Intraoral repair of fractured ceramics: a literature review

Abstract

Background: Fracture or chipping of veneering ceramic resulting in aesthetic and functional issues is a frequent technical complication encountered with fixed dental prostheses. Treatment options include extraoral or intraoral repair of the ceramic restoration; the latter being minimally invasive and cost-effective. We reviewed the various intraoral repair techniques for ceramic fractures and their efficiency in the last decade. Methods: A literature search was carried out between 2017 and 2022 using the PubMed database with keywords: intraoral, repair, ceramics, porcelain, and ‘porcelain fused to metal’. Screening of abstracts and full texts was carried out to determine the final list of eligible studies. Results:  Twenty-one eligible studies were included in the review which consisted of 17 in vitro studies, three case reports, and one prospective clinical study. Researchers and dentists preferred repairing cracked veneered zirconia-based restorations intraorally if the restoration is in acceptable condition. However, successful intraoral repair of veneering fractures relies on the bond between the previous restoration and the new repair material, the right adhesive resin, and adequate surface conditioning. The review indicated that the best technique to fix chipping in a complex made of zirconia core and veneering ceramic is to treat the veneering ceramic with hydrofluoric acid before covering the core ceramic with silica. Conclusion: Intraoral repair is an efficient and economic procedure without the need for repeated sessions. However, the success and longevity of the restoration rely on the technical skills of the clinicians and adherence to prescribed protocols.