Influence of Self-Adhesive Resin Composite Deep Marginal Elevation on the Sealing Ability of CAD/CAM Lithium Disilicate Glass-Ceramic Inlays: An In Vitro Study

Deep margin elevation (DME) is a conservative technique used to relocate subgingival proximal margins to a more favorable supragingival position, facilitating adhesive procedures and impression taking. This in vitro study evaluated the influence of two DME materials—a universal flowable resin composite and a self-adhesive flowable resin composite—on the cervical interfacial sealing ability of lithium disilicate glass–ceramic CAD/CAM inlay restorations. Twenty extracted maxillary premolars were randomly allocated into two groups (n = 10). Group A received DME using a universal flowable resin composite (3M™ Filtek™ Z350 XT) preceded by a conventional adhesive system, while Group B received DME using a self-adhesive flowable resin composite (Vertise™ Flow). All teeth were restored with lithium disilicate CAD/CAM inlays (CEREC Tessera) cemented with a self-adhesive resin cement (Breeze®). Specimens underwent thermocycling (10,000 cycles; 5–55 °C). Marginal gaps were assessed at the DME interface using high-resolution micro-computed tomography (micro-CT) in both coronal and sagittal cross-sections, before and after thermocycling. Statistically significant differences were found between groups in both sections before and after thermocycling (p < 0.05). The self-adhesive composite (Group B) demonstrated significantly lower gap values compared to the universal flowable composite (Group A) in both coronal and sagittal assessments. Thermocycling increased the gap in both groups; however, Group B maintained considerably lower leakage. The self-adhesive resin composite showed superior sealing ability at the DME interface compared to the universal flowable composite when used under lithium disilicate glass–ceramic inlay restorations. Further clinical studies are recommended to validate these findings.