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All dental restorations are liable to failure during function. Failure could be biologic, aesthetic, mechanical or a combination. Ceramic restorations in particular, including metal-ceramics, are prone to mechanical fracture, especially the fracture of veneering porcelain. Fracture of a metal-ceramic restoration jeopardizes function as well as aesthetics. It is equally onerous to manage for both patient and dentist. Optimal management of such cases requires a detailed knowledge of the aetiology behind this phenomenon. The current paper aims to highlight possible causative factors involved in the mechanical failures of metal-ceramic restorations.
CPD/Clinical Relevance: Ceramic fracture in metal-ceramic crowns and fixed partial dentures is routinely encountered in dental clinics. Knowledge of the aetiology is required to diagnose and manage such cases accurately as well as to avoid these errors in future.
Article
Rehabilitation of teeth with crowns has increased greatly over the last three decades.1 Despite rapid advancements in the development of newer and stronger ceramic systems,2 metal-ceramic restorations still remain the ‘gold standard’ in prosthodontics since their introduction in the 1960s.3 Metal-ceramic systems combine the biomechanical advantages of metals with the aesthetics of ceramic materials,4 resulting in restorations with considerable clinical longevity.5 A survival rate of 97% for metal-ceramic restorations was reported by Eliasson et al6 after a period of ten years in clinical service.
All dental restorations are liable to failure during function. Failure may be biologic, aesthetic, mechanical or a combination. Ceramic restorations in particular, including metal-ceramics, are more prone to mechanical fracture (Figure 1), especially the fracture of veneering porcelain.7 A systematic review carried out by Goodacre et al8 revealed that fracture of veneering porcelain is a common complication associated with metal-ceramic prostheses. However, a review on the survival rate and complications of metal-ceramic restorations reported a mean chipping rate of 2.9% after a 5-year observation period.9 Such paradoxes in survival rate values exist because of a lack of detailed reporting systems for describing fractures of ceramic-based restorations.10
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