Indirect restorative systems—A narrative review

Abstract

Objective: The background and clinical understanding of the properties of currently available indirect restorative systems and fabrication methods is, along with manufacturer and evidence-based literature, an important starting point to guide the clinical selection of materials for tooth and/or implant supported reconstructions. Therefore, this review explores most indirect restorative systems available in the market, especially all-ceramic, along with aspects of manufacturing process, clinical survival rates, and esthetic outcomes. Overview: Progressive incorporation of new technologies in the dental field and advancements in materials science have enabled the development/improvement of indirect restorative systems and treatment concepts in oral rehabilitation, resulting in reliable and predictable workflows and successful esthetic and functional outcomes. Indirect restorative systems have evolved from metal ceramics and polymers to glass ceramics, polycrystalline ceramics, and resin-matrix ceramics, aiming to improve not only biological and mechanical properties, but especially the optical properties and esthetic quality of the reconstructions, in attempt to mimic natural teeth. Conclusions: Based on several clinical research, materials, and patient-related parameters, a decision tree for the selection of indirect restorative materials was suggested to guide clinicians in the rehabilitation process. Clinical Significance: The pace of materials development is faster than that of clinical research aimed to support their use. Since no single material provides an ideal solution to every case, professionals must continuously seek information from well designed, long-term clinical trials in order to incorporate or not new materials and technological advancements.

Finishing technique effect on strength of zirconia‐reinforced lithium silicate ceramic

“…The higher characteristic strength observed for the glazed condition might be explained by the surface flaws in the as‐cut and polished specimens acting as stress raisers which decrease the strength of ZLS. In the glazed specimens, such flaws are filled by the glaze layer, leading to increased strength [8]. Furthermore, heating ZLS ceramics has been associated with significant microstructural changes and defect healing which may also impact its mechanical performance [24].…”

“…The use of glass-ceramics for the manufacturing of monolithic dental crowns has gained interest in oral rehabilitation due to their favorable balance between optical and mechanical properties [1,2], and their outstanding clinical performance in the long term [3][4][5][6]. When the lower fracture toughness porcelain veneer is eliminated, full-contour all-ceramic materials with higher toughness may increase the restorative system's overall performance [7,8].…”

“…The mechanical performance of dental materials depends on several factors [8]. Among them, surface finishing plays a critical role in stress accumulation and crack propagation under loading [8,22].…”

“…The mechanical performance of dental materials depends on several factors [8]. Among them, surface finishing plays a critical role in stress accumulation and crack propagation under loading [8,22]. When subjected to compressive loads, small superficial flaws can become stress concentration points that produce initial cracks followed by its propagation and subsequent catastrophic failure [23].…”

Effects of erosion and abrasion on resin‐matrix ceramic CAD/CAM materials: An in vitro investigation

“…Thus, the amount of ceramics can be increased up to 86% [4,10,11]. CAD/CAM resin-based ceramics consist of a polymer matrix with a high amount of ceramic fillers, polymerized by pressure and heat resulting in improved mechanical properties compared to resin-based composite materials for direct application [12].…”