Abstract: Biomimetetic Alternative to Full Coverage Crowns
For many years, full coverage crowns have been the first treatment option when cuspal coverage was needed. Yet, this did not come without compromises. Crown preparations remove 70 – 75% of the tooth structure by weight, significant amount of tooth structure must be removed. With the advancements witnessed in dental materials in the last few decades, we now possess materials like lithium disilicates and composite resins which when used to their full potential, can allow the clinician to mimic and replace the biomechanics and esthetics of the lost natural structures. Adhesive Partial coverage restorations along with a highly bonded composite base offer a very promising alternative to the invasive full coverage design.
The success and longevity of restorations is greatly affected by the amount of remaining tooth structure. Adhesive Partial coverage restorations remove 32 – 47 % of tooth structure by weight.
In addition, these restoration function in harmony with natural occurring biomechanics of the tooth. Engineering a highly bonded composite base with the use of immediate dentin sealing and ultra-high molecular weight poly-ethylene fibers Ribbond makes it possible to create a bond that is stronger than the cohesive strength of the dentin enamel junction. Thus, the need for retention forms is no longer present, which is why much more tooth structure is being conserved. Moreover, the fracture resistance of adhesive partial coverage restorations is superior to the full coverage design, thanks to the more favorable stress dissipation platform, ribbond fibers and immediate dentin sealing.
In conclusion, Using the novel materials along with old aggressive designs makes less use of their full potential. Adhesive partial coverage restorations are a biomimetic alternative to the full coverage design. This have been well studied in the literature and proved to be superior on many levels. Following the biomimetic approach, less root canals are needed, more tooth structure is saved thus better longevity for restorations.
Objectives: – Rethink the need for full coverage preparation design
– Recognize the importance of the cervical portion of natural teeth regarding stress distribution under function
– Understand the importance of composite base to support indirect restorations in relation to the natural tooth biomechanics