Conservative direct and indirect resin posterior restorative alternatives for cracked dentition

Cracked posterior teeth are often discovered when an existing restoration is removed for routine treatment. When the entire cusp is completely worn or fractured, recent advances in dentin bonding technology, ceramic systems, and composite restorative materials allow conservative onlay restorations as opposed to the aggressive removal of sound tooth structure for a full-coverage crown restoration. Questions have arisen as to what is the optimal treatment when cracks are discovered in posterior dentition when the cusps remain intact, i.e., whether the unaffected cusps should be removed. The learning objective of this article is to present conservative alternatives to the aggressive removal of sound tooth structure, utilizing direct resin restorative materials and current adhesive technology.