Aesthetic all-ceramic restorations: a philosophic and clinical review

The current focus of aesthetic dentistry is on tooth-colored, metal-free restorations in the anterior and the posterior regions and the biocompatibility and toxicologic safety of these restorative materials. This article reviews eight years of clinical experience with all-porcelain restorations and documents the observations of several clinical cases. It discuss tooth preparation for all-ceramic inlays, onlays, and veneer and crown restorations, as well as isolation, etching, placement, bonding, and lightor dual-curing of the materials. The learning objective of this article is to share the experience and observations with other clinicians. The author concludes that restorations, identical to natural dentition, can be predictably achieved with current allporcelain systems and that critical scientific analysis of dentin bonding agents must continue. The utilization of all-porcelain material in multiple-unit bridges should still be viewed with caution, and further long-term experience is required.