Ceramics for restorative dentistry: Critical aspects for fracture and fatigue resistance

Development of non-metallic restorative materials is a high priority due to biocompatibility issues and environmental concerns associated with metals waste and disposal. Ceramics are an ideal candidate for replacing metal-based restorative materials. Ceramics provide excellent chemical durability, wear resistance, biocompatibility, environmental friendliness and esthetics. However, widespread all-ceramic restoration use has been hindered by concerns related to marginal fracture resistance and clinical longevity. The recent introduction of higher toughness materials, especially partially stabilized zirconia, has expanded the range of clinically acceptable applications for all-ceramic restorative systems. In addition, advanced fabrication techniques such as CAD/CAM have reduced some of the problems associated with processing-induced flaws that can lead to short-term catastrophic failures in vivo. Some current research is focused on surface modification techniques (thin films, coatings, advanced adhesives) intended to minimize the effects of fabrication-induced defects.