Ceramic Fracture in Bilayered All-ceramic Indirect Restoration: A Review of the Literature

Background: High incidence of fracture of all-ceramic crowns may compromise the clinical outcome and is a source of hassle for both patients and dentist. Objective: The objective of the present review was to identify reasons for high ceramic fracture or chipping and to minimize these incidents in dental settings. Methods: The final search strategy was executed on Medline via OvidSP, PubMed, and Web of Knowledge. Studies meeting the following inclusion criteria were included in the current review. (1) Literature in English language only, (2) in vitro studies, (3) studies providing evidence on ceramic fracture, and (4) studies only related to indirect restoration and ceramics. Moreover, the exclusion criteria were based on (1) articles other than English, (2) studies reporting direct restoration, (3) any non-peer-reviewed gray literature, and (4) studies discussing fracture other than ceramic material. Results: From the initial search strategy, 101 studies were retrieved from different databases. A total of 3 studies were scrutinized through other resources. Following duplicate removal (n = 24), 80 studies were screened for the title and abstract. Moreover (n = 49) studies were shortlisted for full text and review. Following review and discussion in the final result, only 26 studies were included. Conclusions: Many improvements in the material, its fabrication process, and surface treatments can reduce the incidence of fracture within the material.