Insightful Understanding of the Role of the Mechanical Properties in Defining the Reliability of All-Ceramic Dental Restorations: A Review

Abstract

Since the last two decades, restorative dentistry has been witnessing an increased acceptance of the use of the well-known all-ceramic materials for the fabrication of single dental restorations, such as inlays, onlays, crowns, anterior and posterior fixed partial dentures (PFPDs). These restorations certainly offer the potential for better biocompatibility coupled with superior aesthetic qualities, especially when compared with the conventional prostheses made from porcelain that is fused with metal ceramic restorations. However, brittleness and extreme sensitivity of all-ceramic materials to micro-like defects or cracks that are inherently present, or may grow, in their microstructure during different laboratory fabrication steps, during necessary clinical adjustments, or from post-placement chewing activity, remain major shortcomings of these dental restorations. In fact, many researchers are of the opinion that the improved mechanical properties can significantly improve the lifetime of all-ceramic restorations and result in enhanced reliability. Therefore, efforts of researchers, as well as manufacturers, have been directed towards the improvement of the mechanical properties in order to overcome such limitations. This article reviews the characterization of the most important mechanical properties that can delineate the behavior of all-ceramic dental materials upon loading. These include fracture mechanics, the brittle nature of ceramics, the relationship between microstructural features and fracture behavior, sources of cracks and flaws that may initiate a fracture and the effect of different fabrication procedures and/or clinical adjustments on the mechanical behavior of dental ceramics are also reviewed and discussed.