{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:12:46Z","timestamp":1792177966989,"version":"4.4.0"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical &amp;amp; Exp Dental Res"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the effect of deep margin elevation (DME) and immediate dentin sealing (IDS) on the fracture strength of premolars restored with lithium disilicate inlay restorations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Standard MOD inlays with proximal box preparations extending 3\u2009mm apical to the cementoenamel junction were prepared on forty sound premolars (<jats:italic>n<\/jats:italic>\u2009=\u200910) randomly divided into four groups: inlays without DME and without IDS (G1); inlays without DME but with IDS (G2); inlays with DME but without IDS (G3); and inlays with both techniques applied (G4). Composite resin was applied incrementally to elevate the proximal cervical margin coronally to the cementoenamel junction. For immediate dentin sealing, bonding agent was applied immediately after tooth preparation. All teeth were restored with lithium disilicate inlays and, after adhesive resin cementation, specimens were thermomechanically aged for 500 cycles at 5\u00b0\u201355\u00b0C and then subjected to load failure testing. Failure loads and locations were recorded and analyzed using one\u2010 and two\u2010way ANOVA with Tukey's post\u2010hoc testing (<jats:italic>\u03b1<\/jats:italic>\u2009=\u20090.05). Failure modes were analyzed using descriptive statistics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean fracture loads were 565.76\u2009\u00b1\u2009233.22\u2009N, 978.47\u2009\u00b1\u2009394.2\u2009N, 974.31\u2009\u00b1\u2009334.7\u2009N, and 1108.21\u2009\u00b1\u2009292.41\u2009N for G1, G2, G3, and G4, respectively. Deep margin elevation (<jats:italic>p<\/jats:italic>\u2009=\u20090.011) and immediate dentin sealing (<jats:italic>p<\/jats:italic>\u2009=\u20090.010) were associated with significantly increased fracture loads. Fracture loads were significantly lower for G1 teeth than for G2\u2010G4 teeth, but there were no significant differences between G2, G3, and G4. G1 teeth showed 50% catastrophic and non\u2010catastrophic failures, which increased to 60% for G2 and decreased to 20% for G3 teeth. Samples with both seals and elevation (G4) had a 60% catastrophic failure rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>When applied individually or together, deep margin elevation and immediate dentin sealing significantly increase the fracture strength of premolars restored with indirect lithium disilicate inlays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Implications<\/jats:title><jats:p>In the challenging setting of margin elevation, studies on the effects of immediate dentin sealing have generally been limited to evaluating marginal integrity and bond strength. The findings of this In Vitro study suggest that both deep margin elevation and immediate dentin sealing protocols are likely to improve clinical outcomes of indirect lithium disilicate inlay restorations and may be considered viable options in clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cre2.70161","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T14:49:34Z","timestamp":1750776574000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Influence of Deep Margin Elevation and Immediate Dentin Sealing on the Fracture Strength of Premolars Restored With Indirect Inlays: An In Vitro Study"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9286-488X","authenticated-orcid":false,"given":"Lulwa E.","family":"Al\u2010Turki","sequence":"first","affiliation":[{"name":"Department of Oral Maxillofacial Prosthodontics, Faculty of Dentistry King Abdulaziz University Jeddah Makkah Province Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0922-2868","authenticated-orcid":false,"given":"Osamah A.","family":"Alsulimani","sequence":"additional","affiliation":[{"name":"Department of Oral Diagnostic Sciences, Faculty of Dentistry King Abdulaziz University Jeddah Makkah Province Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9863-9501","authenticated-orcid":false,"given":"Khadijah M.","family":"Baik","sequence":"additional","affiliation":[{"name":"Department of Oral Maxillofacial Prosthodontics, Faculty of Dentistry King Abdulaziz University Jeddah Makkah Province Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haytham","family":"Othmani","sequence":"additional","affiliation":[{"name":"Choueifat Medical Center Jeddah Makkah Province Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naif M.","family":"Alqarni","sequence":"additional","affiliation":[{"name":"Al\u2010Rahaily