this clinical application cannot be recommended for
clinical use.
Acknowledgements
This study was supported by Ivoclar-Vivadent, Schaan,
Liechtenstein. The authors want to thank participating
dentists and patients for their kind cooperation and the
dental technicians B. Schlueter and R. Gerhardt for the
laboratory work
references
1. Bergenholtz G, Nyman S. Endodontic complications
following periodontal and prosthetic treatment of patients
with advanced periodontal disease. Journal of Periodontology
1984;55:64–8.
2. Edelhoff D, Sorensen JA. Tooth structure removal associated
with various preparation designs for anterior teeth. Journal
of Prosthetic Dentistry 2002;87:503–9.
3. Stokholm R, Isidor F. Resin-bonded inlay retainer prostheses
for posterior teeth. A 5-year clinical study International Journal
of Prosthodontics 1996;9:161–6.
4. Serdar Cotert H, Ozturk B. Posterior bridges retained by
resin-bonded cast metal inlay retainers: a report of 60 cases
881
followed for 6 years. Journal of Oral Rehabilitation 1997;24:697–
704.
5. Ohlmann B, Rammelsberg P, Schmitter M, Schwarz S,
Gabbert O. All-ceramic inlay-retained fixed partial dentures:
preliminary results from a clinical study. Journal of Dentistry
2008;36:692–6.
6. Wolfart S, Bohlsen F, Wegner SM, Kern M. A preliminary
prospective evaluation of all-ceramic crown-retained and
inlay-retained fixed partial dentures. International Journal of
Prosthodontics 2005;18:497–505.
7. Edelhoff D, Spiekermann H, Yildirim M. Metal-free inlay-
retained fixed partial dentures. Quintessence International
2001;32:269–81.
8. Bindl A, Luthy H, Mormann WH. Fracture load of CAD/CAM-
generated slot-inlay FPDs. International Journal of
Prosthodontics 2003;16:653–60.
9. Kilicarslan MA, Kedici PS, Kucukesmen HC, Uludag BC. In
vitro fracture resistance of posterior metal-ceramic and all-
ceramic inlay-retained resin-bonded fixed partial dentures.
Journal of Prosthetic Dentistry 2004;92:365–70.
10. Mehl C, Ludwig K, Steiner M, Kern M. Fracture strength of
prefabricated all-ceramic posterior inlay-retained fixed
dental prostheses. Dental Materials 2010;26:67–75.
11. Ohlmann B, Gabbert O, Schmitter M, Gilde H, Rammelsberg
P. Fracture resistance of the veneering on inlay-retained
zirconia ceramic fixed partial dentures. Acta Odontologica
Scandinavica 2005;63:335–42.
12. Puschmann D, Wolfart S, Ludwig K, Kern M. Load-bearing
capacity of all-ceramic posterior inlay-retained fixed dental
prostheses. European Journal of Oral Sciences 2009;117:312–8.
13. Walton TR. An up to 15-year longitudinal study of 515
metal-ceramic FPDs. Part 1: Outcome. International Journal of
Prosthodontics 2002;15:439–45.
14. Kaplan EL, Meier P. Nonparametric estimation from
incomplete observations. Journal of the American Statistical
Association 1958;53:457–81.
15. Wolfart S, Eschbach S, Scherrer S, Kern M. Clinical outcome
of three-unit lithium-disilicate glass-ceramic fixed dental
prostheses: up to 8 years results. Dental Materials
2009;25:e63–71.
16. 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. Clinical Oral Implants Research 2007;18:86–96.
17. Cardoso MV, Yoshida Y, van Meerbeek B. Adhesion to tooth
enamel and dentin. a view on the latest technology and
future perspectives. In: Roulet J-F, Kappert HF, editors.
Statements. diagnostics and therapy in dental medicine today and in
the future. London: Quintessence Publ. Co. Ltd.; 2009. p. 25–43.
18. Wolfart S, Kern M. A new design for all-ceramic inlay-
retained FPDs. A report of two cases. Quintessence
International 2006;37:27–33.
19. Wolfart S, Ludwig K, Uphaus A, Kern M. Fracture strength of
all-ceramic posterior inlay-retained fixed partial dentures.
Dental Materials 2007;23:1513–20.
20. Abou Tara M, Wolfart S, Kern M. Preliminary results with
newly designed zirconia ceramic inlay-retained FDPs.
Journal of Dental Research 2010;89(Abstr No.):178.
21. Aboushelib MN, Feilzer AJ, Kleverlaan CJ, Salameh Z. Partial-
retainer design considerations for zirconia restorations.
Quintessence International 2010;41:41–8.