The teaching of all-ceramic restorations in North American dental schools: curricular requirements and indications

A survey was conducted to examine the manner in which North American dental school curricula provide instruction to pre-doctoral students in the applications of all-ceramic restorative materials. A questionnaire was sent to all 64 dental schools and the response rate was 80%. All dental schools offered didactic instruction, and 96% also provided some clinical experience. Most of the time, two departments are involved in teaching this clinical subject, with fixed prosthodontics being the department most frequently cited. Veneers were the most commonly taught all-ceramic restoration. Crowns were most frequently used on anterior teeth and premolars, especially in the maxillary arch. Inlays were almost exclusively performed for class I and class II lesions, whereas onlays were considered when the isthmus width of an inlay preparation exceeded one half of the intercuspal distance. Contraindications for the use of these materials were listed, with occlusal dysfunction such as bruxism being the most commonly cited reason for not using all-ceramic materials. The primary reasons for not teaching these procedures included insufficient longitudinal research and the lack of in-house laboratory support. Most schools indicated that the relative importance of all-ceramic restorations as a component of their curriculum was increasing.