medical Center Jeddah Makkah Province Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah A.","family":"Alqarni","sequence":"additional","affiliation":[{"name":"Periodontics Resident King Fahad General hospital Jeddah Makkah Province Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2610-9592","authenticated-orcid":false,"given":"Raghad A.","family":"Al\u2010Dabbagh","sequence":"additional","affiliation":[{"name":"Department of Oral Maxillofacial Prosthodontics, Faculty of Dentistry King Abdulaziz University Jeddah Makkah Province Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8111932"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dental.2021.10.005"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.actbio.2012.02.022"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.12893"},{"issue":"3","key":"e_1_2_9_6_1","first-page":"115","article-title":"Dual Application of Dentin Bonding Agents: Effect on Bond Strength","volume":"9","author":"Bertschinger C.","year":"1996","journal-title":"American Journal of Dentistry"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmbbm.2020.103950"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prosdent.2016.09.015"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-021-01630-z"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0300-5712(02)00041-6"},{"issue":"1","key":"e_1_2_9_11_1","first-page":"47","article-title":"Current Clinical Concepts for Adhesive Cementation of Tooth\u2010Colored Posterior Restorations","volume":"10","author":"Dietschi D.","year":"1998","journal-title":"Practical Periodontics and Aesthetic Dentistry: PPAD"},{"issue":"2","key":"e_1_2_9_12_1","first-page":"210","article-title":"Evidence\u2010Based Concepts and Procedures for Bonded Inlays and Onlays. Part I. Historical Perspectives and Clinical Rationale for a Biosubstitutive Approach","volume":"10","author":"Dietschi D.","year":"2015","journal-title":"International Journal of Aesthetic Dentistry"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-022-04790-6"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdsr.2021.05.004"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-021-04219-6"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dental.2016.01.001"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmbbm.2020.103906"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCIDE.S42016"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.4012\/dmj.2016-289"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dental.2017.09.006"},{"key":"e_1_2_9_21_1","unstructured":"Lindhe J. T.Karring andN. P.LangPeriodontolog\u00eda cl\u00ednica e implantolog\u00eda odontol\u00f3gica. Ed. M\u00e9dica Panamericana;2009."},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2842.1986.tb01556.x"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prosdent.2005.10.010"},{"issue":"2","key":"e_1_2_9_24_1","first-page":"86","article-title":"Deep Margin Elevation: A Paradigm Shift","volume":"2","author":"Magne P.","year":"2012","journal-title":"American Journal of Esthetic Dentistry"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpor.2016.04.001"},{"key":"e_1_2_9_26_1","first-page":"40","article-title":"Tissue Management in Restorative Dentistry","volume":"1","author":"Robbins J. W.","year":"2007","journal-title":"Funct Esthet Restor Dent"},{"issue":"5","key":"e_1_2_9_27_1","first-page":"440","article-title":"Temporary Cement Remnants as an Adhesion Inhibiting Factor in the Interface Between Resin Cements and Bovine Dentin","volume":"10","author":"Watanabe E. K.","year":"1997","journal-title":"International Journal of Prosthodontics"},{"issue":"3","key":"e_1_2_9_28_1","first-page":"203","article-title":"Improvement in the Tensile Bond Strength Between Resin Cement and Dentin Surfaces After Temporary Cement Application","volume":"11","author":"Watanabe E. K.","year":"1998","journal-title":"International Journal of Prosthodontics"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0252269"}],"container-title":["Clinical and Experimental Dental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cre2.70161","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T06:15:09Z","timestamp":1751004909000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cre2.70161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1002\/cre2.70161"],"URL":"https:\/\/doi.org\/10.1002\/cre2.70161","archive":["Portico"],"relation":{},"ISSN":["2057-4347","2057-4347"],"issn-type":[{"value":"2057-4347","type":"print"},{"value":"2057-4347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]},"assertion":[{"value":"2024-06-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70161"}}