Ceramic Inlay Debonding — ORE Part 1 MCQ

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ModerateDental MaterialsCeramic Inlay DebondingORE Part 1

A 35-year-old patient presents with a debonded ceramic inlay from a premolar. Clinical examination reveals the tooth preparation is intact and the inlay is undamaged. What is the most likely reason for debonding?

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Correct answer: B — Contamination of the bonding surface (saliva or blood contamination during cementation)

Explanation lettering: E = shown as A · A = shown as B · D = shown as C · C = shown as D · B = shown as E

The correct answer is A: contamination of the bonding surface during cementation. Saliva and blood contamination significantly impair adhesive bond strength and are a well-documented cause of inlay debonding. During clinical adjustment and try-in of ceramic restorations, contamination cannot be prevented without rigorous isolation. This is an adhesive failure mode (distinct from fracture of the restoration or preparation). Options B, C, D, and E are distractors: rigid ceramic is not a cause of debonding; an intact preparation indicates adequate retention; soft chewing does not cause debonding; and cement thickness alone is not the leading cause when the preparation and restoration are mechanically sound.

Reference: Systematic review: Effect of contamination and decontamination methods on the bond strength of adhesive systems to dentin. PubMed, 2023. Supporting literature: Saliva contamination effects on bonding (PubMed 2012, 2024); Clinical performance of ceramic inlays (PubMed 2000). https://pubmed.ncbi.nlm.nih.gov/22876017/