Current ceramic materials and systems with clinical recommendations: A systematic review

https://doi.org/10.1016/S0022-3913(07)60124-3Get rights and content

Statement of problem

Developments in ceramic core materials such as lithium disilicate, aluminum oxide, and zirconium oxide have allowed more widespread application of all-ceramic restorations over the past 10 years. With a plethora of ceramic materials and systems currently available for use, an overview of the scientific literature on the efficacy of this treatment therapy is indicated.

Purpose

This article reviews the current literature covering all-ceramic materials and systems, with respect to survival, material properties, marginal and internal fit, cementation and bonding, and color and esthetics, and provides clinical recommendations for their use.

Material and methods

A comprehensive review of the literature was completed seeking evidence for the treatment of teeth with all-ceramic restorations. A search of English language peer-reviewed literature was undertaken using MEDLINE and PubMed with a focus on evidence-based research articles published between 1996 and 2006. A hand search of relevant dental journals was also completed. Randomized controlled trials, nonrandomized controlled studies, longitudinal experimental clinical studies, longitudinal prospective studies, and longitudinal retrospective studies were reviewed. The last search was conducted on June 12, 2007. Data supporting the clinical application of all-ceramic materials and systems was sought.

Results

The literature demonstrates that multiple all-ceramic materials and systems are currently available for clinical use, and there is not a single universal material or system for all clinical situations. The successful application is dependent upon the clinician to match the materials, manufacturing techniques, and cementation or bonding procedures, with the individual clinical situation.

Conclusions

Within the scope of this systematic review, there is no evidence to support the universal application of a single ceramic material and system for all clinical situations. Additional longitudinal clinical studies are required to advance the development of ceramic materials and systems.

Section snippets

Material and methods

A broad systematic search of English peer-reviewed dental literature was designed to identify evidence supporting the restoration of teeth with current all-ceramic materials and systems. Key words or phrases included crowns, dental porcelain, ceramics, aluminum oxide, zirconium oxide, dental cements, composite resin cements, adhesives, computer-aided design, color, dental restoration failure, and dental prosthesis design. MEDLINE and PubMed searches were conducted focusing on evidence-based

Results

A total of 285 articles were identified through the MEDLINE and PubMed searches. Abstracts were reviewed to confirm the articles met the inclusion criteria. A total of 148 articles published between 1996 and 2006 were identified and read in their entirety. Nineteen prospective and 4 retrospective clinical trials related to survival were reviewed. The literature demonstrated that multiple all-ceramic materials and systems are currently available for clinical use and there is not a single

Glass ceramics

IPS Empress 2 (Ivoclar Vivadent, Schaan, Liechtenstein) is a lithium-disilicate glass ceramic (SiO2-Li2O) that is fabricated through a combination of the lost-wax and heat-pressed techniques. A glass-ceramic ingot of the desired shade is plasticized at 920°C and pressed into an investment mold under vacuum and pressure. Its predecessor, IPS Empress (Ivoclar Vivadent), is a leucite-reinforced glass ceramic (SiO2-Al2O3-K2O) which, due to its strength, is limited in use to single-unit

Conclusions

All-ceramic restorations are developed with cores of glass ceramics, aluminum oxide, or zirconium oxide, and are manufactured by heat pressing, slip-casting, sintering, or milling. Successful application of these materials will depend upon the clinician's ability to select the appropriate material, manufacturing technique, and cementation or bonding procedures, to match intraoral conditions and esthetic requirements.

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