Influence of variations in ceramic thickness and bonding substrate on the fracture resistance of lithium disilicate restorations

Abstract

Restorative dentistry aims to replace lost or damaged tooth structure with durable and life-like alternatives. To accommodate the inherent limitations and weakness of the restorative materials, preparation techniques often require the sacrifice of healthy tooth structure to create enough restorative space. This can lead to weakening of the remaining tooth structure, with subsequent damage or catastrophic failure. When using indirect restoratives, the development of adhesive luting agents (adhesive cements) and stronger allporcelain restorations (lithium disilicate) has contributed to the development of “minimally invasive” preparation techniques and concepts such as cavity design optimization (CDO) and bio-substitution. With these techniques, resin materials are combined with ceramic restoratives in an attempt to not only produce strong restorations, but also increase the longevity of the remaining tooth. The clinician needs to therefore find the ideal preparation design that combine such materials to produces a clinically performing restoration while increasing the strength and longevity of the underlying tooth.