Linah M. Ashy, BDS, DMSc/Hanadi Marghalani, BDS, MSc, PhD/Nikolaos Silikas, BSc, FADM, MPhil, PhD: Purpose: To investigate the marginal and internal adaptations of ceramic inlay restorations placed with immediate dentin sealing (IDS) vs delayed dentin sealing (DDS) procedures. Materials and Methods: Mesial and distal Class II cavities were prepared in 12 extracted molar teeth, which were randomly allocated into six groups of 2 teeth each. Lava Ultimate inlays were fabricated and luted to the cavities using All-Bond universal adhesive system and eCEMENT dual-curing resin cement following IDS/immediate cementation (control groups 1 and 2), IDS/delayed cementation (groups 3 and 4), or DDS/delayed cementation (groups 5 and 6) protocols. Teeth in groups 2, 4, and 6 were subjected to thermocycling of 500 cycles between 5?C and 55?C after inlay cementation. Following staining with silver nitrate solution, the marginal and internal gap volumes were determined using microcomputed tomography images. Statistical analyses were conducted using independent t test and one-way analysis of variance followed by Tukey post hoc test (P < .05). Results: Marginal gap volume for DDS (1.856 ± 0.323 mm3) was significantly higher than that of IDS immediately after inlay cementation (0.891 ± 0.281 mm3) (P = .025). Following thermocycling, the internal gap volume for DDS (0.838 ± 0.248 mm3) was significantly higher than that for IDS (0.098 ± 0.066 mm3) (P = .000), but the marginal gap volume of DDS (1.964 ± 0.956 mm3) was not significantly different from that of IDS (1.426 ± 0.725 mm3) (P = .622). Conclusion: Luted ceramic inlays have a superior marginal adaptation right after cementation and a superior internal adaptation after thermocycling when using the IDS technique compared to the DDS technique. However, marginal adaptation after thermocycling was not significantly different between the two techniques.