Ceramic Porcelain Fracture Guidelines: First Steps
by John Nosti
by Dr. John Nosti
A frustrating phenomenon in the world of dentistry is when a patient presents with fracture of a ceramic restoration. This event is one of the most disheartening that can happen in a dental office and because of this, many doctors will become so fearful of the fracture that they will avoid placing ceramic restorations at all.
Dealing with the Fear of Ceramic Porcelain Fracture
There are 3 reasons why dentists back away from ceramic restorations:
- They mistakenly believe that porcelain fused to metal counterparts are superior in strength and will prevent ceramic fracture.
- They use full contour zirconia crowns to try and outperform what some consider to be the evil “forces” acting upon restorative dentistry.
- They think the problem can’t be solved or can’t be solved easily, so they simply don’t place ceramic restorations at all.
If you’re dealing with one of these misconceptions, stop and consider when you recommend parafunctional control appliance to your patients after completing treatment. This should be your first concern beyond what materials are appropriate to the cosmetic case.
Answer these 2 questions:
- Are you sure your patient(s) is being 100% compliant with your recommendations?
- Are you relying solely on the patient wearing an appliance?
The best solution is to take every precaution necessary to ensure the success of your restorations.
In my upcoming series, I’ll explore my top 6 guidelines for limiting the percentage of porcelain fracture in the office. These tips are a compilation of ceramic restoration knowledge that I have put together over 10 years of performing “cosmetic rehabilitations.”
The ceramic porcelain fracture topics will range from protecting patients who break their temporaries repeatedly to setting the occlusion up as a parafunctional appliance that cannot be removed.
Read Dr. Nosti’s whole series on porcelain fracture series including; setting up occlusion, the best approach to occlusion to prevent broken dentistry, why you must evaluate a patients past tendencies to breaking temporaries, protecting patients where anterior guidance is not achievable, the warning signs of increasing diastema and occlusal jump.
